[Federal Register: April 27, 2005 (Volume 70, Number 80)]
[Notices]
[Page 21740-21743]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr27ap05-68]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Privacy Act of 1974; System of Records
AGENCY: Office of the Secretary, DoD.
ACTION: Notice to alter a system of records.
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SUMMARY: The Office of the Secretary of Defense proposes to alter a
system of records to its inventory of record systems subject to the
Privacy Act of 1974 (5 U.S.C 552a), as amended. The Office of the
Secretary is proposing to alter the existing system of records by
expanding the purposes, categories of individuals covered, categories
of records being maintained, and by adding three new routine uses.
DATES: The changes will be effective on May 27, 2005, unless comments
are received that would result in a contrary determination.
ADDRESSES: Send comments to OSD Privacy Act Coordinator, Records
Management Section, Washington Headquarters Services, 1155 Defense
Pentagon, Washington, DC 20301-1155.
FOR FURTHER INFORMATION CONTACT: Ms. Juanita Irvin at (703) 601-4722,
extension 110.
SUPPLEMENTARY INFORMATION: The Office of the Secretary of Defense
notices for systems of records subject to the Privacy Act of 1974 (5
U.S.C. 552a), as amended, have been published in the Federal Register
and are available from the address above.
The proposed systems reports, as required by 5 U.S.C. 552a(r) of
the Privacy Act of 1974, as amended, were submitted April 18, 2005, to
the House Committee on Government Reform, the Senate Committee on
Homeland Security and Governmental Affairs, and the Office of
Management and Budget (OMB) pursuant to paragraph 4c of Appendix I to
OMB Circular No. A-130, `Federal Agency Responsibilities for
Maintaining Records About Individuals,' dated February 8, 1996
(February 20, 1996, 61 FR 6427).
Dated: April 18, 2005.
Jeannette Owings-Ballard,
OSD Federal Register Liaison Officer, Department of Defense.
DHA 07
System name:
Military Health Information System (August 13, 2004, 69 FR 50171).
Changes:
* * * * *
System Location:
Delete last sentence for Secondary location and replace with
`Program Executive Officer, Joint Medical Information Systems Office,
5109 Leesburg Pike, Suite 900, Skyline Building 6, Falls Church,
Virginia 22041-3241. For a complete listing of all facility addresses
write to the system manager.'
Categories of Individuals covered by the system:
Add to the end of the entry `Uniformed services medical
beneficiaries who receive or have received care at one or more dental
treatment facilities or other system locations including medical aid
stations, Educational and Development Intervention Services clinics and
Service Medical Commands. Uniformed service members serving in a
deployed status and those who receive or received care through the
Department of Veterans Affairs (VA)'.
Categories of records in the system:
Add a second paragraph to `CLINICAL ENCOUNTER DATA' as follows:
`Electronic data regarding dental tests, pharmacy prescriptions and
reports, data incorporating medical nutrition therapy and medical food
management, data for young MHS beneficiaries eligible for services from
the military medical departments covered by the Individuals with
Disabilities Education Act (IDEA). Data collected within the system
also allows beneficiaries to request an accounting of who was given
access to their medical records prior to the date of request. It tracks
disclosure types, treatment, payment and other Health Care Operations
(TPO) versus non-TPO, captures key information about disclosures,
process complaints, process and track request for amendments to
records, generates disclosure accounting and audit reports, retains
history of disclosure accounting processing'.
Add two new entries after `Clinical Data' as follows:
Occupational and Environmental Exposure Data: Electronic data
supporting exposure-based medical surveillance; reports of incidental
exposures enhanced industrial hygiene risk reduction; improved quality
of occupational health care and wellness programs for the DoD
workforce; hearing conservation, industrial hygiene and occupational
medicine programs within the MHS; and timely and efficient access of
data and information to authorized system users'.
Medical and Dental Resources: Electronic data used by the MHS for
resource planning based on projections of actual health care needs
rather than projections based on past demand'.
