MICHAEL REESE MEDICAL CENTER
CORPORATIONPRIVACY NOTICE
Effective
Date:
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US.
PLEASE
REVIEW THIS NOTICE CAREFULLY.
If
you have any questions about this notice, please contact the
Admitting/Registration Manager
Who Will Follow This NoticeThis notice describes our hospital’s privacy
practices including those of:
Ø Any healthcare professional
authorized to enter information into your medical chart;
Ø All departments and units of
the Hospital and/or clinics you may visit;
Ø Any member of a volunteer
group we allow to help you while you are in the Hospital;
Ø All employees, staff and
other personnel who may need access to your information; and
Ø Those entities, sites and
locations listed below who may share medical information with each other for
treatment, payment, or hospital operation purposes described in this notice.
Ø Cambridge Manor Health and
Wellness Program; Centro Medico-Back of the Yards; Centro Medico-Pilsen; Chicago Osteopathic Clinic; Chicago Radiation
Oncology, Dialysis Centers of America; Emergency Care Physician Services; JEG
Diversified Healthcare; Michael Reese Anesthesiology Associates; Midwest NeoPeds; Pathology Associates of Chicago, Ltd; Unimed, Ltd; and Sodexo
Management, Inc.
Our Pledge Regarding Medical Information
We understand that medical
information about you and your health is personal. We are committed to
protecting medical information about you. We create a record of the care and
services you receive at the hospital. We need this record to provide you with
quality care and to comply with certain legal requirements. This notice applies
to all of the records of your care generated by the hospital, whether made by
hospital personnel or your personal doctor. Your personal doctor may have
different policies or notices regarding the doctor's use and disclosure of your
medical information created in the doctor's office or clinic.
This notice will tell you
about the ways in which we may use and disclose medical information about you.
We also describe your rights
and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
·
make sure that medical information that identifies you is kept private;
·
give you this notice of our legal duties and privacy practices, and
your rights with respect to medical information about you; and
·
follow the terms of the notice that is currently in
effect.
The following categories
describe different ways that we use and disclose medical information. For each
category of uses or disclosures we will explain what we mean and try to give
some examples. Not every use or disclosure in a category will be listed.
However, all of the ways we are permitted to use and disclose information will
fall within one of the categories.
For Treatment. We may use medical
information about you to provide you with medical treatment or services. We may
disclose medical information about you to doctors, nurses, technicians, medical
students, or other hospital personnel who are involved in taking care of you at
the hospital. For example, a doctor treating you for a broken leg may need to
know if you have diabetes because diabetes may slow the healing process. In
addition, the doctor may need to tell the dietitian if you have diabetes so
that we can arrange for appropriate meals. Different departments of the
hospital also may share medical information about you in order to coordinate
the different things you need, such as prescriptions, lab work and x-rays. We
also may disclose medical information about you to people outside the hospital
who may be involved in your medical care after you leave the hospital, such as
family members, clergy or others we use to provide services that are part of
your care.
For Payment. We may use and disclose
medical information about you so that the treatment and services you receive at
the hospital may be billed to and payment may be collected from you, an
insurance company or a third party. For example, we may need to give your
health plan information about surgery you received at the hospital so your
health plan will pay us or reimburse you for the surgery. We may also tell your
health plan about a treatment you are going to receive to obtain prior approval
or to determine whether your plan will cover the treatment.
For Health Care Operations. We may use and disclose your medical
information in connection with our health care operations. Health care operations include:
· quality assessment and
improvement activities;
· reviewing the competence or
qualifications of health care professionals, evaluating practitioner and
provider performance, conducting training programs, accreditation,
certification, licensing or credentialing activities;
· medical review, legal
services, and auditing, including fraud and abuse detection and compliance;
· business planning and
development; and
· business management and general
administrative activities, including management activities relating to privacy,
customer service, resolution of internal grievances, and creating de-identified
medical information or a limited data set.
We may disclose your medical
information to another entity which has a relationship with you and is subject
to the federal Privacy Rules for their health care operations relating to
quality assessment and improvement activities, reviewing the competence or
qualifications of health care professionals, or detecting or preventing health
care fraud and abuse.
Appointment Reminders. We may use and disclose
medical information to contact you as a reminder that you have an appointment
for treatment or medical care at the hospital or any of our care locations.
