Protected Health Information (PHI)

Protected Health Information (PHI) is defined as individually identifiable health information. Individually identifiable health information refers to any health information which pertains to the patient's past, present, or future condition, provision and payment of services received in the past, present, or future, and which identifies the patient (e.g., name, social security number). It is important to remember that the regulations protect information in the medical record and the financial/billing record as well as PHI contained in reports, other documents, and verbal communications.

Individually identifiable health information transmitted in any form or medium, either orally, in writing, or electronically is protected under law. This means that on a daily basis, we are required to protect individually identifiable health information for living or deceased patients (whether oral, in writing, or electronically) from individuals that do not have a need to know this information.

Individuals that do not have a need to know PHI include:

• Non-workforce members (e.g., the public)
• Workforce members whose jobs or functions do not require they have this information

Sharing or discussing PHI (in any medium) with workforce members that do not have a business need to know is a privacy violation and subject to sanction. The regulations give specific direction on how we, as an organized health care arrangement, can use and disclose PHI.

Data elements that make health information individually identifiable include:

• Names of Individuals and Relatives
• Birth dates
• Address (geographic subdivisions smaller than a state)
• Marital Status
• Telephone and Fax Numbers
• Insurance and Medical Record Identification
• Social Security Numbers
• Electronic Mail Address, URLs, Internet Protocol Addresses
• Account Numbers
• Certificate/License Numbers
• Vehicle Identifiers and Serial Numbers
• Biometric Identifiers - including finger and voice prints
• Full Face Photographic Images - including any comparable images
• Any unique identifying number, characteristic, or code (e.g., rare disease or procedure codes)
• Information that on a reasonable basis can be used to identify an individual
• All other information that facilitates payment for services the individual received or will receive in the past, present, or future

Previous | TOC | Next