A Jan. 10 report by the Government Accountability Office stated that the department has not yet created a plan for addressing key privacy principles or outlined milestones for integrating the results of HHS' multiple, ongoing privacy-related assessments. GAO officials advised action on those issues.
HHS disagreed with the recommendations in a letter, stating that the department "believes that the tightly scripted milestones GAO recommends would impede our processes and preclude necessary public-private dialogue."
At Thursday's hearing, Sen. Daniel Akaka, D-Hawaii, said he was "surprised" to learn of the department's protest. As businesses, physicians and insurance carriers accelerate their health information technology activities, he said, "I fear that privacy suffers while HHS takes time to decide how to implement privacy protection."
The subcommittee convened to focus on health IT privacy matters related to the Office of Personnel Management's benefits program. It is the country's largest employer-sponsored health insurance program, covering about 8 million federal employees, retirees and their families.
Akaka asked an OPM official if current circumstances could result in an insurance plan developing an electronic health record that would not be protected under the Health Insurance Portability and Accountability Act.
Dan Green from OPM's employee and family support policy center said no, adding that he is "convinced" that contract requirements protect enrollees from inappropriate misuse of electronic health information.
Akaka highlighted arguments by witness Mark Rothstein, the chairman of an HHS advisory panel on privacy and confidentiality. Rothstein said private-sector health IT initiatives, like the system being devised by Wal-Mart and other big employers, are "usually not subject to any federal or state regulation." Rothstein, who is also director of the Institute for Bioethics, Health Policy and Law at the University of Louisville, stressed that he was giving his personal views.
Witness Rob Kolodner, the interim HHS national coordinator for health IT, said there are private entities not covered by HIPAA, adding that two HHS advisory bodies have started to consider whether certain entities not subject to the law now should be held accountable.
Sen. George Voinovich, R-Ohio, asked Kolodner if the stopgap spending bill that covers HHS for the rest of fiscal 2007 had harmed the department's progress in safeguarding privacy. Kolodner said his office has not been forced to slow in any way.
In further testimony, Rothstein recommended that Congress "condition continued appropriations" for developing a nationwide health information network on HHS "demonstrating significant progress" in resolving privacy issues.
"The health benefits of electronic health-record networks will never be realized unless the American public has a high degree of trust in network privacy protections," he said. "We can't build the network and then build the trust."