Is this form HIPAA compliant?

WIC is not a HIPAA Covered Entity and is governed by federal regulations related to Personally Identifiable Information (PII). However, the WIC Referral System follows HIPAA protocols and procedures for data collection and storage.

The application that stores the information entered into this form meets the security requirements required for HIPAA. Access to referral data is obtained through an electronic application. This application has role-based access and is only seen by WIC staff who would be following up with referrals or monitoring referral progress for WIC. This application is hosted across the web on a SSL (Secure Socket Layer Line) and the information is stored on a database that is within a classified network of servers hosted currently at eFort. This classified architecture only hosts applications that involve PII and PHI datasets.

In regards to a medical practitioner entering data for referral, the HIPAA Privacy Rule allows those doctors, nurses, hospitals, laboratory technicians, and other health care providers that are covered entities to use or disclose protected health information, such as X-rays, laboratory and pathology reports, diagnoses, and other medical information for treatment purposes without the patient’s authorization. This includes sharing the information to consult with other providers, including providers who are not covered entities, to treat a different patient, or to refer the patient (i.e. referral to WIC). See 45 CFR 164.506.