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Introduction
Cross-country variations in health policy represent a crucial research topic and a prospective barrier to successful professional assimilation in nurse migration scenarios. Aside from regional deviations from clinical practice standards, health information handling practices and policies deserve close attention. This paper seeks to compare the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in the U.S. with its Australian equivalent or the Privacy Act of 1988/2000.
U.S. Policy Information
In the U.S., the HIPAA Privacy Rule seeks to establish national standards for the protection of healthcare consumers’ health-related information and personally identifiable details from unauthorized access. The policy has implications for patient data use, management, and entry activities that permeate the practice of healthcare providers, insurers, and independent contractors acting as business associates (Kels, 2020). The Privacy Rule posits that paper-based and electronic patient health information (PHI), including demographic/geographic identifiers, contact information, medical record numbers, medical bill data, medical anamneses, and test results, should be managed following the patient’s storage- and disclosure-related preferences (Oyeleye, 2021). For the establishment of standardized disclosure practices, the policy also specifies the range of circumstances in which PHI disclosure requires no approval from the patient. These include its disclosure to the PHI’s owner without third parties’ involvement, as well as the information-sharing required for treatment coordination, payment, and healthcare operations (Oyeleye, 2021). Disclosures required to pursue the public’s interests are also explained.
Australian Policy Information
Amended in 2000, the Privacy Act applies to public and private health service providers in Australia and seeks to prevent instances of health data sharing that lead to harm. Apart from the national healthcare market, the policy regulates printed and electronic data management in the education sector, governmental agencies, and entities with annual turnovers exceeding $3 million (Daly, 2018). The act instrumentalizes the thirteen Australian Privacy Principles (APPs), including the similarity of the primary purpose of data collection and the actual rationale for use, data de-identification and destruction protocols, and data breach provisions (Daly, 2018). To regulate data-sharing processes, the policy establishes viable rationales for releasing patient health data without approval, such as high-risk health conditions requiring immediate action, cases of dangerous patients, data meeting the definition of approved research, and legal requirements (Daly, 2018). Thus, the policy maintains the right balance between individual privacy and public well-being.
Comparisons/Insights
Similarities
As the synopses suggest, the two policies share similarities in terms of the considered media types, disclosures mandated by law, and the inclusion of various health service providers as covered entities. To start with, due to recent updates, both acts apply to electronic records and paper-based medical documentation equally and have implications for nurses’ and other providers’ social media activity and personal communication (Daly, 2018; Kels, 2020). Next, the policies classify the release of data as required by the country’s laws as exceptions from the no-disclosure rule (Daly, 2018; Oyeleye, 2021). Moreover, both countries’ policies cover an entire continuum of care, which includes adjunct therapy providers and alternative medicine institutions. The insights promoted by these intersections pertain to the universalization of health data use duties in public and private sectors, including the providers of services with a limited evidence base. Finally, policy compliance is multi-dimensional and might involve individual contributions, but large-scale penalties are not assigned individually.
Differences
The countries’ health data privacy policies differ in terms of the overall scope of application, the definitions of protected data, and the corporate consequences of the failure to comply. The first differentiating factor is exclusivity to the health professions. The HIPAA Privacy Rule pertains to data involved in healthcare service provision and public health research, while the Privacy Act also lists non-healthcare businesses and gyms as covered entities. This results in the Australian policy’s broader definition of protected data, with the addition of photographs, IP addresses, and biometric or device location data as separate categories (Daly, 2018). Also, under the HIPAA, the fine for non-compliance is limited to $25.000 per one category of violation or up to $1.5 million annually, whereas the annual costs of non-compliance with the Privacy Act can exceed $2.6 million (Daly, 2018; Katuska, 2018). When it comes to insights, the dissimilarities suggest Australian covered entities’ increased exposure to the risks of non-compliance and costly health and business data breaches, and coverage-related differences create benefits for Australian small businesses outside of the healthcare sector.
International Organizations’ Role in Policy Development
In the specified case, neither policy addresses extraterritoriality and applies internationally, implying international entities’ insignificant roles in policy development and promotion. Instead of active collaboration with the countries’ governments, international bodies’ contributions to the policies’ emergence were passive and limited to the provision of international medical coding systems for implementation as part of health data management endeavors. For example, the HIPAA makes the use of the ICD-10 taxonomic system for disease categorization a mandatory requirement for covered entities (Uysal, 2019). The Privacy Act does not specify this explicitly, which stems from its broader selection of professional fields. The ICD-10 system’s maintenance is handled by the World Health Organization (Uysal, 2019). Thus, the organization’s role is limited to establishing the common language of medical documentation to standardize PHI, which facilitates the safe and effective transfer of medical data in approved cases, such as for treatment.
Conclusion
To sum up, based on the HIPAA and the Privacy Act, health-related policies about safe personal data management within the frame of healthcare service provision utilize rather similar criteria of disclosures’ legality. They can, however, differ in terms of specificity to the health industry, the details of penal consequences, and data types classified as sensitive and identifiable information. Nursing-related and health-related policies vary in terms of intergovernmental structures’ contributions.
References
Daly, A. (2018). The introduction of data breach notification legislation in Australia: A comparative view.Computer Law & Security Review, 34(3), 477-495. Web.
Katuska, J. T. (2018). Wearing down HIPAA: How wearable technologies erode privacy protections.The Journal of Corporation Law, 44, 385-400. Web.
Kels, C. G. (2020). HIPAA in the era of data sharing. Journal of American Medical Association, 323(5), 476-477.
Oyeleye, O. A. (2021). The HIPAA Privacy Rule, COVID-19, and nurses’ privacy rights.Nursing2021, 51(2), 11-14. Web.
Uysal, S. (2019). ICD-10-CM diagnosis coding for neuropsychological assessment.Archives of Clinical Neuropsychology, 34(5), 721-730. Web.
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