Privacy issues

[Marshall E. Fryman]

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The privacy regulation draws attention to a reasonable effort to maintain the privacy of patient's information except on a "need to know" basis. If we take the premise of a doctor's office where Person A types a letter to a patient containing confidential information. If Person A then walks away from their terminal, I would reasonably conclude that there should be some sort of password-protected screen saver that automatically pops up to blank the screen so that anyone passing by can not read said letter. If this workstation is setup using Windows 9x, is it also reasonable to claim that this machine is not securable? If I reboot the Win 9x machine, I can bypass any password that was originally setup on this machine and still read the letter. If I upgrade this machine to Windows NT / 2000 / XP, it is no longer possible to bypass the security system. This is clearly a more secure environment, but has anyone attempted to define if this falls within the "reasonable" precautions that a practice should take?

Anyone have any ideas? I have talked to CMS and they said that they were not really qualified to answer the question. Their initial reaction was that this was an issue of security not privacy, but they later changed their mind and said it might fall within the "reasonable" clause.

Thanks,
Marshall


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