Isabella Carter
Protected Health Information (PHI) is a term used to describe an individual's health, treatment, and payment information, as well as any other information that could be used to identify them. This includes genetic information, and information relating to the past, present, or future physical or mental health of an individual. PHI is protected under HIPAA, which stands for Health Insurance Portability and Accountability Act. This act sets out rules and regulations to protect PHI, and applies to healthcare providers, health plans, and healthcare clearing houses that qualify as HIPAA Covered Entities.
| Characteristics | Values |
|---|---|
| Definition | "Protected health information means individually identifiable health information transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium" |
| Health information | Any information, including genetic information, whether oral or recorded in any form or medium |
| Created or received by | A health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse |
| Relates to | The past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care |
| Applies to | Health care providers, health plans, and health care clearing houses that qualify as HIPAA Covered Entities, and only to Business Associates while they are performing a service for or on behalf of a Covered Entity |
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What You'll Learn
Health information
Protected health information (PHI) under HIPAA is defined as "protected health information means individually identifiable health information transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium". In other words, it is any information relating to a patient's condition, the past, present, or future provision of healthcare, or payment thereof. This includes genetic information, whether oral or recorded in any form or medium.
PHI is considered to be an individual's health, treatment, and payment information, and any further information maintained in the same designated record set that could identify the individual or be used with other information in the record set to identify the individual. It is important to note that PHI definitions only apply to health care providers, health plans, and health care clearing houses that qualify as HIPAA Covered Entities, and only to Business Associates while they are performing a service for or on behalf of a Covered Entity.
PHI is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse. It becomes individually identifiable health information when identifiers are included in the same designated record set, and it becomes protected when it is transmitted or maintained in any form by a covered entity.
There is no definitive list of what is considered PHI under HIPAA, as there are times when a covered entity might not maintain identifying information with health, treatment, or payment information. However, HIPAA rules and regulations are substantially about protecting PHI, and understanding what constitutes PHI is crucial for HIPAA compliance.
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Individually identifiable health information
Protected Health Information (PHI) under HIPAA is defined as:
> protected health information means individually identifiable health information transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium.
PHI is an individual's health, treatment, and payment information, as well as any other information that could be used to identify them. This includes genetic information, whether oral or recorded in any form or medium. It is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse.
PHI is only considered as such when it is created, received, maintained, or transmitted by a "covered entity" or a "business associate". A covered entity is a healthcare provider, health plan, or healthcare clearing house that qualifies as a HIPAA Covered Entity. A business associate is an entity that performs a service for or on behalf of a Covered Entity.
PHI is not the same as patient health data or the 18 HIPAA identifiers.
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Designated record sets
Protected Health Information (PHI) under HIPAA is defined as an individual's health, treatment, and payment information, and any further information maintained in the same designated record set that could identify the individual or be used with other information in the record set to identify the individual.
Covered entities are defined as health care providers, health plans, and health care clearinghouses that qualify as HIPAA Covered Entities. This includes employers, life insurers, schools, and universities. When these entities create, receive, maintain, or transmit health information, it becomes protected health information under HIPAA.
The designated record set can be in any form or medium, including electronic media or paper records. It is important to note that the HIPAA PHI definitions only apply to covered entities and business associates while they are performing a service for or on behalf of a covered entity.
Understanding what constitutes a designated record set under HIPAA is crucial for ensuring compliance and protecting individuals' health information. By following the guidelines, covered entities can safeguard sensitive information and prevent unauthorised access or disclosure.
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Covered entities
> protected health information means individually identifiable health information transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium.
This means that any information that can be used to identify an individual, and relates to their health or healthcare, is considered PHI. This includes genetic information, and information about an individual's past, present, or future physical or mental health, healthcare provision, or payment for healthcare.
When it comes to covered entities, it's important to note that there is no definitive list of what constitutes PHI. This is because there are times when a covered entity might not maintain identifying information with health, treatment, or payment information. However, covered entities are still responsible for ensuring that PHI is protected and that they are compliant with HIPAA regulations.
HIPAA rules and regulations are primarily focused on protecting PHI. Covered entities must ensure that they have appropriate safeguards in place to protect PHI, such as encryption and access controls. They must also ensure that they are compliant with HIPAA's privacy and security rules, which include requirements for the handling and disclosure of PHI.
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Business associates
The HIPAA PHI definitions only apply to business associates while they are performing a service for or on behalf of a covered entity. This means that health, treatment, or payment information, and any identifiers maintained with this information, is considered Protected Health Information under HIPAA if the information is created, received, maintained, or transmitted by a business associate.
The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or otherwise. The Security Rule protects a subset of individually identifiable health information, referred to as electronic protected health information (ePHI), which is protected health information that is maintained in or transmitted by electronic media. Unlike the Privacy and Breach Notification Rules, the Security Rule does not apply to PHI that is maintained or transmitted on paper or verbally.
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Frequently asked questions
PHI stands for Protected Health Information.
Protected Health Information under HIPAA is defined as: "protected health information means individually identifiable health information transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or medium".
This means that any information relating to a patient's condition, the past, present, or future provision of healthcare, or payment thereof is protected under HIPAA. This information becomes individually identifiable when identifiers are included in the same designated record set.