Health and
Treatment Related Services. We may use your medical information to contact you
with information about health-related benefits and services or about treatment
alternatives that may be of interest to you.
We may disclose your medical information to a business associate to
assist us in these activities.
We may use or disclose your
medical information to encourage you to purchase or use a product or service by
face-to-face communication or to provide you with promotional gifts.
Fundraising. We may use your demographic
information and the dates of your health care to contact you for our
fundraising purposes. We may disclose
this information to a business associate or foundation to assist us in our fundraising
activities. When we provide you with any
fundraising materials, we will include a description of how you may opt out of
receiving future fundraising communications.
Hospital Patient Directory. We may use your name and your location in our
hospital patient directory. We will
disclose this information to members of the clergy and to other persons who ask
for you by name. We will provide you
with an opportunity to prohibit disclosures for our hospital patient directory
unless emergency circumstances prevent your opportunity to object.
To Your Family and Friends. We may disclose your medical
information to a family member, friend or other person to the extent necessary
to help with your health care or with payment for your health care. We may use
or disclose your name, location, and general condition or death to notify, or
assist in the notification of (including identifying or locating), a person
involved in your care.
Research. Under certain circumstances, we may use and
disclose medical information about you for research purposes. For example, a
research project may involve comparing the health and recovery of all patients
who received one medication to those who received another, for the same
condition. All research projects, however, are subject to a special approval
process. This process evaluates a proposed research project and its use of
medical information, balancing research needs with patients' need for medical
information privacy. Before we use or disclose medical information for research,
the project will have been approved through a research approval process, but we
may, however, disclose medical information about you to people preparing to
conduct a research project, for example, to help them look for patients with
specific medical needs, so long as this information does not leave the
hospital. We will ask for your specific permission if a researcher will have
access to your name, address or other information that reveals who you are, or
will be involved in your care at the hospital except in situations where a research
project meets specific, detailed criteria established by law.
As Required By Law. We will disclose medical information about you
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 medical 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 the threat.
Organ and Tissue Donation. If you are an organ donor,
we may release medical information to organizations that handle organ
procurement or organ, eye or tissue transplantation or to an organ donation bank,
as necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans. If you are a member of the
armed forces, we may release medical information about you as required by
military command authorities. We may also release medical information about
foreign military personnel to the appropriate foreign military authority.
Workers' Compensation. We may release medical information about you for workers' compensation
or similar programs. These programs provide benefits for work-related injuries
or illness.
Public Health Risks. We may disclose medical
information about you for public health activities including activities to:
· prevent or control disease,
injury or disability;
· report births and deaths;
· report child abuse or neglect;
· report reactions to
medications or problems with products;
· notify people of product
recalls;
· notify a person who may have
been exposed to a disease or may be at risk for contracting or spreading a
disease or condition;
· notify the appropriate government
authority if we believe a patient has been the victim of abuse, neglect or
domestic violence. We will only make this disclosure if you agree or when
required or authorized by law.
Health Oversight Activities. We may disclose medical
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 medical information about you in response
to a court or administrative order. We may also disclose medical information about
you in response to a subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts have been made to
tell you about the request or to obtain an order protecting the information
requested.
Law Enforcement. We may release medical information if asked to do
so by a law enforcement official:
· In response to a court order,
subpoena, warrant, summons or similar process;
· To identify or locate a
suspect, fugitive, material witness, or missing person;
· About the victim of a crime
if, under certain limited circumstances, we are unable to obtain the person's
agreement;
· About a death we believe may
be the result of criminal conduct;
· About criminal conduct at the
hospital; and
· In emergencies to report a
crime; the location of crime or victims; or the identity, description or
location of person who committed the crime.
Coroners, Medical Examiners and Funeral
Directors. We may release medical information to a coroner or medical examiner.
This may be necessary, for example, to identify a deceased person or determine
the cause of death. We may also release medical information about patients of
the hospital to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities. We may release medical
information about you to authorized federal officials for intelligence,
counterintelligence, and other national security activities authorized by law.
Protective Services for the President and
Others. We may disclose medical information about you to authorized federal
officials so they may provide protection to the President, other authorized
persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the
custody of a law enforcement official, we may release medical information about
you to the correctional institution or law enforcement official. This release
would be necessary (1) for the institution to provide you with health care; (2)
to protect your health and safety or the health and safety of others; or (3)
for the safety and security of the correctional institution.
