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Oregon Imaging THIS NOTICE DESCRIBES HOW
MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY. Summary of this Notice: Below is a summary of the
Joint Notice of Privacy Practices (“Notice”) for PeaceHealth,
Oregon Imaging Center, and their medical staffs, workforce, volunteers,
and students:
·
The Community Health Record. We use an
electronic medical record. This
is a computer system that allows those listed in the Notice and
other providers that are not related to us to read and add health
information about you.
·
Use and Disclosures. We generally use
and disclose your information:
o
For treatment, payment, and health care operations.
o
Through a facility directory, to friends and family involved in your care,
or for notification after you have had a chance to object.
o
For fundraising, to remind you of appointments, or to give you information
about treatment alternatives or health-related benefits and services.
o
As permitted or required by law.
o
For certain activities, such as: public
health; reporting of abuse, neglect, or domestic violence; health
oversight; lawsuits and disputes; law enforcement activities;
coroner, medical examiner, or funeral director purposes; organ
donation; avoidance of a serious threat to health or safety; workers’
compensation; and national security.
o
With your authorization.
·
Your Rights. As limited by law, you generally
have the right to:
o
Inspect and copy your records.
o
Ask to amend incomplete or inaccurate information in your records.
o
Receive an accounting of certain disclosures of your health information.
o
Ask for additional privacy protections (although we do not have to agree).
o
Ask for alternative confidential communications.
o
Receive a paper copy of this Notice.
o
File a complaint without penalty.
·
Our Duties. We must maintain the privacy
of your health information, and we must give you a copy of and
follow the terms of the Notice.
We may change the Notice.
For more information, please read the Notice or call your
Regional Privacy Officer. Who is Subject to this Notice:
·
PeaceHealth, which includes its employees and workforce members at: Oregon Region:
Sacred Heart
Medical Center
o
Cottage Grove
Hospital
o
Oregon Medical
Laboratories
o
South Lane
Medical Group
o
PeaceHealth
Medical Group –
Oregon Siuslaw Region:
o
Peace Harbor
Hospital
o
Health Associates
of Peace Harbor Lower
Columbia Region:
o
St. John
Medical Center
o
PeaceHealth
Medical Group – LCR Whatcom Region:
o
St. Joseph
Hospital
o
Northwest Regional Laboratories Southeast Alaska Region:
o
Ketchikan
General Hospital
o
Island View
Manor
·
PeaceHealth employee assistance programs, workplace wellness centers, chemical
dependency programs, home health agencies, hospices, and retail
pharmacies
·
Oregon Imaging Center (“OIC”), which includes its employees and
workforce members
·
Medical staff members when providing services at or through PeaceHealth
or OIC
·
Students/trainees and volunteers at PeaceHealth or OIC This Notice covers only the
health information collected, created, and maintained by, through,
or at PeaceHealth or OIC. “We,”
“us,” and “our” in this Notice refer to the
parties listed above. This Notice does not cover the care that you
may receive from independent providers outside PeaceHealth or
OIC or actions by any health plan. The Community Health Record: To promote quality care, PeaceHealth
operates an electronic “community health record” called
the “CHR.” This
is a computer system that keeps information about you, your health,
and the care you receive. We and outside providers add health information
about you and read what other providers put in. For example, if you had to go to a PeaceHealth
emergency room, then the nurse and the physician treating you
would be able to find out about your health history, medications
you are on, and other information from PeaceHealth and community
physicians to treat your emergency. Not all information about
you is kept in the CHR. Some
of your health information is kept on paper and in other media. Not every provider that treats you looks at
and/or adds information in the CHR.
We cannot remove information once it is placed in the CHR. This Notice does not apply to access to the
CHR by non-PeaceHealth and non-OIC providers.
PeaceHealth is not responsible for actions by independent
providers or facilities. PeaceHealth
and OIC also are not responsible for the acts of the other entity.
