According to a recent article published in the New England Journal of Medicine, reformed privacy and security requirements under the Health Insurance Portability and Accountability Act (HIPAA) could allow better access to increasing patient engagement technology.

Ameet Sarpatwari, JD, PhD, and Niteesh K. Choudhry, MD, PhD from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, argue that patient engagement might improve if providers implemented a system that required patients to elect to receive current privacy and security standards for sharing protected health information. However, such a change would require amending HIPAA regulations.

Patient engagement has been called the “blockbuster drug of the 21st century,” according to the researchers, yet current regulations are dimming some of the promise offered by interventions that are being developed, tested, and implemented to tackle the challenge of making patients active participants in their own care. Patient portals, smartphone applications, and Bluetooth-connected biometric devices, such as blood pressure cuffs and glucose monitors, can facilitate ongoing communication between physicians and patients.

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The researchers noted that in order for these engagement tools to work, they must be accessible, allow for personalized communication, and facilitate instantaneous sharing of information. However, HIPAA regulations designed to protect patient privacy may be preventing these tools from being used to their full potential.

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Many hospitals and physician’s offices prohibit the inclusion of protected health information in text messages or unencrypted email, and patients often need a key to access healthcare portals or encrypted messages. The investigators argue that these policies may not reflect what patients need or want, and that they can hinder clinicians’ abilities to engage with patients. Amending existing HIPAA regulations to allow better access to technological advances could meaningfully increase patient engagement with the healthcare system, and ultimately improve patient outcomes.


Sarpatwari A, Choudhry NK. Recalibrating privacy protections to promote patient engagement. N Engl J Med. 2017;377(16):1509-1511.