Authority for maintenance of the system:
Delete entry and replace with 5 U.S.C. 301, Department Regulation;
10 U.S.C., Chapter 55; Pub. L. 104-91, Health Insurance Portability and
Accountability Act of 1996; DoD 6025.18-R, DoD Health Information
Privacy Regulation; 10 U.S.C. 1071-1085, Medical and Dental Care; 42
U.S.C. Chapter 117, Sections 11131-11152, Reporting of Information; 10
U.S.C. 1097a and 1097b, TRICARE Prime and TRICARE Program; 10 U.S.C.
1079, Contracts for Medical Care for
[[Page 21741]]
Spouses and Children; 10 U.S.C. 1079a, Civilian Health and Medical
Program for the Uniformed Services (CHAMPUS); 10 U.S.C. 1086, Contracts
for Health Benefits fore Certain Members, Former Members, and Their
Dependents; DoD Instruction 6015.23, Delivery of Healthcare at Military
Treatment Facilities (MTFs); DoD 6010.8-R, CHAMPUS; 10 U.S.C. 1095,
Collection from Third Party payers Act; and E.O. 9397 (SSN)'.
Purpose(s):
Add five new paragraphs as follows: `The electronic medical records
portion of the system (EMR) addresses documenting and tracking
environmental health readiness data located in arsenals, depots, and
bases. Data collected and maintained is used to assess the medical and
dental deployability of Service members for the purposes of pre- and
post-deployment and any changes during and after deployment.
Data collected and maintained in the EMR system is used to perform
disease management and the prevention of exacerbations and
complications using evidence-based practice guidelines and patient
empowerment strategies. Data collected and maintained in the EMR system
s used in proactive health intervention activities for the active duty
and non-active duty beneficiary population. Data collected and
maintained is used to capture data on hearing loss and occupational
exposures, to perform noise exposure surveillance and injury referrals
to assess auditory readiness.
Data collected and maintained in the EMR system s used to establish
individual longitudinal exposure records using pre-deployment exposure
records. These records are used as a base line against new exposures to
facilitate post-deployment follow-up and workplace injury root-cause
analysis in an effort to mitigate loss work tie within the DoD.
Data collected within and maintained in the system is used for
patient administration (including registration, admission, disposition
and transfer); patient appointing and scheduling' delivery of managed
care; workload and medical services accounting; and quality assurance.
Data collected will be provided to Special Oversight Boards created
by applicable DoD authorities to investigate special circumstances and
conditions resulting from a deployment of DoD personnel to a theater of
operations.
Routine users of records maintained in the system, including
categories of users and the purposes of such uses: Add three new
paragraphs as follows:--`To the National Research Council, National
Academy of Sciences, National Institutes of Health, Armed Forces
Institute of Pathology, and similar institutions for authorized health
research in the interest of the Federal Government and the public. When
not essential for longitudinal studies, patient identification data
shall be deleted from records used for research studies. Facilities/
activities releasing such records shall maintain a list of all such
research organizations and an accounting disclosure of records released
thereto.
To local and state government and agencies for compliance with
local laws and regulations governing control of communicable diseases,
preventive medicine and safety, child abuse, and other public health
and welfare programs.
To federal offices and agencies involved in the documentation and
review of defense occupational and environmental exposure data,
including the National Security Agency, the Army corps of Engineers,
National Guard, and the Defense Logistics Agency.
Add a Note 2 after Note 1 as follows:
Note 2: Personal identity, diagnosis, prognosis of treatment
information of any patient maintained in connection with the
performance of any program or activity relating to substance abuse
education, prevention, training, treatment, rehabilitation, or
research, which is conducted, regulated, or directly or indirectly
assisted by any department or agency of the United States, except as
provided in 42 U.S.C. 290dd-2, will be treated as confidential and
will be disclosed only for the purposes and under the circumstances
expressly authorized under 42 U.S.C. 290dd-2. The ``Blanket Routine
Uses'' do not apply to these types of records.
* * * * *
DHA 07
System name:
Military Health Information System.
