Can I collect health information from participants in Wisconsin? What are the requirements?

Collection of Health Information in Wisconsin

In Wisconsin, health care information can be collected from health care providers, insurers, and administrators for the purpose of providing information to health care providers, insurers, consumers, governmental agencies, and others ^[2.1]. However, the collection and dissemination of health care information is subject to certain restrictions and requirements.

Requirements for Collection and Dissemination of Health Care Information

The Wisconsin Department of Health Services (DHS) is responsible for collecting and disseminating health care information from health care providers other than hospitals and ambulatory surgery centers ^[2.1]. The entity under contract with the DHS is responsible for collecting and disseminating health care information from hospitals and ambulatory surgery centers ^[2.1].

The data organization under contract with the DHS may request health care claims information from insurers and administrators and must analyze and publicly report the health care claims information with respect to the cost, quality, and effectiveness of health care ^[2.1]. The data organization must also develop and maintain a centralized data repository ^[2.1].

Confidentiality of Health Care Information

Health care information collected and disseminated in Wisconsin is subject to confidentiality requirements. For example, incident or occurrence reports and any information acquired in connection with the review or evaluation of health care services may not be disclosed except as provided by law ^[1.1]. Any person who discloses information in violation of these requirements is civilly liable to any person harmed by the disclosure ^[1.1].

Uses and Disclosures of Protected Health Information

In Wisconsin, a covered entity or its business associate may use, disclose, or request for disclosure of protected health information for purposes of treatment, payment, or health care operations ^[1.2]. A covered entity that is a treatment facility shall comply with the notice of privacy practices obligations under 45 CFR 164.520, including the obligation to include in plain language in the notice of privacy practices a statement of the individual’s rights with respect to protected health information and a brief description of how the individual may exercise those rights including the right to request restrictions on uses and disclosures of protected health information about the individual to carry out treatment, payment, or health care operations as provided in 45 CFR 164.522 ^[1.2].

Conclusion

In summary, health care information can be collected from participants in Wisconsin subject to certain restrictions and requirements. The Wisconsin DHS is responsible for collecting and disseminating health care information from health care providers other than hospitals and ambulatory surgery centers, while the entity under contract with the DHS is responsible for collecting and disseminating health care information from hospitals and ambulatory surgery centers. Health care information collected and disseminated in Wisconsin is subject to confidentiality requirements. A covered entity or its business associate may use, disclose, or request for disclosure of protected health information for purposes of treatment, payment, or health care operations.

Source(s):

• [1.1] Health care services review; confidentiality of information.
• [1.2] Uses and disclosures of protected health information.
• [2.1] Collection and dissemination of health care and related information.

Jurisdiction

Wisconsin

• Privacy