[Federal Register Volume 70, Number 80 (Wednesday, April 27, 2005)]
[Notices]
[Pages 21740-21743]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-8057]


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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