Protected health information: Overview, definition, and example
What is protected health information?
Protected health information (PHI) refers to any individually identifiable health information that is created, received, stored, or transmitted by a healthcare provider, insurer, employer, or business associate. PHI includes medical records, billing details, and other personal health-related data that is protected under privacy laws, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States.
For example, a patient’s medical history, treatment plans, lab results, and insurance information are considered protected health information and must be handled in compliance with HIPAA regulations.
Why is protected health information important?
PHI is important because it safeguards patient privacy and prevents unauthorized access to sensitive medical data. Regulations like HIPAA establish strict guidelines on how PHI can be used, shared, and stored to protect individuals from identity theft, discrimination, and breaches of confidentiality.
For businesses in healthcare, compliance with PHI regulations is essential to avoid legal penalties, maintain patient trust, and ensure secure handling of medical information. Violations can result in fines, lawsuits, and reputational damage.
Understanding protected health information through an example
Imagine a hospital maintains electronic health records (EHR) for all patients. The records include names, diagnoses, medications, and doctor’s notes. Because this data qualifies as protected health information, the hospital must ensure it is securely stored, only accessible to authorized personnel, and not disclosed without patient consent (except under specific legal circumstances).
In another case, a health insurance company processes claims that include PHI, such as policyholder names, medical treatments, and billing details. The insurer must follow HIPAA compliance measures when sharing this information with healthcare providers or processing payments.
An example of a protected health information clause
Here’s how a clause like this might appear in a healthcare agreement:
“The Parties acknowledge that they may receive, process, or transmit Protected Health Information (PHI) as defined under HIPAA. Each Party agrees to implement appropriate safeguards to protect PHI from unauthorized access, disclosure, or misuse and to comply with all applicable federal and state healthcare privacy laws.”
Conclusion
Protected Health Information (PHI) is a critical component of healthcare privacy, ensuring that patient data remains confidential and secure. Compliance with HIPAA and other privacy laws is essential for healthcare providers, insurers, and businesses handling PHI. Proper safeguards help prevent breaches, protect patient rights, and maintain trust in healthcare systems.
This article contains general legal information and does not contain legal advice. Cobrief is not a law firm or a substitute for an attorney or law firm. The law is complex and changes often. For legal advice, please ask a lawyer.