The number of hospitals and health systems achieving significant compliance with Health Insurance Portability and Accountability Act (HIPAA) privacy regulations has dropped slightly in the last year according to a survey conducted by the American Health Information Management Association (AHIMA).

The percentage of healthcare privacy officers and others whose jobs relate to HIPAA privacy who believe their institution is more than 85 percent compliant dropped to 85 percent in 2006, down from 91 percent in 2005. As a result, the percent who believe they are less than 85 percent compliant increased from 9 percent in 2005 to 15 percent in 2006.

The majority of respondents-55 percent-cited a lack of sufficient resources as the most significant barrier to full privacy compliance. Respondents report sensing a loss of support from senior management, both in ensuring facility staff is aware of the need for privacy as well as ensuring sufficient budgeting for continued education and training. This lack of resources and competing priorities has led to a diminished focus on the privacy rule by some hospital and health system staff.

"HIPAA implementation has been a challenge for organizations and the majority are meeting that challenge, but the need for privacy, confidentiality, and security remains-especially as organizations tighten staffing and budgets," says Jill Callahan Dennis, JD, RHIA, AHIMA president. "A slight drop in the number of facilities reporting themselves to be fully or mostly compliant with HIPAA should serve as a warning to the industry that compliance should not be taken for granted."

The survey also highlights the continued difficulties with certain provisions of the privacy rule, most notably accounting for disclosures. Many respondents would like to see changes in this provision, finding it not only burdensome but also significantly inefficient since demand for such accounting is extremely low. An overwhelming majority of respondents reported receiving only a few requests for an accounting with 64 percent receiving no requests at all.

One year into the HIPAA security regulations, 25 percent of respondents indicate full compliance with another 50 percent indicating they are between 85 and 95 percent compliant. This represents an increase over 2005, when 17 percent of all respondents described themselves as fully compliant and 43 percent described themselves as 85 to 95 percent compliant. These results appear to indicate that the security regulations were much easier to achieve than the privacy rules.

When asked about patient privacy concerns, 30 percent of respondents said they encountered more questions from consumers this year and, more disturbingly, 22 percent reported an increase in the number of patients who refused to sign release of information forms. While more research is needed to understand the concerns behind this increase, it is clear the industry has an opportunity to better educate consumers regarding the protection of their personal health information.

"Communicating with consumers, answering their questions and addressing their concerns, is a key to advancing health information exchange activities," says Linda Kloss, MA, RHIA, AHIMA CEO.

"Without consumer confidence the nationwide health information network will never succeed."

The lung transplant team, recruited to the University of Chicago, completed their first transplant in their new setting. Allen Leonard, an officer with the Chicago Police Department, received two new lungs in an operation that began at about 10 P.M. on a Friday evening and lasted until about 6:30 A.M. on Saturday. Leonard, 44, suffered from scleroderma-associated pulmonary fibrosis. Until last fall he worked as a bicycle policeman on Chicago's lakefront. About six months ago, however, his disease began to progress rapidly and he had to shift to a desk job. His health continued to worsen and one month ago he was placed on the waiting list for a lung transplant.

He was sitting at his desk at work when the call came on Friday. He came straight to the hospital while the organ recovery team flew out of state to retrieve the lungs for transplant. The overnight operation went smoothly and he was in an intensive care unit by 7 A.M.

He recovered quickly and had his breathing tube removed by noon the day of his surgery. By Monday morning he was sitting in a chair, happy to have the waiting and the operation behind him.

Leonard is "progressing normally," said Wickii Vigneswaran, surgical director of the transplant team. "He came through the operation without problems and he has recovered nicely so far."

The team of five lung transplant physicians - including Edward Garrity, now vice chair of clinical operations in the department of medicine at the University of Chicago, Bhorade and Vigneswaran - moved to the University of Chicago Hospitals last December. Eight additional members of the team, including an anesthesiologist, an infectious disease specialist and six nurses, transferred with them.

Someone once said, "America is not the real world." Think about that. Indeed, most of us are far removed from the poverty and hardships that have followed countless people into the 21st century. But if any good can come from unfortunate circumstances, it is that the spirit of humanitarian service is strengthened when we team together to help those in need. There is no better example of this than the upcoming Alliance for Smiles (AFS) surgical mission to Shenyang, China.

AFS is a San Francisco based non-profit organization that organizes cleft lip and palate missions to China. They have chosen to focus their efforts in China because of the high incidence of children born with the cleft anomaly (1 in 400) and too few financial resources for treatment. The overwhelming need and the infrastructure of the country lend themselves, not only to the missions, but to the establishment of permanent cleft centers and long term treatment programs.

From April 16 – 27, 2006, an AFS team of volunteer medical and dental experts from the United States will travel to Shenyang, China to provide free reconstructive surgery for approximately 100 children with untreated cleft lips and palates. The surgical team will be comprised of 25 volunteer plastic surgeons, anesthesiologists, pediatricians, nurses and dentists. They will be supported by Rotary volunteers from the Chicago area, who will provide logistical and non-medical assistance. What they all share in common is the belief that no child should suffer physically or emotionally because of an untreated, repairable cleft lip or palate.

Before surgery

After surgery

The Shenyang team will partner with the Beijing based China Population Welfare Foundation, the Red Cross and the Shenyang Educational Foundation. In addition to the surgeries, the goal of the AFS team will be an active interchange of ideas and practices through one-on-one mentoring and medical lectures, with the volunteer doctors providing advanced training in reconstructive surgery techniques.

The mission is underwritten by 32 Chicago-area Rotary Clubs, The Elnekave Family Fund of the Chicago Community Trust, and Fitness Resource Inc.

Chicago Rotarian and AFS spokesperson Debbie Jefkin-Elnekave commented, "It is extraordinarily gratifying to realize the full impact of this mission. We are the reason that 100 children will smile for the first time. What better gift could we possibly give?"