GloucesterTimes.com, Gloucester, MA

July 10, 2008

Gloucester: Health System denies privacy breach in pregnancy numbers

By Patrick Anderson

The president of the company that runs the Gloucester High School health center yesterday denied knowledge of any breaches of patient privacy in the reporting of the numbers of pregnant students at the school this year, and said he was unaware of any statistics released by the clinic related to student pregnancies.

In a letter released yesterday responding to an inquiry by Mayor Carolyn Kirk, Northeast Health System President Stephen Laverty did not define what information was considered confidential and said he could neither confirm nor deny the accuracy of reports from Dr. Brian Orr, former medical director of the clinic, that 18 students had become pregnant from June 2007 to May 2008.

Laverty said the only statistics he was aware of were city-wide pregnancy numbers reported to the student health center's advisory board by Orr and former nurse practitioner Kim Daly. He also declined to say whether the number of pregnancy tests requested by students had been released or whether the age or grade level of any pregnant students was reported.

He said accounts of the reaction of students to any medical tests would be considered a violation and that he was "not aware" that this had occurred.

"The responses of (Addison Gilbert Hospital) to the media have been professional and did not include any information specific to the treatment of any student or constitute a breach of confidentiality," Laverty said in the letter to Kirk. "The only statistic of which I am aware is the total number of teenage pregnancies in Gloucester."

Daly told the Times in May that she had done around 150 pregnancy tests since the beginning of the school year.

A policy paper written by the advisory group in May and obtained by the Times lists the grade levels of 15 girls confirmed to be pregnant at the time. The advisory board includes the clinic staff and school, city and hospital representatives.

Laverty said the school clinic reports total visits from students by type — such as respiratory, eye and reproductive health visits — to the clinic advisory board each month and to the state Department of Public Health each year, but that the only statistics made public to his knowledge were citywide and not from the Gloucester High School health center.

A spokesman for Northeast yesterday said additional information about Laverty's response to the mayor was not available and could not say whether the company had conducted an investigation of the issue.

Attempts to reach Orr by phone were unsuccessful.

On June 27, Kirk sent a letter to Laverty that said too much medical information about Gloucester students had been released and asked what measures Northeast was taking to ensure that "no future breach" occurs.

Kirk's letter asked whether the release of statistics by clinic staff — such as the number of pregnancy tests performed, number of repeated requests for pregnancy tests, number of confirmed pregnancies, ages of students requesting tests and behavior of students receiving the results of tests — would be considered privacy violations.

Yesterday Kirk said Laverty's response had answered some of her questions, but the larger issue of whether the release of health data had allowed some students to be tracked down by the press remained.

"It is what I would expect," Kirk said about Laverty's letter. "It narrows the scope of what the next questions are. The only thing that I think needs to be looked at now is whether the data was de-identified enough."

Kirk last week said she believed federal medical privacy laws did not allow information on patient information, such as a pregnancy, to be subdivided into geographic areas smaller than a state.

Yesterday she said she intended to have the city's legal counsel, Suzanne Egan, study the federal Health Insurance Portability and Accountability Act (HIPPA) to determine whether violations had occurred.

The position that HIPPA prohibits the release of aggregate health statistics for areas smaller than a state is not commonly held in the legal or medical community, according to at least one local expert.

Kate Borten, president of The Marblehead Group, a health care privacy and security consulting firm, said this week that she did not believe pregnancy statistics released by themselves would be considered HIPPA violations.

"If it is just a statistic, it is outside HIPPA," Borten said. "If it was something that included characteristics that could be used to identify someone, that would be an issue. But if is just a number with no identifying information, then I don't think it is a violation."

In other information included in the letter to Kirk, Laverty said Northeast had not received any reports of sexual abuse from the Gloucester High School health center this year. Doctors and nurses are required by law to report any suspected abuse of minors and there had been speculation that investigations may be conducted based on the ages of some of the girls who had become pregnant.

At a news conference last month, Kirk told reporters she believed at least one report to state officials about possible abuse had been made.

Patrick Anderson can be reached at panderson@gloucestertimes.com.