Use and disclosure of patient information
The following categories describe different purposes for which we may use and
disclose your patient information without the specific written authorization of
you (or your parent or other personal representative). We explain each category
of use or disclosure below and include examples, but we do not list every use or
disclosure in a category.
However, for certain other activities and purposes, we must obtain your
written authorization to use or disclose your patient information. For instance,
we will obtain written authorization before disclosing any of your patient
information when required by law, including laws providing extra protection for
information or records about HIV/AIDS testing, mental health or developmental
disability services, alcohol or drug abuse treatment services, genetic testing,
child abuse or sexual assault.
Treatment
We may use patient information about you to provide you with treatment
services, for example, to diagnose or treat your injury or illness. We may
disclose patient information about you to physicians, nurses, counselors, or
other treatment personnel who are involved in taking care of you. Our different
treatment areas may share patient information about you in order to coordinate
the different services you need, such as prescription drugs, lab tests or
radiology tests. We also may disclose patient information about you to health
care providers outside our facilities and offices who are involved in your
treatment.
Payment
We may use and disclose patient information about you so that the treatment
and services you receive may be billed to and payment may be collected from you,
a health insurance company, another health plan or other third party responsible
for paying for your treatment. For example, we may need to give your health plan
information about treatment you received so your health plan will pay us or
reimburse you for your treatment. We may also contact your health plan about a
treatment you are going to receive to obtain prior approval or to determine
whether your plan will pay for the treatment.
Health Care Operations
We may use and disclose your patient information for our health care
operations, which include internal administration and planning and various
activities that improve the quality and cost effectiveness of the care that we
deliver to you. For example, we may use patient information to evaluate the
quality and competence of our physicians, nurses and other treatment personnel.
We may disclose patient information to our Patient Relations representatives in
order to resolve any complaints you may have and ensure that you have a
comfortable visit with us.
Appointment Reminders
We may also use and disclose patient information to contact you as a reminder
that you have an appointment or missed an appointment for treatment in order to
reschedule the appointment.
Treatment Follow-up Alternatives
We may use and disclose patient information to tell you about
or recommend possible continuing care options that will benefit
you.
Research: We may use or disclose your patient information
without your authorization if our Institutional Review Board approves a waiver
of authorization. If a waiver has not been approved, your written authorization
will generally be required before your health information is used for
research.
Directory of Individuals in Children’s Memorial Hospital
We may include your name, location in Children’s Memorial Hospital, general
health condition and religious affiliation in a patient directory unless you
object to inclusion in the directory or are located on a unit which indicates
that you
are receiving treatment for a mental illness or
developmental disability. Unless you request restrictions
on the disclosure of directory information, it may be disclosed to anyone who
asks for you by name or members of the clergy; provided, however, that religious
affiliation will only be disclosed to members of the clergy.
Relatives, Close Friends and Other Caregivers
If we (1) obtain your agreement; (2) provide you with the opportunity to
object to the disclosure and you do not object; or (3) reasonably infer that you
do not object to the disclosure, we may disclose your patient information to a
family member, other relative, a close personal friend or any other person
identified by you when you are present for, or otherwise available prior to, the
disclosure.
If you are not present or in the case of your incapacity or an emergency, we
may exercise our professional judgment to determine whether a disclosure is in
your best interests and then disclose only information that we believe is
directly relevant to the person’s involvement with your health care or payment
related to your health care.
We may also disclose your patient information in order to notify (or assist
in notifying) your caregivers of your location, general condition or death. For
instance, in the event of a disaster, we may disclose your location, general
condition or death to a disaster relief organization so that it may notify your
caregivers of such information.
Philanthropic Communications
In the continuing effort to enhance Children’s Memorial Hospital’s capacity
to conduct its mission of
service to children and families,
periodic communications and invitations to consider
philanthropic support may be sent to patient families and friends of the
hospital. In connection with any such communication or request, we may use
demographic information and dates on which we provide health care to you or your
child or disclose that information to Children’s Memorial Foundation or its
related philanthropic organizations.
Marketing
We will obtain your written authorization before using patient information
about you to send you any marketing materials. However, we may provide you with
marketing materials in a face-to-face encounter and/or give you a promotional
gift of minimal value. We may also communicate with you about products or
services relating to your treatment, care settings or alternative therapies.
As Required by Law
We will disclose patient information when required to do so by federal, state
or local law.
To Avert a Serious Threat to Health or Safety
We may use and disclose patient information about you when necessary to
prevent a serious threat to your health and safety or the health and safety of
the public or another person. Any disclosure, however, would only be to someone
able to help prevent or avoid the threatened or imminent harm.
Workers’ Compensation
We may release patient information about you to comply with state laws
regulating workers’ compensation or similar programs providing benefits for
work-related injuries or illness.
Public health activities
We may disclose patient information about you for public health activities
authorized or required by law. These activities include disclosures:
- To public health authorities to prevent or control
disease, injury or disability;
- To report child abuse or neglect to the Department of
Children and Family Services;
- To report reaction to medication or problems with
products to the United States Food and Drug Administration; or
- To notify a person who may have been exposed to a disease or may be at
risk for contracting or spreading a disease or condition.
Health Oversight Activities
We may disclose patient information to a health oversight agency for
activities authorized by law. These oversight activities include, for example,
audits, investigations, inspections, and licensure. These activities are
necessary for the government to monitor the health care system, government
programs, and compliance with civil rights laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose patient
information about you in response to a proper court order, subpoena, or other
lawful process from someone else involved in the dispute.
Law Enforcement
We may release patient information about you to the police or other law
enforcement officials if the release is required or allowed by applicable law or
to comply with a proper court order, grand jury or administrative subpoena or
similar legal process.
Medical Examiners
We may also release patient information about a decedent to a coroner or
medical examiner. This may be necessary, for example, to identify a deceased
person or determine the cause of death.
Organ and Tissue Procurement
We may disclose your patient information to organizations that facilitate
organ, eye or tissue procurement, banking or transplantation.
Specialized Government Functions
Under limited circumstances authorized by law and for national security and
intelligence purposes, we may release patient information about you to
authorized federal government officials for intelligence, counterintelligence,
and other national security activities.