sorry if i was unclear. if a company is storing medical history data that falls under HIPPA which is serious.

If a company just has data about you that is not medical data then there is no legal requirements as to who can have access to it internally. (So Joe's Sprocket's has a list of everyone who has bought sprockets and their phone numbers - anyone in the company could look at that info and there would be no legal implications)

I see. I think I misinterpreted the "0 legal requirements" part of your comment. It gave me the impression employees not involved in the care could access medical data. Thanks for clarifying.

No. Anyone internal to the company viewing medical data without an explicit need is in violation of hipaa.

But I don’t think that’s what the poster was saying.

I see. I don't know the details of HIPAA but that seems reasonable. What kinds of needs justify use of the data?

One example. A friend of mine who works at a hospital told me about a colleague (a nurse) who looked up her own test results since she was anxious and could not wait using her login to the main system (for providers). She got flagged in the system and reprimanded. Every access is logged.

it's worth noting for others that this was almost certainly a hospital policy violation, not a hipaa violation. There's nothing in hipaa that prevents a person from accessing their own record (though I have heard hospital administrators try to claim otherwise).

You need to be part of a patient’s care team, using that data to further their care. Any other access is a violation.

Med students get a little grey area on this because their job is to absorb as much info as possible without necessarily providing care, but even they shouldn’t venture outside the census of their supervising physician.

That's absolutely false. Many other people need to be able to access the data just to keep systems working. I've worked in a HIPAA environment (as well as FDA class 1 / ISO 13485) for nearly 15 years now.

Also, many companies who deal with medical data, but are say startups but not an actual healthcare provider gets audited for compliance - and it is fairly rigorous and so think of it like a SOX audit, but even further. Some companies have dedicated rooms with limited, tracked, badge access to the machines in that area which are the only machines that can access the data.

So if any breach occurs, access can be tracked to individuals.

So programs are allowed access to the data, provided they are audited?

In my country, one programmer who unfortunately lost his newborn daughter to sepsis decided to make a machine learning program to help doctors diagnose the infection early. The software has access to patient data and it recognizes patterns that match the development of sepsis. It decreased the number of severe sepsis cases per month from 1.5 to 0.5 and cut the waiting time before effective treatment was administered by 60%.

People have told me this sort of system would not have been impossible in the USA because of the HIPAA. Is this true?

These types of programs do exist in most insurance companies in the United States. Predictive analytics against claims and clinical data to do early intervention care management is a common thing here.

That said, the company has to make sure that only the people that have a clinical need to access the data have access. So the developers would probably use a de-identified data set to write and test the program. Only the clinicians (care management and disease management nurses) would have access to the identified data so they can contact the patient to offer care.

Yep - de-identified data is the best way to assure compliance when developing/working-on/dealing with large sensitive data-sets.

that said, compliance audits are pretty strict if they are doing it correctly, and not-so-fun. It will be an interesting world when there is a medical-data-firehose pointed at an AI that is looking at all the available med records to do predictive analytics against an entire population....

We are likely a decade from that.

I think there would be significant challenges to do so. I think this is one of the reasons why google's health care initiatives in the US failed so horrifically and one of the reasons why their deepmind NHS initiative is with the NHS and not someone in the US.