Patient Conditions

Release of Patient Information

As of March 1, 2003, all St. Louis area hospitals follow new guidelines for releasing patient information, in accordance with federal Health Insurance Portability and Accountability Act (HIPAA) regulations.

HIPAA privacy standards have specific provisions for the release of limited "directory" information. Directory information includes:

• 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 (for clergy only)

In order for members of the news media to receive information from the patient directory, the following must happen:

• Reporter must supply patient's name.
• The health care provider must obtain consent from the patient or next of kin to release directory information to anyone who asks about the patient by name.
• The health care provider must confirm that the patient's family has been notified.

If the above conditions are met, general condition information may be provided, as long as it does not communicate specific information about the individual. Information such as a patient's age and nature and extent of injuries will not be provided. When accidents occur, the media should call the Public Relations Department at St. John's Mercy for a condition report. Reporters should obtain the patient's name from officials at the scene or through other means.

St. John's Mercy will use the following one-word descriptions of a patient's condition.

Undetermined - Patient awaiting physician assessment.

Good - Vital signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.

Satisfactory - 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

Minor Children
Minor children (under the age of 18) may have information released only with the consent of a parent or legal guardian, in accordance with the preceding guidelines.

Emergency Situations
The privacy regulations address situations where the opportunity to 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 consistent with a prior expressed preference of the individual, if any, that is known to the covered health care provider AND in the individual's best interest as determined by the covered health care provider, in the exercise of professional judgment.

Additional Restrictions
Information may not be released in instances where releasing information 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.

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.

Deaths
The death of a patient may be announced and/or confirmed by Public Relations after family has been notified and consent has been obtained. Reporters are encouraged to obtain this information from police departments.

Public Information
Police reports and other information about hospital patients often are 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 protected health information (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.