[Federal Register Volume 71, Number 61 (Thursday, March 30, 2006)]
[Notices]
[Pages 16127-16130]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-3076]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[DOD-2006-OS-0053]


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 is altering a system of 
records to its existing inventory of record systems subject to the 
Privacy Act of 1974 (5 U.S.C. 552a), as amended.

DATES: The changes will be effective on May 1, 2006 unless comments are 
received that would result in a contrary determination.

ADDRESSES: Send comments to the 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) 696-4940.

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 March 23, 2006 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: March 24, 2006.
L.M. Bynum,
OSD Federal Register Liaison Officer, Department of Defense.
DHA 07

System Name:
    Military Health Information System (August 3, 2005, 70 FR 44574).

Changes:
* * * * *

Categories of records in the system:
    Add the following to the paragraph titled ``CLINICAL ENCOUNTER 
DATA'': ``The Protected Health Management Information Tool (PHMIT), an 
electronic disclosure-tracking tool, assists in complying with the 
HIPAA Privacy disclosure accounting requirement. The PHIMT stores 
information about all disclosures, complaints, authorizations, 
restrictions and confidential communications that are made about or 
requested by a particular patient.''

[[Page 16128]]

* * * * *
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 Deitrick, 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 22041-3241. Joint Task Force Sexual 
Assault Prevention and Response Office (JTF-SAPR), 1401 Wilson Blvd., 
Suite 402, Arlington, VA 22209-2318. 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 or DHHS healthcare delivery programs where such programs effect 
benefits determinations between these Department-level programs, 
continuity 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 
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. The Protected Health Management Information Tool (PHMIT), 
an electronic disclosure-tracking tool, assists in complying with the 
HIPAA Privacy disclosure accounting requirement. The PHIMT stores 
information about all disclosures, complaints, authorizations, 
restrictions and confidential communications that are made about or 
requested by a particular patient.
    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 and outpatient 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 
rahter 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

[[Page 16129]]

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 
empowerment 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 predeployment 
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 lost 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.
    Data collected and maintained in electronic and paper records is 
used to track victims of sexual assault crimes, and medical and other 
support services provided to them. Data collected and maintained is 
also used to capture demographics and perform trend analysis.

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 facilitate 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 collaborative 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 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.
    The DoD `Blanket Routine Uses' set forth at the beginning of OSD's 
compilation of systems of records 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 809, 5111 Leesburg Pike, Falls Church, 
VA 22041-3201.
    Program Manager, Joint Task Force Sexual Assault Prevention and 
Response, 1401 Wilson Blvd., Suite 402, Arlington, VA 22209-2318.

Notification procedure:
    Individuals seeking to determine whether information about 
themselves is contained in this system should address written inquires 
to the TRICARE Management Activity Privacy Office, Skyline 5, Suite 
810, 5111 Leesburg Pike, Falls Church, VA 22041-3201 or Commander, 
Joint Task Force Sexual Assault Prevention and Response, 1401 Wilson 
Blvd., Suite 402, Arlington, VA 22209-2318.
    Requests should contain the full names of the beneficiary and 
sponsor,

[[Page 16130]]

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 or Commander, Joint Task 
Force Sexual Assault Prevention and Response, 1401 Wilson Blvd., Suite 
402, Arlington, VA 22209-2318.
    Requests 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. 06-3076 Filed 3-29-06; 8:45 am]
BILLING CODE 5001-06-M