A Study of U.S. Battlefield Medical Treatment/Evacuation Compliance with HIPAA Requirements

The Health Insurance Portability and Accountability Act (HIPAA, 1996) requires secure and private treatment of medical information. Congress included the U.S. military healthcare system under HIPAA´s umbrella. However, a combat environment can place unusual constraints on the provision of medical services. This paper develops a model of battlefield medical treatment and evacuation, and then uses the knowledge of experts in a Delphi group to assess the completeness and accuracy of that model, and to recommend improvements to the process. The Delphi group agreed that partial compliance is provided for HIPAA at the beginning of treatment and evacuation, and full compliance is followed later in the process. Recommendations for improving this model were largely administrative, (written guidance, training, and use of cover sheets.) Authorities may want to revisit the issue of the partial compliance to bring law and policy into agreement with practice learned in the crucible of the battlefield.