The Tension Between Confidentiality and Accessibility保密性与可达性之间的张力.pptVIP

The Tension Between Confidentiality and Accessibility Edward B. Goldman, J.D. Deputy General Counsel University of Michigan October 10, 2007 Michigan Confidentiality Law Any information acquired to treat a patient may not be disclosed to any third party. Except: To defend a malpractice action, avoid injury to a child, vulnerable adult or identified third party, obtain payment, respond to a court order, protect the public health, etc. Federal Confidentiality laws Substance abuse information. HIPAA Privacy (Health Insurance Portability and Accessibility Act of 1996): Any patient information can only be used for treatment, billing or normal operations. Any other use requires a specific patient authorization except... 04/03 HIPAA Privacy Requires a Notice of Privacy Rights. Confidentiality exceptions for public health purposes, child or vulnerable adult abuse,law enforcement, and many many other listed exceptions. Use and disclosure law. Issue: Proper balance? Case Example 1 A child is transported from Rural to Academic Hospital. Rural wants to know the outcome of the case. The child did well and does not need further care. Can Academic tell Rural the medical details? Can they say anything? (Issue: Is there an ongoing treatment relationship? QA rational?) Case Example 2 Hospital has an electronic medical record. It is password protected. Nurse signs on to document care for a patient then is called away for a patient emergency. The computer is left on and a visitor uses the computer to look up his neighbors medical record. Who is responsible? (Time out or biometrics needed?) Case Example 3 It’s May 1, 2003. New mother gives birth to New Baby. There is a chart for both mother and child. Father wants to see both charts. Is that allowed? Is the information about mom in the babies chart protected? i.e. Must mom give consent to allow it to be seen? Can the information be used for care? Case Example 3 Continued Can the treating staff use the data for QA? For Grand Rounds? For