QUESTIONS If you have questions, please
contact your Regional Privacy Officer. USE AND DISCLOSURE OF YOUR HEALTH INFORMATION The following categories describe
different ways we use and disclose health information. Not every use or disclosure in a category will
be listed. Generally,
except as allowed by law, we restrict access to your information,
including nonpublic financial information, to those workforce
members who need to know that information.
We maintain physical, electronic, and procedural safeguards
to protect your information. Use and Disclosure of Your Health Information for Treatment,
Payment, and Operations: Treatment: We may use and disclose
your health information to give you care and to coordinate and
manage your treatment or other services.
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. We also
may disclose your health information to other health care providers
who are not employed by PeaceHealth or OIC. For example, we may provide your health information to a doctor
who is seeing you in his or her office. Payment: We may use and disclose
your health information to bill and collect payment from you or
your health plan for services you received.
We will get your authorization to disclose this information. For example, we may give information about
your surgery to your health plan so your health plan will pay
us or reimburse you for the treatment.
We also may share your information with other providers
who are involved in your care for their payment purposes.
For example, we may give your insurance information to
an ambulance company that brought you to the hospital.
Some of the health information we collect includes financial
information, including information contained in forms you complete
and submit to obtain services (your social security number, insurance
number, credit information, etc.) and information relating to
your transactions with us or others, such as your payment history
and insurance and financial information.
Health Care Operations: We may use
and disclose health information about you for our operations. For example, our quality improvement teams
may use your health information to assess the care and outcomes
in your case and others like it.
We may disclose health information to health care providers
for educational purposes. We may disclose your health information to
other providers or to health plans for their own health care operations
as allowed by law. Appointment Reminders, Treatment Alternatives, and Health-Related
Benefits and Services: We may use
and disclose your health information to:
remind you about appointments with us; tell you about alternative
treatment therapies, providers, or settings of care; and tell
you about health-related products, benefits, or services related
to your treatment or care. We
may send you newsletters about general health matters, our services,
local health fairs, wellness programs, and similar events. Uses and Disclosures That We May Make Unless You Object: Directory: Unless you object,
the PeaceHealth inpatient/acute care
directory may list certain limited information about you,
including your name, location in a facility, and your general
condition (fair, stable, etc.). Directory information may be disclosed to people
who ask for you by name and to members of the clergy, whether
or not they ask for you by name.
This is so family, friends, and clergy may visit you and
generally know how you are doing.
If you wish to opt out of the directory, please notify
the Admitting or Patient Registration Department. If you opt out, then we will not tell callers
or visitors that you are a patient, and we will have to return
letters and deliveries (such as flowers) addressed to you at PeaceHealth
or OIC. Individuals Involved in Your Care or for Notification: We may disclose to a family member, close personal friend, or other
person you identify certain health information that is needed
for that person’s involvement in your care or payment for
your care. Except in limited situations, such as an emergency,
we will ask you or determine if you object. We may use professional judgment and experience
when allowing a person to pick up prescriptions, medical supplies,
x-rays, or other similar health information on your behalf. We also may disclose your health information,
directly or through a disaster relief entity, to find and tell
those close to you of your location or condition. Uses and Disclosures We May Make Without Your Authorization: As Required by Law: We will disclose
health information about you when required to do so by federal,
state, or local law. Fundraising: We may use, or disclose
to a foundation related to PeaceHealth or to a business associate,
limited information about you to raise money for PeaceHealth. They may tell you about PeaceHealth projects
as well as sending you fundraising materials.
The fundraising materials will tell you how to opt-out
of future materials. Business Associates: We may disclose
health information to “business associates” with which
we contract to perform services on our behalf.
