In Pursuit of Precision - University of Alabama at Birmingham

Physicians’ Forum By
Roger Shuler
The regulations of the Health Insurance Portability and Accountability Act (HIPAA) affect virtually
every aspect of the health-care industry, from billing and accounting practices to research. Every
provider is required to comply with rules concerning privacy and security to protect the confidentiality
of patient information. Among other regulations, HIPAA provides guidelines for the use of computers
and PDAs, mandates the adoption of standardized file formats and electronic data interchange
(EDI) code sets, and defines which information can be shared for marketing purposes.
Failure to implement these requirements can lead to penalties including civil fines, criminal fines
and penalties, and government investigation.
How will HIPAA regulations affect practicing physicians? The Alabama
Medical Alumni Bulletin asked two UASOM alums. Noble Anderson, M.D.
(1989), is an otolaryngologist in private practice in Montgomery,
Alabama. Eric Neilson, M.D. (1975), is Morgan professor of medicine
and chair of the Department of Medicine at Vanderbilt University.
MAB: Will it take a substantial amount of time and/or resources for you, your practice, or
your institution to comply with HIPAA?
Noble Anderson, M.D.
Anderson: I do think that it will take a substantial amount of time and resources in my practice to
comply with the regulations. Like any new federal regulation, it will place stress on the office personnel,
requiring more documentation and work than is already done. It will require an appointment of a
compliance officer—or “information security officer”—to oversee the necessary documentation. Also,
there apparently will be standardized electronic claims regulations; these may, in theory, increase efficiency,
but I am concerned that most practices will not be able to invest a lot of money in the required
computer hardware or software. We all are continuing to see decreasing reimbursement and increasing
practice costs.
Neilson: There are many good things about HIPAA that are intended to enhance health-care privacy
in an electronic age where so much can be easily misused. Academic medical centers are an important
environment to provide leadership in this effort. But it is, of course, additional work, and nobody
likes to bear the costs of unfunded congressional mandates. It will be virtually impossible for small practices
to comply with HIPAA (to assign a compliance officer, implement new technology, change their
procedures, and so on) unless they can join or form consortia to handle these issues. Either way, it is a
new expense.
Eric Neilson, M.D.
MAB: Will complying with this law change the way you practice your specialty?
Anderson: It will be a burden for practices to assign a compliance officer and change procedures, and
the technological requirements will be an additional expense, especially for smaller businesses. I think
it will, in effect, change the way my practice is run. But I do not believe it will change the way I practice
medicine.
Neilson: The first regulations from HIPAA focus on those who are entitled to have access to patient
information (doctors, payers, and health-care organizations) and how they will communicate electronical-
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