Computer security breaches throw a wrench into the
workings of medical practices and hospitals. Joseph Schneider, MD, a Dallas pediatrician
and chair of the Texas Medical Association’s Committee on Health Information
Technology, saw that first-hand a few years ago.
“One of my employees had a
hospital-owned computer with 800 names from a previous practice where [that
employee] worked,” Dr. Schneider said. “The computer got stolen, and it wasn’t
The employee and hospital staff spent
hundreds of hours investigating how many patients were involved in the breach
to determine whether they had to report it immediately to the U.S. Department
of Health and Human Services Office for Civil Rights. Breaches involving 500 or
more individuals must be reported within 60 days (tma.tips/BreachNotices).
“The IT security folks had to figure
out from backups whose information was in those files and how many there were,”
Dr. Schneider said. “It was a huge undertaking – far, far, far more expensive
than encrypting and securing the computer.”
The federal requirements have not
changed, but starting Jan. 1, breach notification requirements became even
more stringent for Texas physicians or medical entities. The Texas Legislature
dropped the threshold for breach reporting from 500 patients to 250. House Bill
4390 also requires medical entities to report breaches to the Texas attorney
general’s office within 60 days of the breach.
“That’s a new development,” says Troy
Alexander, TMA associate director of advocacy. Not only is the threshold lower,
“it’s new reporting because it’s not just [reporting] to the federal office
about the breach. Reports on breaches also go to the [state] attorney general
It’s too early to say how the new
state threshold will affect Texas practices and hospitals, Dr. Schneider says.
The change will probably cause a small uptick in the number of breaches
“In this day and age, with electronic
records, when there’s a breach, it’s generally a big breach,” he said. “But I
suspect that there are some breaches in that 250-to-500 range that will be
HB 4390 also established the Texas
Privacy Protection Advisory Council to study and evaluate state, national, and
international data privacy laws and then recommend to state officials specific
changes by Sept. 1. The 15-member council, to which Dr. Schneider was appointed
in November 2019, must include a representative from the medical profession.
Lawmakers created the council to keep
Texas up-to-date on legal developments in personal privacy, Dr. Schneider says.
“It’s important to have an advisory
group that is able to harmonize [privacy laws] so that we’re not making things
so complex that it’s impossible to accomplish it. … Whatever comes out of this
[should be] as protective of privacy as it needs to be, but also as supportive
of practice efficiency and effectiveness as it can be,” he said.
Data breaches have risen sharply over
the past few years as more physicians use electronic medical records, according
to the HIPAA Journal. In August 2019,
health care data breaches of 500 or more records continued to be reported at a
rate of more than 1.5 per day, or about 49 per month total, which was around
twice the monthly average in 2018, the journal said. By September, the number
of breaches had declined to 36 for the month, but the number of records
compromised had actually risen 168%.
TMA has strong policy in support of
protecting patient information (www.texmed.org/TMAMedicalPrivacy).
Some physicians view all the work they
do on privacy protection as a distraction from practicing medicine, Dr.
Schneider says. But it’s essential, given the universal presence of computers,
smart phones, and other devices that can be hacked.
“Having your identity stolen is a
horrible experience, and as physicians we should be supportive of these
efforts” by state lawmakers to improve privacy, he said. “In our practices we should
be reinforcing with patients that their health information should be protected
as they get access to more of it.”
Tex Med. 2020;116(1):28-29
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