Public Health Activities: We may disclose
your health information for public health activities, including: to a public health authority authorized by
law to collect information to prevent or control disease, injury,
or disability; to report actual or suspected child abuse or neglect;
for certain federal Food and Drug Administration activities; to
a person who may have been exposed to a communicable disease or
may be at risk for contracting or spreading a disease or condition,
as authorized by law; and to an employer about an employee, in
certain situations. Victims of Abuse, Neglect, or Domestic Violence: As allowed or required by law, we may disclose health
information about an individual we reasonably believe to be the
victim of abuse, neglect, or domestic violence to a government
authority authorized to receive such reports. Health Oversight: We may disclose
health information to a health oversight agency for activities
authorized by law, such as audits, investigations, inspections,
and licensure. Lawsuits and Disputes: We may disclose
health information about you in response to a court or administrative
order, subpoena, discovery request, or other lawful process, as
allowed or required by law. Law Enforcement Activities: We may disclose health information if asked to do so by a law enforcement
official: as required
by a law that mandates certain types of reporting; in response
to court orders, subpoenas, warrants, summons, grand jury subpoenas,
certain administrative requests, or similar processes; to identify
or locate a suspect, fugitive, material witness, or missing person
(but we will give only limited information); about the victim
of a crime in certain circumstances; about a death we believe may be the result of criminal conduct;
about criminal conduct on our premises; and, in emergencies, to
report a crime, the location of the crime or victims, or the identity,
description, or location of the person who committed the crime. Coroners, Medical Examiners, and Funeral Directors: We may disclose health information to a medical examiner or coroner
as necessary or required to identify a deceased person or determine
the cause of death. We
also may disclose health information to funeral directors so they
can perform their duties. Organ and Tissue Donations: We may disclose health information to authorized organizations as
required or needed for organ, eye, or tissue donation and transplants. Research: Under certain circumstances,
we may use and disclose health information about you for research
purposes. Most of the
time, we will ask for your authorization. To Avert a Serious Threat to Health or Safety: We may use and disclose your health information when we reasonably
believe it is necessary to prevent a serious threat to the health
and safety of you, the public, or another person. The disclosure would only be to someone who is likely to help prevent
the threat. Workers’ Compensation: We may disclose
health information about you for workers’ compensation or
similar programs. National Security, Intelligence Activities, Protective Services,
and Military Personnel: We may disclose
health information about you to authorized federal officials for
intelligence, counterintelligence, special investigations, and
other national security activities authorized by law or to protect
the President or other authorized persons.
If you are a member of the armed forces, we may disclose
health information about you as required by your military command
authorities. Inmates: We may disclose health
information about an individual who is an inmate or is in custody
to a correctional institution or law enforcement official. Organized Health Care Arrangement: Solely for purposes of complying with federal privacy laws, PeaceHealth
and its medical staff characterize themselves as an “organized
health care arrangement” and have agreed to follow this Notice
for services by, at, or through PeaceHealth.
These providers may share health information with each
other for treatment, payment, and the health care operations of
the organized health care arrangement and as described in this
Notice. PeaceHealth is
not responsible for actions by independent medical staff members. Incidental Disclosures: Certain incidental
disclosures of your health information may occur as a by-product
of permitted uses and disclosures.
For example, a roommate may inadvertently overhear a discussion
about your care if you share a room. De-identified Information and Limited Data Sets: We may use and disclose health information that has been “de-identified”
by removing certain identifiers (such as name and address) making
it unlikely that you could be identified. We also may disclose limited health information, contained in a
“limited data set,” as allowed by law. Personal Representatives:
Minors
and incapacitated adults may have “personal representatives.” These personal representatives may be able
to act on the individual’s behalf and exercise the individual’s
privacy rights. Uses and Disclosures with Authorization: Your Authorization: Other uses
and disclosures of your health information, including financial
information, not covered by this Notice or permitted by law will
be made only with your written permission or authorization.
You may revoke your authorization, in writing, at any time
(unless you are told otherwise at the time you sign the authorization). If you revoke your authorization, then we will
no longer use or disclose your health information for the reasons
covered by your written authorization, except to the extent that
we already have relied on your authorization.
