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use_and_disclosure_of_health_information [2016/01/25 14:46] jillian_nadette_de_leon |
use_and_disclosure_of_health_information [2016/06/28 23:31] 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: \\ | + | * A formal procedure to authorize disclosure of personal health information shall be developed by health facilities.\\ |
| - | a. For planning of quality services\\ | + | |
| - | b. DOH reporting intervention and disease prevention\\ | + | * Use and disclosure of health information shall only be to the extent of consent given by the patient and for the following purposes: \\ |
| - | c. Continuing care to patients\\ | + | a. For planning of quality services.\\ |
| - | 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:\\ | + | b. DOH reporting intervention and disease prevention.\\ |
| + | c. Continuing care to patients.\\ | ||
| + | d. Requirements and reporting for communicable and notifiable diseases as well as those with serious health and safety threat to the public such as, but not limited to:\\ | ||
| //Meningitis//\\ | //Meningitis//\\ | ||
| //Food poisoning (mass)//\\ | //Food poisoning (mass)//\\ | ||
| Line 16: | Line 18: | ||
| e. Reporting of serious and less serious physical injury.\\ | e. Reporting of serious and less serious physical injury.\\ | ||
| f. Reporting of maltreated or abused child to proper authorities.\\ | 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.\\ | + | g. Reporting of diseases as registered in the Philippine Integrated Disease Surveillance and Response; |
| - | * Use and disclosure of health information shall only be to the extent of consent given by the patient.\\ | + | h. 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). \\ |
| - | * After discharge from the hospital the following information can be disclosed:\\ | + | |
| + | //Deceased Individuals.// Disclosure of Health information of a deceased individual shall be to the authorized legal representative. For medico-legal cases, information may be disclosed to the next of kin or to the legal representative.\\ | ||
| + | |||
| + | //Privilege Communication//\\ | ||
| + | * Both patient and physician must provide consent for its use and disclosure otherwise, information shall not be released. The PHCP has the authority to disclose information upon patient request for his legitimate personal use.\\ | ||
| + | |||
| + | //Information disclosed after discharge//\\ | ||
| + | * The following information may be disclosed after patient discharge from the health facility:\\ | ||
| a. Clinical abstract\\ | a. Clinical abstract\\ | ||
| b. Laboratory result\\ | b. Laboratory result\\ | ||
| c. Doctor's order\\ | c. Doctor's order\\ | ||
| d. Discharge summary\\ | 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.\\ | + | e. Medical Certificate\\ |
| - | * Both patient and physician must provide consent for the use and disclosure of privilege communication otherwise, information shall not be released.\\ | + | f. Prescription\\ |
| - | * 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;\\ | + | **Use and disclosure of health information to legal authorities/government agencies:**\\ |
| - | b. For patients who are U.S. war veterans, they should come with a signed consent to release medical records;\\ | + | * 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: \\ |
| - | 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 a 3rd party:** | + | |
| - | * 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.\\ | 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.\\ | + | 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.\\ | + | *Without a court order, release of information shall be pursuant to hospital policy otherwise, patient records shall not be released or disclosed.\\ |
| - | * 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.\\ | + | |
| - | * A non-disclosure clause shall be included in the contract of the schools with affiliations to a health facility.\\ | + | |
| - | **Others:** | + | * //Release of Health Information to Legal Authorities.// 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 facility for record purposes.\\ |
| - | * 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?\\ | + | **Use and Disclosure of Health Information by a third party:**\\ |
| + | * Third party providers shall not disclose health information other than as provided by contract with the PHCP or as required by law. They shall also agree to use appropriate safeguards to prevent use and disclosure of the health information other than as provided by contract with the primary health care provider or as required by law. | ||
| + | * Third party providers shall report to the primary health care provider any use or disclosure of health information not provided for by the agreement of which it becomes aware, including breaches of unsecured health information, and any security incident of which it becomes aware.\\ | ||
| + | |||
| + | * All research protocols pertaining to patient condition shall pass thru strict review by the Institutional Review Board or Ethics Review Board by Hospitals or Academe to safeguard patient information. Protocols for requesting and accessing aggregate and de-identified information for research, both public and private, shall be clearly defined by health facilities. All research data collected shall not be subject to commercial purposes.\\ | ||
| + | * //Information gathered by training hospitals and students for academic requirement purposes.// Guidelines for retrieval of information for purposes of Professional Regulation Commission requirements shall be made by health facilities. A non-disclosure clause shall be included in the contract of schools with affiliations to a health facility. Personnel and/or students accessing data for academic requirement purposes shall also sign a non-disclosure agreement.\\ | ||
| + | |||
| + | * For facilities 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 | ||
| + | * 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. | ||