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**This is an old revision of the document!**

  1. Use of health information shall include the following purposes:
    * For planning of quality services
    * DOH reporting intervention and disease prevention
    * Continuing care to patients.
  2. Use of health information shall only be to the extent of consent given by the patient.
  3. DOH may order the use and disclosure of health information for identification of highly contagious diseases and other emergency or disaster situations.
    4, Person/officer of DOH who is responsible to issue order should be identified. Secretary of Health or any designated official.
  4. Use and disclosure of health information for:
    * Requirements and reporting of communicable and notifiable diseases.
    * Reporting of serious and less serious physical injury.
    * Reporting of maltreated or abused child to proper authorities.
    * Mandatory reporting required by licensing and accreditation bodies (e.g. DOH, PhilHealth, etc)
    5 a. Stipulate list of mandatory reporting requirements.
  5. The following data/information can be disclosed after discharge from the hospital:
    * Clinical abstract
    * Laboratory result
    * Doctor's order
    * Discharge summary
  6. PNP Subpoena Duces Tecu, should be honored and complied with, if signed by the head of the agency.
  7. Process on how to disclose medico-legal cases.
  8. The health facility is in the position to identify and recognize serious health and safety threat to the public. Serious health and safety threat to the public shall include the following:
    * Meningitis
    * Food poisoning (mass)
    * Breakthrough of epidemic contagious disease
    * Biological/ chemical warfare
    * Anthrax
    * Notifiable diseases
    * Emerging and re-emerging diseases
    * Ebola
  9. 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:
    * For PNP subpoena, obtain consent of patient before death otherwise, consent should be obtained from next of kin.
    * For medical/financial assistance requesting abstracts or similar documents; authorization from patient is required.
    10 a. For medical and financial assistance regarding Abstract, only the next of kin shall be allowed.
  10. 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.
  11. The hospital shall develop a policy for the release of information which includes requirements for identification and authorization.
    12 a. For authorization, the authorizing entity shall provide any of the following for identification: biometrics, specimen signature, e-signature.
    12 b. Set controls to safeguard patient information: consent, tracking of records, establish authorization per access.
  12. Hospitals shall continue keeping patient's health records pursuant to own hospital policy.
  13. Hospital will be the custodian or records and has the power to limit access regarding the data to be disclosed.
  14. Privilege communication under the rules of court covers the communication between a physician and patient regarding any advice or treatment given by him (physician) or any information which he may have acquired in attending to the patient in professional capacity and which would blacken the reputation of the patient.
    15 a. Both patient and physician must provide consent for use and disclosure of privilege communication otherwise, information shall not be released.
  15. The PHCP should transmit information from patient's records to the PHIE as shared health record: - If patient consents, the patient's shared health record may be processed in PHIE without the need of de-identification. - If patient does not consent to participate in PHIE, the patient's health information shall be de-identified containing only information necessary for generation of health statistics.
  16. As custodian of health information, the PHCP has the authority to disclose information upon patient request for his legitimate personal use: release of insurance/HMO required medical record, for patient who are US war veterans, they should come with a signed consent to release medical records.
    17 a. Situation: HMO requesting for health records of the patient:
    * There should be a clear agreement or a contract should be made that will stipulate consent of patient enrolled in HMOs.
  17. Specify the information that can be disclosed or withheld.
  18. There should be an orientation for the patients regarding Data Privacy Disclosure.
  19. Management policy in use and disclosure of health information must be established.
  20. Special codes shall be assigned to cases that pose a potential public health concern. (HIV)
  21. All research protocols pertaining to patient condition shall pass thru strict review by the IRB (Institutional Review Board) to safeguard patient information.
    22 a. Protocols for requesting and accessing aggregate and de-identified information for research, both public and private, should be clearly identified.
    22 b.Creation of IRB on ethical standards to all government and private health sectors to monitor disclosure of health information.
    22 c. Accreditation of research facilities by DOH.
  22. Identify who is the authorized person to use the information in consideration to the approval of the shared info. A criteria or basis is up to approval.
  23. Disclosure of medical records to medical students: Guidelines for retrieval of information for purposes of PRC requirements for compliance application abroad should be made.
    24 a. Suggest to PRC to require other certification instead of requiring nursing students applying for NLE to submit the list of cases that these students handled.
  24. Medical representatives should review their contract.
  25. For unconscious patient: spouse, relative, or the doctor can ask for the decision of the family. In case of an unconscious patient with not relative, the doctor can decide in behalf of the patient.
  26. In case of minor patients, notify them when they come of legal age.
  27. ISSUE: Facilities that do not participate in PHIE, in-case of de-identified data, PHIC will hod the benefits or the capitation:
    * A workflow should be made. A need for a notification protocol. Suggest making a flow chart. (Suggestion to use the present epidemiologic surveillance framework)
    * Health facility shall immediately notify the RESU (using the present framework).
    * DOH notifies the EMR, EMR to the facility.
    * EMR suggested to have codes which gives them the signal to release the information.

To ponder on:
1. In case of a deceased patient separated with his/her partner but not legally separated and the partner is requesting for the patient's health record for purposes of claims, what is the rule for disclosure?

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See Also