We are unable to take back any disclosures we already have
made based on your authorization, and we are required to retain
our records of the care that we provided to you. Specially Protected Health Information: Unless otherwise required or permitted by law, we may need your
authorization to disclose AIDS/HIV/ARC, mental health, drug addiction,
alcoholism, and other substance abuse treatment, developmental
disabilities, and/or genetic information or records. YOUR HEALTH INFORMATION RIGHTS Although your health record
is our property, you have the rights described below: Right to Inspect and Copy: You have the
right to inspect and obtain copies of health information that
we may use to make decisions about your care.
We may deny your request in certain limited circumstances. To inspect or obtain a copy of your health information, you must
submit your request on our designated form to the Health Information
Management (“HIM”)/Medical Records Department or the
Regional Privacy Officer. PeaceHealth may charge you a reasonable fee
for the costs of copying, mailing, or other supplies related to
your request. Right to Amend: If you feel
that health information we have about you is incorrect or incomplete,
then you have the right to request a reasonable amendment for
as long as we keep this information.
We may deny your request in certain situations.
To request an amendment, you must submit your request on
our designated form to the HIM/Medical Records Department or the
Regional Privacy Officer. Right to an Accounting of Disclosures: You have the right to request an accounting of certain disclosures
of your health information made by us. This accounting will not include disclosures: for treatment, payment, or health care operations;
to you under your right of access to your records; that you authorized;
to persons involved in your care or for facility directory and
notification purposes; incidental to an otherwise permitted use
or disclosure; as part of a limited data set; for national security
or intelligence purposes; to correctional institutions or other
custodial law enforcement officials; or that occurred before April 14,
2003. To request this
list or accounting, you must submit your request on our designated
form to the Regional Privacy Officer. Right to Request Restrictions: You have the right to request a restriction or limitation on the
health information we use about you for treatment, payment, or
health care operations. You
also have the right to request a limit on the health information
we disclose about you to someone who is involved in your care
or the payment for your care. To request a restriction, you must submit your
request on our designated form to the Admitting/Patient Registration
Department or the Regional Privacy Officer.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information
is needed to provide you with emergency treatment. Right to Request Confidential Communications: You have the right to request that we communicate with you about
health matters in a certain way or at a certain location. To request confidential communications regarding
billing, you must submit our designated form to Patient Financial
Services or the Regional Privacy Officer.
To request confidential communications regarding your health
information, you must submit our designated form to the Admitting/Patient
Registration Department or the Regional Privacy Officer. We will agree to the request if it is reasonable
for us to do so. Right to a Copy of this Notice: You have the right to receive a written copy of this Notice (even
if you agreed to receive this Notice electronically). Copies of the Notice are available from the Admitting/Patient Registration
Department or Regional Privacy Officer. You may print a copy of this Notice from our website at www.peacehealth.org. OUR RESPONSIBILITIES REGARDING
YOUR HEALTH INFORMATION We are required by law to:
maintain the privacy of your health information; give you
this Notice of our legal duties and privacy practices with respect
to the information we collect and maintain about you; and follow
the terms of the Notice that is currently in effect. CHANGES TO THIS NOTICE We reserve the right to change
this Notice. The revised
Notice will be effective for information we already have about
you as well as any information we receive in the future.
Unless required by law, the revised Notice will be effective
on the new effective date of the Notice.
The current Notice will be available in our registration
areas or on our websites and will be posted in our facilities.
The Notice will state an effective date. COMPLAINTS If you believe that your privacy
rights have been violated, you may complain to the Privacy Officer
by calling the PeaceHealth Integrity Line (toll free) at (877)
261‑8031, by emailing to OIDepartment@peacehealth.org,
or by faxing to (425) 649‑3825. You also may
contact your Regional Privacy Officer at OIDepartment@peacehealth.org or
as follows:
In addition, you may file
a complaint with the Secretary of the Department of Health and
Human Services or the Office for Civil Rights.
The Privacy Officer or a Regional Privacy Officer can give
you information about filing a complaint. You will not be penalized for filing a complaint.
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