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.
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.
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.
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 & 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.
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.
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.
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
- 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 & 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.
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.
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 & 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.