System location:
Primary location: Defense Enterprise Computing Center-Denver/WEE,
6760 E. Irvington Place Denver, CO 80279-5000.
Secondary locations: Directorate of Information Management,
Building 1422, Fort Detrick, MD 21702-5000; Service Medical Treatment
Facility Medical Centers and Hospitals: Uniformed Services Treatment
Facilities; Defense Enterprise Computing Centers; TRICARE Management
Activity, Department of Defense, 5111 Leesburg Pike, Skyline 6, Suite
306, Falls Church, VA 22041-3206; Joint Medical Information Systems
Office, 5109 Leesburg Pike Suite 900, Skyline Building 6, Falls Church,
VA 22041-3241, and contractors under contract to TRICARE. Program
Executive Officer, Joint Medical Information Systems Office, 5109
Leesburg Pike, Suite 900, Skyline Building 6, Falls Church, Virginia
20041-3241. For a complete listing of all facility addresses write to
the system manager.
Categories of individuals covered by the system:
Uniformed services medical beneficiaries enrolled in the Defense
Enrollment Eligibility Reporting System (DEERS) who receive or have
received medical care at one or more of DoD's medical treatment
facilities (MTFs), Uniformed Services Treatment Facilities (USTFs), or
care provided under TRICARE programs. Uniformed services medical
beneficiaries who receive or have received care at one or more dental
treatment facilities or other system locations including medical aid
stations, Educational and Developmental Intervention Services clinics
and Service Medical Commands. Uniformed service members serving in a
deployed status and those who receive or received care through the
Department of Veterans Affairs (VA).
Categories of records in the system:
Personal Identification Data: Selected electronic data elements
extracted from the Defense Enrollment and Eligibility Reporting System
(DEERS) beneficiary and enrollment records that include data regarding
personal identification including demographic characteristics.
Eligibility and Enrollment Data: Selected electronic data elements
extracted from DEERS regarding personal eligibility for and enrollment
in various health care programs within the Department of Defense (DoD)
and among DoD and other federal healthcare programs including those of
the Department of Veterans Affairs (DVA), the Department of Health and
Human Services (DHHS), and contracted health care provided through
funding provided by one of these three Departments.
Clinical Encounter Data: Electronic data regarding beneficiaries;
interaction with the MHS including health care encounters, health care
screenings and education, wellness and satisfaction surveys, and cost
data relative to such healthcare interactions. Electronic data
regarding Military Health System beneficiaries' interactions with the
DVA and DHHS healthcare delivery programs where such programs effect
benefits determinations between these Department-level programs,
continuity
[[Page 21742]]
of clinical care, or effect payment for care between Departmental
programs inclusive of care provided by commercial entities under
contract to these three Departments.
Electronic data regarding dental tests, pharmacy prescriptions and
reports, data incorporating medical nutrition therapy and medical food
management, data for young MHS beneficiaries eligible for services from
the military medical departments covered by the Individuals with
Disabilities Educations Act (IDEA). Data collected within the system
also allows beneficiaries to requests an accounting of who was given
access to their medical records prior to the date of request. It tracks
disclosure types, treatment, payment and other Health Care Operations
(TPO) versus non-TPO, captures key information about disclosure,
process complaints, process and track request for amendments to
records, generates disclosure accounting and audit reports, retains
history of disclosure accounting processing.
Budgetary and Managerial Cost Accounting Data: Electronic budgetary
and managerial cost accounting data associated with beneficiaries'
interactions with the MHS, DVA, DHHS or contractual commercial
healthcare providers.
Clinical Data: Inpatient an out patient medical records, diagnosis
procedures, and pharmacy records.
Occupational and Environmental Exposure Data: Electronic data
supporting exposure-based medical surveillance; reports of incidental
exposures enhanced industrial hygiene risk reduction; improved quality
of occupational health care and wellness programs for the DoD
workforce; hearing conservation, industrial hygiene and occupational
medicine programs within the MHS; and timely and efficient access of
data and information to authorized system users.
Medical and Dental Resources: Electronic data used by the MHS for
resource planning based on projections of actual health care needs
rather than projections based on past demand.
