Beyond the One-Word Condition: Media Access to Patients
The following activities require written authorization from the patient:
- Drafting a detailed statement (i.e., anything beyond the one-word condition) for approval by the patient or the patient's legal representative
- Taking photographs of patients
- Interviewing patients
In general, if the patient is a minor, permission for any of these activities must be obtained from a parent or legal guardian. Under certain circumstances, minors can authorize disclosure of information without parental approval or notification. State laws may vary.
In the event a patient has charges pending from a law enforcement agency, access to that patient must be obtained through that agency and cleared through the DCH Communication Department.
Permission to interview or photograph a University of Alabama or Stillman College athlete must be obtained through the school's Athletic Department and cleared through the DCH Communication Department.
Question: Should the hospital obtain consent from individuals who appear in the background of photos taken in a public place such as the hospital lobby?
The HIPAA privacy rule does not speak to background photos. Under the HIPAA privacy rule, however, hospitals may not release identifiable photographs of patients at the hospital, without the patient’s authorization.
Condition and Location of Patients: When We Will Not Release Any Information
Patients can “opt out” of providing information altogether
The hospital has a responsibility to tell patients what information will be included in the hospital directory (name, general condition, location and religion) and to whom that information will be disclosed (to people, including media, who ask for the patient by name, and to clergy). The hospital may inform the patient of this information verbally or in writing. The patient has the option to expressly state that he or she does not want information released—including information confirming his or her presence in the facility. The hospital may obtain the patient’s agreement or objection verbally or in writing. If a patient opts-out of the hospital directory, information still may be disclosed to family and friends who are involved in the patient’s care or payment for care. In such case, only information directly relevant to the person’s involvement in the patient’s care or payment may be released.
We do not release information that could embarrass or endanger patients
Spokespersons should not report any information that may embarrass a patient. Situations where room location information could embarrass patients include (but are not limited to) admission to a psychiatric or substance abuse unit; admission to an obstetrics unit following a miscarriage, ectopic pregnancy or other adverse outcome; or admission to an isolation room for treatment of an infectious disease. In addition, where knowledge of a patient’s location could potentially endanger that individual (i.e., the hospital has knowledge of a stalker or abusive partner), no information of any kind should be given, including confirmation of the patient's presence at the facility.
Consider other applicable federal laws
Be aware that federal laws prohibit hospitals from releasing any information regarding a patient undergoing treatment for alcohol or substance abuse. These include the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970; the Drug Abuse Office and Treatment Act of 1972; and 42 CFR Part 2, 188. Other state laws also may apply. We will exercise good judgment in situations where patients can't express a preference
In some cases, patients will not have had the opportunity to state a preference related to the release of their information. For example, a patient's medical condition may prevent hospital staff from asking about information preferences upon admission. In those circumstances, condition and location information should be released only if, in the hospital’s professional judgment, releasing such information would be in the patient's best interest. As soon as the patient recovers sufficiently, the hospital must ask about information preferences.
Question: When a patient has opted-out of the hospital directory, what should the hospital say? If the hospital states that it has no information on the patient or that it is unable to confirm the patient’s presence in the facility, the media may infer that the patient is at the hospital.
Under the HIPAA medical privacy rule, a hospital is permitted to release only directory information (i.e., the patient's one-word condition and location) to individuals who inquire about the patient by name unless the patient has requested that information be withheld.
Question: If a patient opts to make directory information available, but does not want information released to the press, how can the hospital assure that directory information is not provided to reporters who provide the patient’s name?
The hospital is obligated to ensure that no impermissible disclosures are made. Therefore, at a minimum, the hospital will be required to ask for additional information from anyone inquiring about a patient in an attempt to determine whether the person making the inquiry is with the press.
Matters of Public Record
What is a matter of public record
Matters of public record refer to situations that are reportable by law to public authorities, such as law enforcement agencies, the coroner or public health officer. While laws and/or regulations require health care facilities to report a variety of information to public authorities, it is not the responsibility of facilities to provide that information in response to calls or other inquiries from the media or other parties, including law enforcement officials. Instead, such calls should be directed to the appropriate public authority.
Are public record cases different from other cases
No. Patients who are involved in matters of public record have the same privacy rights as all other patients, as far as the hospital is concerned. The mode of transportation by which a patient arrives at the hospital should have no bearing on the hospital's approach to releasing information about the patient. The fact that someone has been transported to the hospital by the police or fire department from an accident, crime scene or fire is a matter of public record likely to be reported by those agencies. These public records may prompt media calls to the hospital requesting a patient's condition. As long as the patient has not requested that information be withheld, we may release the patient's one-word condition and location to individuals who inquire about the patient by name. In those circumstances where a patient's medical condition may prevent hospital staff from asking about information preferences upon admission, condition and location information should be released only if, in the hospital’s professional judgment, releasing such information would be in the patient's best interest. For many hospitals, this may represent a change from previous policies.
There are numerous state statutes addressing reporting of incidents ranging from child abuse to gunshot wounds. The fact that a hospital has an obligation to report certain confidential information to a governmental agency does not make that information public and available to news reporters. In fact, state laws may provide enhanced privacy protection for some reportable information, such as HIV status; sexually transmitted diseases; child, spouse or elder abuse; and reportable genetic anomalies.
Media questions will be referred to the public entity (such as the coroner's office, police, fire or health department) that receives such reports. The public entity will be guided by the applicable statute as to whether it can release any or all of the information received.