Implications of FOIA on Public Health

For at least three reasons, FOIA is essential to public health practitioners: its capacity to support public health advocacy, its effect on government accountability and transparency, and its ability to promote public health practices and policy making. All states also have enacted laws governing open access to governmental information, many with provisions similar to the federal FOIA.

Over the years, FOIA has played a central role in advancing public health policy by enabling investigations and research on topics as wide-ranging as human radiation experiments conducted during the Cold War, federal farm subsidies, reports about ill airline passengers, implementation of the President’s Emergency Plan for AIDS Relief, and distracted driving due to cell phone use.

FOIA Background

The Freedom of Information Act (FOIA), was signed into law by President Lyndon Johnson in 1966, giving the public the right to access records from any federal agency. FOIA plays a vital role in keeping government transparent and accountable and has been used to expose a wide range of government misconduct and waste, along with threats to the public’s health and safety.

In enacting FOIA, Congress strived to balance the encouragement of government disclosure and the need for accountability with a desire to “protect certain equally important rights of privacy concerning certain information in Government files, such as medical and personnel records.” This attempt to balance government accountability and transparency with the protection of sensitive information has characterized FOIA debates since its enactment.

How Does FOIA Work?

FOIA’s public disclosure provisions are codified at 5 U.S.C. §552(a); these rules require the proactive disclosure of records such as final opinions, policy statements, and staff manuals. The provisions also require public access to certain frequently requested records, the publication of regulations in the Federal Register, and prompt disclosure of records upon request (subject to certain exemptions).

FOIA applies to records in the control or possession of a federal agency subject to nine exemptions and certain exclusions. Records within an agency’s possession and control include those stored in databases as well as those that have been archived. Records include papers, videos, e-mails, audio recordings, maps, and computer documents.

Surveillance Cameras and FOIA

Surveillance cameras can be an effective method for protecting public safety and for detecting or deterring criminal activity. Surveillance cameras are increasingly being installed within and around public buildings (in entrances, hallways, elevators, etc.) in parks, public transportation vehicles, and on the streets. Public entities subject to the Freedom of Information and Privacy Act (FOIPA) need to balance the benefits to the public against individuals’ rights to be left alone. Regulating the collection of personal information is a key issue in privacy protection, thereby avoiding excessive surveillance of individuals.

Personal information is defined as the recorded information about an identifiable person in section 1(n) of the FOIPA Act, including the individual’s race, color, ethnic or national origin; sex; age; the inheritable characteristics of the individual; Information regarding physical or mental disability of an individual; And any other recognizable features set out in that section.

Surveillance System refers to an electronic or mechanical system or device that allows continuous or periodic video recording, observing or monitoring of personal information about individuals in open, public spaces, public buildings (including hospitals and government buildings, libraries, health care facilities, public housing, and educational institutions) or public transportation, including school and municipal transit buses or other similar vehicles.

Tips for Healthcare and Hospital Security

Health care and the security of hospitals is no easy task. Integrated safety systems need to work together to protect patients, doctors, and visitors as well as medicines, equipment, and data. Security cameras, alarms, and access control points all must work together to keep the building safe without hindering operational flow. On top of it all, these devices need to be noticeable enough to make people feel comfortable without offending them.

Surveillance Cameras in Healthcare

Hospitals and healthcare facilities face additional challenges with security cameras, as they must comply with federal FOIA rules. Clearly, outdoor CCTV cameras do not violate the laws, but indoor cameras have to be strategically positioned in public areas to avoid breaking the confidentiality of patients. Most hospitals and doctor’s offices have signs that indicate visitors are being recorded or monitored; in the waiting rooms, lobbies, equipment and medicine storage areas, storage closets, and hallways. On the other hand, records made in operating or treatment rooms could very well contain protected health information (PHI) that needs to be specially securely stored and transmitted, if at all.

Recording and Using Visual and Audio Recordings of Patients

Surveillance cameras are increasingly being deployed in health care facilities, nursing homes, and assisted living facilities, with insufficient attention to what is ethically fraught about this way of assuaging concerns about abuse and other personnel challenges. With seven state laws now regulating camera monitoring and more on the way, it is critical to consider the ethical implications of how technology is used to keep older adults safe, by addressing three ethical issues: The risk to residents privacy and dignity from in-room cameras, And the likely extension of camera use by the facilities to monitor personnel and residents.

The application of web-enabled video cameras for care purposes is becoming normalized, from nanny and child cams to pet cams. With increasing accessibility and affordability, families with loved ones in nursing homes or assisted living often turn to monitor cameras to protect older people in residential care, hoping this monitoring will help protect their loved ones from harm. This phenomenon presents complex legal, ethical, and public health concerns.

The increasing use of technologies such as video and picture messaging has made it considerably easier to record, copy, and transmit recordings of patients. Doctors need to bear in mind that when used for clinical purposes, such recordings form part of the patient’s medical record and the same standards of confidentiality, and the same requirements for consent to the disclosure, apply. When such permission isn’t given, then redaction of confidential information is a must before sharing such information under FOIA. For this, hospitals require automatic redaction software for video redaction as well as the redaction of audio files and the redaction of pdf documents.

Redaction of Sensitive Information for FOIA Requests

If you’re part of a hospital staff or government agency that receives a request under FOIA, you know that it is the duty of your agency to check for documents in response to the application and then review those records to decide which – and which sections – can be shared.

If you find information that is deemed too sensitive to release, you will need to redact it before you send the releasable records to the requestors. Electronic records can easily be redacted using a competent redaction software, making it impossible to determine images, videos, or words that have been withheld.

How to Redact Information Effectively in an FOIA Requested Document?

Secure redaction is a far more complicated issue with electronic files than it is with physically printed documents. Where text is redacted by overlaying graphical elements (e.g. dark rectangles) on text in Portable Document Format (PDF) or word processor formats, the original text remains in the file and can be exposed by basically deleting the overlaid graphics.

Effective redaction of electronic documents requires that all relevant text or image data be removed from the document file and not merely put a dark rectangle on it. Redaction software designed to redact electronic documents are required to do so.

Using PDF redaction software is a simple two-step process that involves first marking the text or graphics for redaction, then applying the redaction. Once you apply the redaction, that content will be gone permanently.

Search and Remove Text in PDF

You can also search for the text you wish to redact to ensure it is omitted from your PDF document. This makes redacting information that appears in multiple locations inside your document quick and easy.

Redaction at Scale

Many large medical facilities receive and develop a considerable number of documents that require standardization in areas such as compliance and accessibility. If your hospital needs to standardize PDF, video and audio services across the organization, create a cornerstone for compliance projects, and have the ability to redact documents at scale, consider redaction services that can redact hundreds of documents, audio and video files quickly using automated redaction based on pattern recognition. All in all, redaction features in our software can help ensure your organization is properly handling FOIA requests at any level.

Conclusion

By understanding FOIA purpose and key provisions, public health workers, law enforcement, journalists, and researchers can make use of this powerful tool to obtain information about important public health issues. With other relevant laws such as the FOIA, FOIA can help ensure that relevant information is disclosed to the public and help advocates of all backgrounds and ideologies participate in government decision-making. Public health workers in government agencies who understand the purpose of FOIA and similar state laws can help promote transparency and accountability in government by being responsive to FOIA requests when received and by correctly understanding the relevant exemptions, and when and how they should apply.

Respect for the confidentiality of patients’ information is a fundamental principle of ethical and effective medical practice. It ensures each patient’s privacy and, more broadly, it upholds public perception of the quality of the healthcare system and its professionals. Never forget that great institutes can lose the business with trivial litigations when fundamental principles of privacy are violated.