Leslie - I agree with your approach.  However, let me play devil's advocate on the 
last part of your message - Suppose I am a cardiologist, and am seeing a new patient 
in my office.  In talking to the patient I discover the patient was recently seen at 
your hospital - I call over to the hospital and ask for a copy of the EKG.  I need 
this information for treatment purposes - however, I was not involved in the patient's 
recent hospitalization.  

Based on your approach, I will need to get an authorization from the patient, fax it 
over to HIM at the hospital and then get the EKG.  I fully understand your reasoning.  
But this is a covered entity requesting information for treatment.  The commentary 
also states that information can be released to individuals to the extent they are 
involved in the care of the patient.  Personally, I do not think the authorization is 
necessary.

My concern is that the approach you outlined could potentially delay the delivery of 
care to patients.  What if the roles were reversed?  What if I am a physician and do 
not have staff privileges at your hospital and am not part of an OHCA?  A patient of 
mine is hospitalized at your facility, and the hospital calls my office asking about 
medical history, etc.  - I then say, sorry you will have to get an authorization from 
the patient and fax it over to get the information - It certainly will not make the 
busy RN or staff physician very happy.

Like I said, I am not disagreeing with your approach, just playing devil's advocate.

Dan Kelsey
Practice Advisor
Indiana State Medical Association

-----Original Message-----
From: Harpe, Leslie [mailto:[EMAIL PROTECTED]
Sent: Tuesday, March 25, 2003 3:15 PM
To: WEDI SNIP Privacy Workgroup List
Subject: section 164.514(d)(3)(iii)(B)


Your opinions on the following scenario:
A patient is seen in the ER last night.  Dr. A ordered labs.  Dr. B calls
the lab for the results today.  Lab only knows the ordering doctor.  Based
on the fact that Dr. B knows labs were ordered and according to section
164.514(d)(3)(iii)(B), we are going to release the lab results without an
authorization.  We believe that this is continuum of care and we are
releasing to another covered entity. (No disclosure is required either.)  If
each department identifies who can release the info, the minimum they can
release for routine disclosure and develop criteria for non-routine
disclosures, this should be an acceptable practice. Page 82545 also supports
this interpretation.  My notice also informs the patient that we will do
this as continuum of care.

Once the chart is received by medical records though, we will require an
authorization if the physician is not on record.  

I hope this is right, if not, we'd better start planting more trees to
support the tremendous mounds of paperwork.    

Thanks,
Leslie Harpe
Privacy Official
South Georgia Medical Center
Valdosta, GA  31603-1727
[EMAIL PROTECTED]


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The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions 
on this listserv therefore represent the views of the individual participants, and do 
not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If 
you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
Database at http://snip.wedi.org/tracking/.   These listservs should not be used for 
commercial marketing purposes or discussion of specific vendor products and services.  
They also are not intended to be used as a forum for personal disagreements or 
unprofessional communication at any time.

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