Authority for maintenance of the system:
5 U.S.C. 301, Department Regulation; 10 U.S.C., Chapter 55; Pub. L.
104-91, Health Insurance Portability and Accountability Act of 1996;
DoD 6025.18-R, DoD Health Information Privacy Regulation; 10 U.S.C.
1071-1085, Medical and Dental Care; 42 U.S.C. Chapter 117, Sections
11131-11152, Reporting of Information; 10 U.S.C. 1097a and 1097b,
TRICARE Prime and TRICARE Program; 10 U.S.C. 1079, Contracts for
Medical Care for Spouses and Children, 10 U.S.C. 1079a, Civilian Health
and Medical Program of the Uniformed Services (CHAMPUS); 10 U.S.C.
1086, Contracts for Health Benefits for Certain Members, Former
Members, and Their Dependents; DoD Instruction 6015.23, Delivery of
Healthcare at Military Treatment Facilities (MTFs); DoD 6010.8-R
CHAMPUS; 10 U.S.C. 1095, Collection from Third Party Payers Act; and
E.O. 9397 (SSN).
Purpose(s):
Data collected within and maintained by the Military Health
Information System supports benefits determination for MHS
beneficiaries between DoD, DVA, and DHHS healthcare programs, provides
the ability to support continuity of care across Federal programs
including use of the data in the provision of care, ensures more
efficient adjudication of claims and supports healthcare policy
analysis and clinical research to improve the quality and efficiency of
care within the MHS.
The electronic medical records portion of the system (EMR)
addresses documenting and tracking environmental health readiness data
located in arsenals, depots, and bases. Data collected and maintained
is used to assess the medical and dental deployability of Service
members for the purposes of pre- and post-deployment exams. This
assists in recording health conditions before deployment and any
changes during and after deployment.
Data collected and maintained in the EMR system is used to perform
disease management and the prevention of exacerbations and
complications using evidence-based practice guidelines and patient
employment strategies. Data collected and maintained in the EMR system
is used in proactive health intervention activities for the active duty
and non-active duty beneficiary population. Data collected and
maintained is used to capture data on hearing loss and occupational
exposures, to perform noise exposure surveillance and injury referrals
to assess auditory readiness.
Data collected and maintained in the EMR system is used to
establish individual longitudinal exposure records using pre-deployment
exposure records. These records are used as a baseline against new
exposures to facilitate post-deployment follow-up and workplace injury
root-cause analysis in an effort to mitigate loss work time within the
DoD.
Data collected within and maintained in the system is used for
patient administration (including registration, admission, disposition
and transfer); patient appointing and scheduling delivery of managed
care; workload and medical services accounting; and quality assurance.
Data collected will be provided to Special Oversight Boards created
by applicable DoD authorities to investigate special circumstances and
conditions resulting from a deployment of DoD personnel to a theater of
operations.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses: In addition to those
disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy
Act, these records or information contained therein may specifically be
disclosed outside the DoD as a routine use pursuant to 5 U.S.C.
552a(b)(3) as follows:
To permit the disclosure of records to the Department of Health and
Human Services (HHS) and its components for the purpose of conducting
research and analytical projects, and to facilities collaborative
research activities between DoD and HHS.
To the Congressional Budget Office for projecting costs and
workloads associated with DoD Medical benefits.
To the Department of Veterans Affairs (DVA) for the purpose of
providing medical care to former service members and retirees, to
determine the eligibility for or entitlement to benefits, to coordinate
cost sharing activities, and to facilitate collaborate research
activities between the DoD and DVA.
To the National Research Council, National Academy of Sciences,
National Institutes of Health, Armed Forces Institute of Pathology, and
similar institutions for authorized health research in the interest of
the Federal Government and the public. When not essential for
longitudinal studies, patient identification data shall be deleted from
records used for research studies. Facilities/activities releasing such
records shall maintain disclosure of records released thereto.
To local and state government and agencies for compliance with
local laws and regulations governing control of communicable disease,
preventive medicine and safety, child abuse, and other public health
and welfare programs.
