An ‘Honest Broker’ mechanism to maintain privacy for patient care and academic medical research

Boyd, Andrew D.; Hosner, Charlie; Hunscher, Dale A.; Athey, Brian D.; Clauw, Daniel J.; Green, Lee A.

doi:10.1016/j.ijmedinf.2006.09.004

Cited by 60 publications

(57 citation statements)

References 3 publications

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“…Because of the Health Insurance Portability and Accountability Act (HIPAA) regulations, an honest broker 11 reviewed medical records from the sampling list at a given practice until a suffi cient number (150 to 175) were collected or until all eligible charts in the practice (for smaller practices with fewer than 150 eligible patients) were reviewed. Pneumococcal vaccination status was determined by searching the medical record back as far as possible after the patient reached age 65 years.…”

Section: Medical Record Reviewmentioning

confidence: 99%

Understanding Adult Vaccination in Urban, Lower-Socioeconomic Settings: Influence of Physician and Prevention Systems

Zimmerman

Nowalk²,

Tabbarah³

et al. 2009

The Annals of Family Medicine

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PURPOSE Vaccination rates for pneumococcal polysaccharide vaccine (PPV) and infl uenza vaccine are relatively low in disadvantaged urban populations. This study was designed to assess which physician and practice characteristics might explain differences in rates across physicians.METHODS PPV and infl uenza vaccination rates were determined for 2,021 patients aged 65 years and older receiving care from 30 physicians in 17 practices surveyed about their offi ce systems for providing adult immunizations. Hierarchical linear modeling (HLM) analyses were used to examine the relationships among vaccination rates, patient-level characteristics, and physician variables.RESULTS Overall, the weighted PPV vaccination rate was 60.0% and varied widely across physicians (range, 11%-98%). At the patient level in HLM, patient race (P = .01) and age (P = .02), but not neighborhood income, were associated with PPV status. By linking physician survey data with PPV rates, we found the best pair of physician variables to be "reported time spent with patients for a well visit" (P = .01) and "use of enhanced immunization documentation" (P = .10). The overall infl uenza vaccination rate was 51.9% (range, 22%-96%). Patient race (P = .003) and age (P = .002) were associated with infl uenza vaccination. The pair of physician variables with the strongest association with infl uenza vaccination was "use of standing orders" (P <.001) and "average observed physician examination room time," regardless of visit type (P = .02).CONCLUSIONS Vaccination rates vary widely in urban settings and are associated with practice characteristics such as time spent with patients and, for infl uenza vaccine, use of standing orders.

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Section: Medical Record Reviewmentioning

confidence: 99%

Understanding Adult Vaccination in Urban, Lower-Socioeconomic Settings: Influence of Physician and Prevention Systems

Zimmerman

Nowalk²,

Tabbarah³

et al. 2009

The Annals of Family Medicine

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“…Such a system of linkages can address some of the challenges of disparate underlying data systems, data transfer, storage, local security requirements, and retrieval of clinical data across independent and otherwise incompatible systems. 17,18 v Creating a central information system that collects information in parallel with existing systems 19 : Data collection in a parallel system may use a generic Web interface to allow effective operation in sites with varied technological capabilities.…”

Section: Strategies To Address Challengesmentioning

confidence: 99%

Signposts Along the NIH Roadmap for Reengineering Clinical Research<subtitle>Lessons From the Clinical Research Networks Initiative</subtitle>

Williams¹

2008

Arch Intern Med

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“…However, we chose not to do so because we lack data on why these biobanks do not have access to identifying information. It is possible, for instance, that an honest broker has access, but the biobank itself does not (Boyd et al, 2007). Therefore, we did not feel comfortable labeling them as not forwardthinking.…”

Section: Discussionmentioning

confidence: 96%

“Forward-Thinking” in U.S. Biobanking

Cadigan

Edwards

Lassiter

et al. 2017

Genetic Testing and Molecular Biomarkers

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Aims: Do biobanks enact policies and plans that allow them to anticipate and respond to potential challenges? If a biobank has one such policy or plan, is it likely to have more? Using survey data from 456 U.S. biobanks, we assess four possible indicators of such ''forward-thinking.'' Methods: We present response frequencies and cross-tabulations regarding policies for return of results and ownership of specimens, and for having a formal business plan and a plan for what happens to specimens if the biobank closes. We analyze the relationships among these indicators, using chi-square for tests of statistical significance.Results: Policies-Sixty-two percent of biobanks have a policy about returning individual research results; 70% have a policy designating ownership of specimens and/or technology. Having these two policies is significantly related ( p < 0.001). Plans-34% of biobanks have a formal business plan; 26% have a written plan for what will happen to the specimens if the biobank closes. Having these two plans is significantly related (p < 0.001). Relationships among indicators-only 7% of biobanks are forward-thinking across all four indicators; 12% are forward-thinking across none. Discussion: The two policies we examined tend to occur together, as do the two plans. These policies and plans seem to tap different aspects of accountability and responsiveness. Specifically, the policies reflect issues most commonly raised in the ethical and legal literature on biobanking, while the plans are indicators of sustainability, a separate area of concern in biobanking.

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An ‘Honest Broker’ mechanism to maintain privacy for patient care and academic medical research

Cited by 60 publications

References 3 publications

Understanding Adult Vaccination in Urban, Lower-Socioeconomic Settings: Influence of Physician and Prevention Systems

Understanding Adult Vaccination in Urban, Lower-Socioeconomic Settings: Influence of Physician and Prevention Systems

Signposts Along the NIH Roadmap for Reengineering Clinical Research<subtitle>Lessons From the Clinical Research Networks Initiative</subtitle>

“Forward-Thinking” in U.S. Biobanking

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