This notice describes the ways in which we may use and disclose medical information about you, your rights and obligations regarding disclosure, and how you can access this information. Please review it carefully. Questions or comments may be directed to Mona Viel, Privacy Officer, St. Joseph’s General Hospital, 70 Spine Rd, Elliot Lake ON, P5A 1X2; Telephone (705) 848-7182 extension 2441; E-mail email@example.com
Who Will Follow This Notice
This notice describes St. Joseph’s General Hospital's practices regarding the use of your medical information and that of any health care professional authorized to enter information into your hospital chart or medical record. This notice applies to the following entities: All departments of the hospital, clinics, or doctor's offices you may visit; any member of a volunteer group we allow to help you while you are in the hospital; all employees, medical staff, and authorized volunteer personnel who may need access to your information in order to provide care. All entities of St. Joseph’s General Hospital, at all locations, will follow the terms of this notice. These entities, at all sites and locations, may share medical information with each other for treatment, payment or health care purposes as described in this notice.
Our Pledge Regarding Medical Information
We are required by law to create a record of the care and services we provide to you. We acknowledge that protecting your privacy is important. We will maintain all medical information that could identify you, individually, in a confidential manner, in compliance with legal requirements. This notice applies to all of the records of your care generated by Athens-Limestone Hospital, whether made by health care professionals or other affiliated personnel. In accordance with our legal obligations, this notice is provided to inform you of our legal duties and privacy practices with respect to your health information, and to serve as our pledge to follow the terms of the notice currently in effect.
Affiliation With Other Entities
The hospital utilizes the designation of an Organized Health Care Arrangement with certain physicians practices where the relationship is a clinically integrated care setting in which individuals typically receive health care from more than one provider and patient health information is shared.
How We May Use and Disclose Medical Information About You
The following categories describe different ways that we may use and disclose medical information in compliance with federal law. For each category of uses or disclosures we have provided examples. Not every use or disclosure in a category will be listed.
For Treatment -- We may use medical information about you in order to provide you with medical treatment or services. In accordance, we may disclose medical information about you to physicians, nurses, technicians, or other health care professionals who are involved in taking care of you.
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 health care professionals 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 or that 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 may be appropriately billed to you and payment may be collected from you, an insurance company, or a third party.
For example: Your insurance company may need to know about your surgery in order to pay us or reimburse you for the surgery. We may also use and disclose medical information about you to obtain prior approval or to determine whether your insurance company will cover the treatment.
For Health Care Purposes -- We may use and disclose medical information about you to make sure that all of our patients receive quality care.
For example: We may use medical information to review treatment and services in order to evaluate the performance of our staff in caring for you. We may also disclose information to doctors, nurses, technicians, medical students, and other hospital personnel for peer review and learning purposes. In these instances, we may remove information that individually identifies you from survey of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.
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.
Treatment Alternatives & Health-Related Benefits and Services -- We may use and disclose medical information to tell you about or recommend health-related benefits or services that may be of interest to you.
Hospital Directory or Patient Census Report -- We may include certain limited information about you in the hospital directory or patient census report while you are a patient in the hospital, such as: your name, and location in the hospital. The directory information may also be released to people who ask for you by name. Members of clergy, may see the directory even if they do not ask for you by name. This is so your family, friends, and clergy can visit you in the hospital and generally know how you are doing. However, if you do not want any of this information made available to the public, you may request ¡§confidential status¡¨ and we will not release this information to anyone without your explicit permission.
Individual Involved in Your Care or Payment of Your Care -- We may release medical information about you to a friend or family member who is involved in your medical care or to someone who helps pay for your care. We may also disclose medical information about you to an entity assisting in a disaster relief effort so that your family may be notified about your condition and location.
As Required By Law -- We will disclose medical information about you when required to do so by national, provincial, 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 another known person or for the public well fare. Any disclosure would only be made to an authorized person who is able to help prevent the threat.
We may release medical information about you for workers compensation or similar programs to provide benefits for work-related injuries or illnesses.
Public Health Risks
We may disclose medical information about you for public health activities as required by law, including:
prevention or control of disease, injury; or disability;
to report child abuse or neglect;
to report reactions to medications;
to notify people of the recall of unsafe products;
to notify a person who may have been exposed to an infectious disease or may be at risk for contracting or spreading disease;
to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
Health Oversight Activities
We may disclose medical information to a health oversight agency for activities authorized by law.
Audits, investigations, inspections, and licensure necessary for the government to monitor the health care system, government programs, and compliance with civil laws.
Lawsuits and Disputes
We may disclose medical information about you in response to a subpoena, discovery request, or other lawful order from a court of law.
We may release medical information as part of law enforcement activities such as in investigations of criminal conduct; in response to court orders; or in emergency circumstances, as required by law.
Coroners, Medical Examiners and Funeral Directors
We may release medical information to a coroner or medical examiner to identify a deceased person or determine the cause of death. We may also release medical information to funeral directors, as necessary, to carry out their duties.
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.
Your Rights Regarding Medical Information 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.
If you exercise your right to inspect and copy your medical information, you must submit a request in writing. If you request a copy of your medical information, we will charge a fee for the reasonable costs of copying, mailing, or other expenses associated with your request.
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. In that instance, another licensed health care professional, chosen by St. Joseph’s General Hospital, will review your request and the denial. The person conducting the review will not be the person who denied your initial request. We will comply with the reviewer's recommendation.
Right to Amend
If you believe that medical information we have on record about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is maintained in accordance with provincial law. All requests for amendment must be made in writing and must provide a reason for your requested amendment.
Please be advised that we may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if your ask us to amend information that is not part of the medical information routinely maintained by St. Joseph’s General Hospital, or if it is deemed to already be accurate and complete by the reviewers of your request.
Right to an Accounting of Disclosures
You have the right to request an "Accounting of Disclosures" which is a list of the disclosures we have made involving medical information about you. Your request must be submitted in writing and must state a time period that may not be longer than six years. Your request should indicate in what form you want the list (for example, on paper, or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time, before any costs are incurred.
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. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment of your care. Please be advised that we are not required to agree to your request. If we do agree, we will comply with your request except where the information is needed to provide emergency treatment.
Your request for restrictions must be made in writing and must include: what information you want to limit; whether you want to limit our use, disclosure or both; and, to who you want the limits to apply.
Right to Request Confidential Communications
You have the right to request how we communicate with you about medical matters such as how or where you wish to be contacted. For example: You may request that we only contact you at work or by mail.
You must make your request for confidential communications in writing. We will not ask you the reason for your request and will make every effort to accommodate all reasonable requests.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this notice at any time, even if you have previously requested to receive this notice electronically. Please make your request in writing to our Privacy Officer.
Changes to This Notice
We reserve the right to revise this notice of privacy practices and 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. When this occurs, we will publish a copy of the current notice with the effective date in the top right-hand corner on the first page.
If you believe your privacy rights have been violated, you may file a complaint with St. Joseph’s General Hospital, through our Privacy Officer, Mona Viel, or with the Chief Executive Officer, Pierre Ozolins; St. Joseph’s General Hospital, 70 Spine Rd, Elliot Lake, Ontario P5A 1X2. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Other Uses Of Medical Information
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 permission for us to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, thereafter we will no longer use or disclose medical information about your for the reasons covered by your written authorization. You must 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
Mail: Information and Privacy Commissioner / Ontario
2 Bloor Street East
Telephone: Toronto Area (416) 326-3333
Long Distance 1-800-387-0073
Fax: (416) 325-9195