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use_and_disclosure_of_health_information [2016/01/19 12:16]
jillian_nadette_de_leon 		use_and_disclosure_of_health_information [2016/07/19 15:27] (current)
jillian_nadette_de_leon
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-##USE AND DISCLOSURE OF HEALTH INFORMATION+##USE AND DISCLOSURE OF HEALTH INFORMATION\\
  
-  ​* Use of health information shall include ​the following purposes: \\ +**Use and Disclosure.** Use and disclosure ​of health information shall only be to the extent of consent given by the patient and for the following purposes:​\\ 
-a. For planning of quality services\\ +a.) For planning of quality services;\\ 
-b. DOH reporting intervention and disease prevention\\ +b.) Requirement for reporting for communicable, infectious ​and other notifiable diseases as well as those with serious health and safety threat to the public such as, but not limited to: \\ 
-c. Continuing care to patients\\ +1.) Meningitis\\ 
-d. Requirements and reporting for communicable and notifiable diseases as well as those with serious health and safety threat to public such as, but not limited to:\\ +2.) Food poisoning (mass)\\ 
-//Meningitis// +3.) Breakthrough epidemic of contagious disease\\ 
-//Food poisoning (mass)// +4.) Biological or chemical warfare\\ 
-//Breakthrough epidemic of contagious disease// +5.) Emerging and re-emerging diseases\\ 
-//Biological or chemical warfare// + c.) Continuing care to patients;\\ 
-//​Anthrax//​ +d.) Reporting of physical injury;\\ 
-//Emerging and re-emerging diseases// +e.) Reporting of interpersonal violence ​to proper authorities;\\ 
-//Ebola// +f.) Reporting of diseases as registered in the Philippine Integrated Disease Surveillance and Response;\\ 
-e. Reporting of serious and less serious ​physical injury.\\ +g.) Mandatory reporting required by licensing and accreditation bodies (Department of Health, Philippine Health Insurance Corporation, Department ​of Interior ​and Local Government, Department ​of Social Welfare ​and Development).\\
-f. Reporting of maltreated or abused child to proper authorities.\\ +
-g. Mandatory reporting required by licensing and accreditation bodies (DOH, PhilHealth, etc). A list of mandatory reporting requirements shall be stipulated.\\ +
-  * Use and disclosure of health information shall only be to the extent of consent given by the patient.\\ +
-  * After discharge from the hospital the following information can be disclosed:​\\ +
-a. Clinical abstract\\ +
-b. Laboratory result\\ +
-c. Doctor'​s order\\ +
-d. Discharge summary\\ +
-  * The health facility shall continue keeping the patient'​s health records and shall have the power to limit access regarding the data to be disclosed.\\ +
-  * Both patient and physician must provide consent for the use and disclosure of privilege communication otherwise, information shall not be released.\\ +
-  * The PHCP has the authority to disclose information upon patient request for his legitimate personal use such as: \\ +
-a. Release ​of insurance/​HMO required medical record;\\ +
-b. For patients who are U.S. war veterans, they should come with a signed consent to release medical records;​\\ +
-c. However, there should be a clear agreement/​contract made between HMO and patient to stipulate the consent of the patient enrolled in the HMO.\\+
  
-**Use and disclosure of health information by 3rd party:** +**Deceased Individuals.** Disclosure ​of health information of a deceased individual ​shall be to the authorized legal representative.\\
-  * The person to issue the order for the use and disclosure ​of health information ​to DOH shall be identified.\\ +
-  * A process on how to disclose medico-legal cases should be defined. PNP Duces Tecum shall be honored and complied with, if signed by the head of the agency.\\ +
-  * As a general rule, before a disclosure is to be made to any other government agency, there must be a court order. It is only in cases of emergency such as that provided in Sec.15, where disclosure can be done without court order. This would be situations where time is of the essence. The situations contemplated are: \\ +
-a. For PNP subpoena, obtain consent of patient before death otherwise, consent should be obtained from next of kin.\\ +
-b. For medical/​financial assistance requesting abstracts or similar documents; authorization of patient is required.\\ +
-  * Unless there is a valid court order, patient records ​shall not be released or disclosed. Without a court order, release of information shall be pursuant ​to hospital policy.\\ +
-  * All research protocols pertaining to patient condition shall pass thru strict review by the IRB (Institutional Review Board) to safeguard patient information. Protocols for requesting and accessing aggregate and de-identified information for research, both public and private, should be clearly defined.\\ +
-  * Guidelines for retrieval of information for purposes of PRC requirements for application abroad should be made.  +
-  * For facilities that are not participating in PHIE, they shall:  +
-a. Make a workflow and a notification protocol for reporting requirements. (Suggestion:​ to use the present epidemiologic surveillance framework)\\ +
-b. Immediately notify the RESU (using the present framework) then the DOH will notify the EMR, the EMR to the facility. The EMR must have codes which gives them the signal to release the information.\\+
  
-**Others:** +**For medico-legal cases.** For medico-legal cases, information may be disclosed to the authorized personnel in-charge upon authorization from the patient or authorized representative (in case when the patient is deceased).\\
-  * There should ​be an orientation for patients regarding data privacy disclosure. \\ +
-  * In case of a deceased patient separated with his/her partner but not legally separated and the partner is requesting for patient's health record for purposes of claims, what is the rule for disclosure?\\+
  
 +**Legal Authorities and/or Government Agencies.** Before a disclosure is made to any other government agency, there must be a court order. It is only in cases of emergency where disclosure can be done without court order. This would be situations where time is of the essence such as:\\
 +1.) For PNP Subpoena, consent is not required from next of kin.\\
 +2.) For medical or financial assistance requiring abstracts or similar documents, authorization of patient is required.\\
 +3.) For DOH programs and other government agencies providing financial public assistance, the said agency shall only disclose de-identified information.\\
  
 +Without a court order, release of information shall be pursuant to hospital policy otherwise, patient records shall not be released or disclosed.\\
  
 +When personal health information is released to legal authority, a cover letter shall be sent containing information reminding the recipient that the information contained is personal health information and must be handled in a confidential manner. A receiving copy shall be maintained by the health care provider for record purposes. \\
 +
 +**Privilege Communication.** Both patient and physician must provide consent for the use and disclosure of patient information for purposes, otherwise, information shall not be released.\\
 +
 +**Training Hospitals and Academic or Clinical Requirement Purposes.** Guidelines for retrieval of information for purposes of Professional Regulation Commission requirements shall be made by participating health care providers. A non-disclosure clause shall be included in the contract of schools with affiliations to a PHCP. Personnel and/or students accessing data for academic or clinical requirement purposes shall also sign a non-disclosure agreement. ​
 +
 +
 +
 +##Others
 +  *   ​Patient orientation regarding data privacy disclosure shall be done. 
 +
 +References:​\\
 +  * Herold R., Beaver K. (2015). //The Practical Guide to HIPAA Privacy and Security Compliance. 2nd edition.// Boca Raton, FL: CRC Press.