to encourage
a cooperative flow of information between the hospital and the news media
to standardize
protocol for releasing information from the hospital
to ensure patients’ rights
to privacy are consistent with applicable law
Hospital’s
Spokesperson
CRMC has a public relations office staffed with professionals who are aware
of the needs and deadlines of the news media. During normal working hours,
members of the media should contact these offices first. Public relations professionals
understand the inner workings of their respective hospitals and are in a position
to gather information and provide appropriate information to the media.
After office
hours and on weekends, the house supervisor will respond to media inquiries.
The hospital
switchboard operators have the names and telephone numbers of persons designated
to respond to media inquiries. Media calls are only given to designated personnel.
Releasing
Patient Information
Privacy regulations issued by the Centers for Medicare & Medicaid Services
pursuant to the Health Insurance Portability and Accountability Act of 1996
(HIPAA) govern the use and release of a patient’s personal health information
(PHI). In the event state law or hospital policy is more restrictive than the
HIPAA privacy standards, the more restrictive law or policy will apply.
HIPAA privacy
standards have specific provisions for the release of limited “directory” information
without the patient’s consent or authorization. However, the patient
must be told about the use of the information and must be given the opportunity
to object to or restrict the use or release of the information. Unless a
patient objects, the following information may be placed in a directory.
the patient’s
name
the patient’s
location in the health care provider’s facility
the patient’s
condition, described in general terms that do not communicate specific
information about the individual
the patient’s
religious affiliation
Disclosure of
this information for directory purposes may be made to members of the clergy
or, except for religious affiliation, to other persons who ask for the individual
by name.
HIPAA privacy standards regulations establish a minimum acceptable threshold
for the use and release of PHI. State and federal law (see the following
topic, “Confidential Information”), as well as hospital policies,
may establish stricter standards. For example, hospitals should be very
cautious about releasing PHI about any patient associated with the commission
of a crime or where the safety and security of both patients and hospital
personnel may be jeopardized.
Patient
Condition Reports and Information
Patient condition may be provided consistent with the limitations imposed
by HIPAA privacy standards. If these standards are met, general condition
information
may be provided that does not communicate specific information about the individual.
CRMC uses the following one-word descriptions of a patient’s condition.
Good — Vital
signs are stable and within normal limits. Patient is conscious and comfortable.
Indicators are excellent.
Fair — Vital
signs are stable and within normal limits. Patient is conscious but may
be uncomfortable. Indicators are favorable.
Serious — Vital
signs may be unstable and not within normal limits. Patient is acutely
ill. Indicators are questionable.
Critical — Vital
signs are unstable and not within normal limits. Patient may be unconscious.
Indicators are unfavorable.
Treated and
Released — received treatment but not admitted.
Note: The term “stable” should
not be used as a condition. Furthermore, this term should not be used in
combination with other conditions, which, by definition, often indicate a
patient is unstable. With written authorization from the patient, a more
detailed statement regarding a patient’s condition and injuries or
illness can be drafted and approved by the patient or legal representative.
When accidents
occur, the media should call the hospital where the patient is transported
for a condition report. Reports at the accident scene are not official condition
reports. A condition report can be assigned to a patient only after a physician’s
assessment.
Minor
Children
Minor children (under the age of 18) may have information released with the
consent of a parent or legal guardian, in accordance with the preceding guidelines.
Minors under age 18 who are authorized to consent to specific medical procedures
under state law retain control over the use and disclosure of PHI.
Emergency
Circumstances
The privacy regulations address situations where the opportunity to object
to or restrict the use or disclosure of directory information cannot be practicably
provided because of an individual’s incapacity or emergency treatment
circumstance. In such a case, a covered health care provider may use or disclose
an individual’s directory information if the use and disclosure is (1)
consistent with a prior expressed preference of the individual, if any, that
is known to the covered health care provider; and (2) in the individual’s
best interest as determined by the covered health care provider, in the exercise
of professional judgment. Please note that conditions 1) and 2) both must apply
for a provider to release patient information under HIPAA. The covered health
care provider must provide the individual with the opportunity to object to
the use and disclosure of directory information, when practicable.
Confidential
Information
In addition to the limitations on release of PHI imposed by the HIPAA privacy
standards, state and federal law also may impose specific limitations.
The release of
any information concerning the HIV/AIDS status of a patient is prohibited
under Missouri state law.
Patients admitted
to an organized alcohol or drug-treatment program that receives any federal
support are entitled to complete confidentiality, including whether they
are in the program or not. Release of information about such patients must
be accomplished in a specific manner established by federal regulations.
Media
Access to Patients
When the media want to interview or photograph a patient, the hospital’s
authorized spokesperson will check with the appropriate hospital staff to ensure
the patient is physically and emotionally capable.
The hospital’s
authorized spokesperson must obtain the patient’s permission. If the
patient is a minor, permission must be obtained from the parent or legal
guardian.
If the patient
is under arrest, permission also must be obtained from the law enforcement
officer in charge of the patient’s custody.
Media representatives will be accompanied by a hospital public relations professional
or other appropriate staff while in the hospital and will be required to sign a confidentiality agreement prior to any interview or the gathering of any video footage.
Disasters
Hospitals or other covered entities, pursuant to the HIPAA privacy standards,
may disclose PHI to a public or private entity authorized by law or its
charter to assist in disaster relief efforts. PHI also may be released
to these types of organizations for the purpose of coordinating with such
entities in contacting a family member, personal representative or person
directly responsible for a patient’s care.
Deaths
Announcements of deaths of patients are not authorized by HIPAA. Exceptions
are made with respect to certain law enforcement inquiries; disclosures
to coroners, medical examiners and funeral directors to allow them to do
their jobs; and to family, a personal representative or another person
directly responsible for the patient’s care. Reports to public health
authorities in their role of collecting vital statistics also are an exception.
Reporters will be referred to the appropriate vital statistics agency to
obtain information that those agencies routinely make available.
Public
Information
Police reports and other information about hospital patients are often obtained
by media. The claim is frequently made that once information about a patient
is in the public domain, the media is entitled to any and all information about
that individual. This is not true. Health care providers are required to observe
the general prohibitions against releasing PHI about patients found in the
HIPAA privacy standards, state statutes or regulations and the common law,
regardless of what information is in the hands of public agencies or the public
in general. Requests for PHI from the media on grounds that a public agency,
such as law enforcement, is involved in the matter will be denied.
Emergency
Medical Services
EMS units or ambulance services that provide health care services to patients
are considered covered entities under HIPAA.
Clergy
Members of the clergy frequently request access to names of patients in a hospital
to determine if members of their congregations have been admitted. Patient
names may be released to members of the clergy if a patient has given permission.
A patient will be asked by CRMC if his or her name may be included in a
hospital directory. A patient also must be asked if religious affiliation
may be included in the directory. The patient may agree or object to the
inclusion of his or her name or religious affiliation in the directory.
If the patient objects to inclusion of his or her name, clergy may not
be told that person is in the hospital. If the patient does not object,
clergy may receive the directory information without asking for the patient
by name.
Adapted
from the Missouri Hospital Association 2002
services