To federal offices and agencies involved in the documentation and
review of defense occupational and environmental exposure data,
including the National Security Agency, the Army Corps of Engineers,
National Guard, and the Defense Logistics Agency.
The DoD `Blanket Routine Uses' set forth at the beginning of OSD's
compilation of systems or records
[[Page 21743]]
notices apply to this system, except as identified below.
Note 1: This system of records contains individually
identifiable health information. The DoD Health Information Privacy
Regulation (DoD 6025.18-R) issued pursuant to the Health Insurance
Portability and Accountability Act of 1996, applies to most such
health information. DoD 6025.18-R may place additional procedural
requirements on the uses and disclosures of such information beyond
those found in the Privacy Act of 1974 or mentioned in this system
of records notice.
Note 2: Personal identity, diagnosis, prognosis or treatment
information of any patient maintained in connection with the
performance of any program or activity relating to substance abuse
education, prevention, training, treatment, rehabilitation, or
research, which is conducted, regulated, or directly or indirectly
assisted by any department or agency of the United States, except as
provided in 42 U.S.C. 290dd-2, will be treated as confidential and
will be disclosed only for the purposes and under the circumstances
expressly authorized under 42 U.S.C. 290dd-2. The ``Blanket Routine
Uses'' do not apply to these types of records.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Records are maintained on optical and magnetic media.
Retrievability:
Records may be retrieved by individual's Social Security Number,
sponsor's Social Security Number, Beneficiary ID (sponsor's ID,
patient's name, patient's DOB, and family member prefix or DEERS
dependent suffix), diagnosis codes, admission and discharge dates,
location of care or any combination of the above.
Safeguards:
Automated records are maintained in controlled areas accessible
only to authorized personnel. Entry to these areas is restricted to
personnel with a valid requirement and authorization to enter. Physical
entry is restricted by the use of a cipher lock. Back-up data
maintained at each location is stored in a locked room. The system will
comply with the DOD Information Technology Security Certification and
Accreditation Process (DITSCAP) Access to HMIS records is restricted to
individuals who require the data in the performance of official duties.
Access is controlled through use of passwords.
Retention and disposal:
Records are maintained until no longer needed for current business.
System manager(s) and address:
Program Manager, Executive Information/Decision Support Program
Office, Six Skyline Place, Suite 8009, 5111 Leesburg Pike, Falls
Church, VA 22041-3201.
Notification procedure:
Individuals seeking to determine whether information about
themselves is contained in this system should address written inquiries
to the TRICARE Management Activity Privacy Office, Skyline 5, Suite
810, 5111 Leesburg Pike, Falls Church, VA 22041-3201.
Requests should contain the full names of the beneficiary and
sponsor, sponsor Social Security Number, sponsor service, beneficiary
date of birth, beneficiary sex, treatment facility(ies), and fiscal
year(s) of interest.
Record access procedures:
Individuals seeking access to information about themselves
contained in this system of records should address written requests to
TRICARE Management Activity Privacy Office, Skyline 5, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041-3201.
Request should contain the full names of the beneficiary and
sponsor, sponsor's Social Security Number, sponsor's service,
beneficiary date of birth, beneficiary sex, treatment facility(ies)
that have provided care, and fiscal year(s) of interest.
Contesting record procedures:
The OSD rules for accessing records, for contesting contents and
appealing initial agency determinations are contained in OSD
Administrative Instruction 81; 32 CFR part 311; or may be obtained from
the system manager.
Record source categories:
The individual data records that are assembled to form the MHIS are
submitted by the Military Departments' medical treatment facilities,
commercial healthcare providers under contract to the MHS, the Defense
Enrollment Eligibility Reporting System, the Uniformed Service
Treatment Facility Managed Care System, the Department of Health and
Human Services, the Department of Veterans Affairs, and any other
source financed through the Defense Health Program.
Exemptions claimed for the system:
None.
[FR Doc. 05-8057 Filed 4-26-05; 8:45 am]
BILLING CODE 5001-06-M