You have the following rights
regarding medical information we maintain about you:
Right to Inspect and Copy. You have the right to
inspect and copy medical information that may be used to make decisions about
your care. Usually, this includes medical and billing records, but does not
include psychotherapy notes. To inspect
and copy medical information that may be used to make decisions about you, you
must complete our authorization form and return it to Release of Information,
Health Information Management,
We may deny your request to
inspect and copy in certain very limited circumstances. If you are denied
access to medical information, you may request that the denial be reviewed.
Another licensed health care professional chosen by the hospital will review
your request and the denial. The review person will not be the person who
denied your request. We will comply with the review outcome.
Right to Amend. If you feel that medical
information we have about you is incorrect or incomplete, you may ask us to
amend the information. You have the
right to request an amendment as long as the information is kept by or for the
hospital. A request for an amendment
must be made in writing and submitted to the Health Information Management
contact person listed at the end of this notice. In addition, you must provide
a reason that supports your request.
We may deny your request for
an amendment if it is not in writing or does not include a reason to support
the request. In addition, we may deny your request if you ask us to amend
information that:
· Was not created by us, unless
the person or entity that created the information is no longer available to
make the amendment;
· Is not part of the medical
information kept by or for the hospital;
· Is not part of the
information which you would be permitted to inspect and copy; or
· Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to
request an "accounting of disclosures." This is a list of the
disclosures we made of medical information about you.
To request this accounting of
disclosures, you must submit your request in writing to the Health Information
Management contact person listed at the end of this notice. Your request must
state a time period which may not be longer than six years and may not include
dates before
Right to Request Restrictions. You have the right to
request a restriction or limitation on the medical information we use or
disclose about you for treatment, payment or health care operations. We are not required to agree to your request. If we agree, we will comply
with request unless the information is needed to give you emergency treatment.
Restriction requests must be
in writing. You may obtain a copy of the
Restriction Request Form from a nurse, technician, scheduler or other hospital
staff who will make your request known to the appropriate hospital
personnel. In your request, you must
tell us (1) what information you want to limit; (2) whether you want to limit
our use, disclosure or both; and (3) to whom you want the limits to apply (for
example, disclosures to your spouse).
Right to Request Confidential Communications. You have the right to
request that we communicate with you about medical matters in a certain way or
at a certain location. For example, you can ask that we only contact you at
work or by mail. Your confidential communications
request must be in writing. You may
obtain a copy of the Confidential Communication Request from a nurse,
technician, scheduler or other hospital staff who will make your request known
to the appropriate hospital personnel.
We will not ask you the reason for your request. We will accommodate all
reasonable requests. You must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a
paper copy of this notice. You may ask us to give you a copy of this notice at
any time by contacting
Admitting/ Registration.
We reserve the right to
change this notice. We reserve the right to make the revised or changed notice
effective for medical information we already have about you as well as any
information we receive in the future. We will post a copy of the current notice
in the hospital.
The notice will contain the
effective date on the first page in the top right-hand corner. You may request a copy of this notice at any
time.
Other uses and disclosures of
medical information not covered by this notice or the laws that apply to us
will be made only with your written permission. If you provide us permission to
use or disclose medical information about you, you may revoke that permission,
in writing, at any time. If you revoke your permission, we will no longer use
or disclose medical information about you for the reasons covered by your
written authorization. You understand that we are unable to take back any
disclosures we have already made with your permission, and that we are required
to retain our records of the care that we provided to you.
Requests, Questions and Complaints
To request disclosure
restrictions, an amendment to your records, an accounting of disclosures, more
information about our privacy practices, or if you have questions or concerns
about this notice, you may let us know by using the contact information at the
end of this notice.
If you are concerned that we
may have violated your privacy rights, or you disagree with a decision we made
about access to your medical information or in response to your request to
amend or restrict the use or disclosure of your medical information or to have
us communicate with you by alternative means or at alternative locations, you
may complain to us using the contact information at the end of this
notice. You also may submit a written
complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file
your complaint with the U.S. Department of Health and Human Services upon
request.
We support your right to the
privacy of your medical information. We
will not retaliate in any way if you choose to file a complaint with us or with
the U.S. Department of Health and Human Services.
Health Information Management (HIM) Coordinator: Address:
2929
Telephone: 312/791-5078
Fax: 312/791-5074