http://www.vdr-soft.net/what-is-a-ddq/

As electronic documents become more prevalent courts must weigh the right of the public to have access to information on their case against the need to protect privacy. Certain states, like Iowa, have already adopted rules that limit access to certain types of files. The remaining states are mulling a variety of choices.

The first option is to maintain the presumption that all files that are not sealed must be available both at the courthouse and electronically via electronic public access. This option would require that lawyers and pro se litigants guard security and privacy concerns on a case-by case basis through motions excluding information from public access to electronic records. This alternative also implies that certain sensitive information should not be included in the files if it does not reflect an understanding of the ruling of the case.

Another limitation is that a covered entity is able to not deny access solely on the basis that it or its business associates are maintaining the PHI required by the individual (e.g. the information is held by a company that stores records offsite). This grounds of denial are only applicable to situations where an individual can demonstrate that the business associate’s management of the PHI may cause injury or harm to a significant extent.

Finally, the final ground of denial comes into play if an accredited health care professional concludes in the exercise of their professional judgment that granting access to a specific person’s PII is likely to put at risk the life or physical security of the individual. This exception must be interpreted narrowly to safeguard the autonomy of individuals and their right to make informed decisions regarding their health under the Privacy Rules.