3. How We May Use And Disclose Protected Health Information About You

Ethics & Patient Rights: Lifespan Joint Privacy Notice

The following categories describe and give examples of the different ways we are permitted or required to use and disclose your protected health information without first asking your permission or offering you the opportunity to agree or object. Not every case or disclosure in a category may be listed. Also, we can release your protected health information without your permission if we first "de-identify" it such that the person looking at it will not know it refers to you.

A. For Treatment—We use your protected health information to provide, coordinate and manage your health care. This will include disclosing protected health information about you to doctors, nurses, technicians, or other health care professionals who care for you, whether or not they are employed by Lifespan. 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 you have diabetes so that we can arrange for appropriate meals. Different health care professionals also may share your protected health information in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose your protected health information to people outside the hospital. For example, your protected health information may be provided to a physician to whom you have been referred so that the physician has the necessary information to treat you.

B. For Payment—We use your protected health information in order to bill and collect from you, your insurance company, or a third party for the services you receive. For example, your insurance company may need to know about the type of surgery you received in order to pay us appropriately. We may also use your protected health information to obtain your insurer's prior approval to provide you with certain types of care, if your insurer requires us to do this. Finally, we can disclose your protected health information for the payment activities of another covered entity or any health care provider.

C. For Health Care Operations Purposes—As permitted by Rhode Island law, we use and disclose your protected health information to support the operations of our organization. This is necessary to make sure all of our patients receive quality care. For example, we may use your protected health information to evaluate the performance of our staff. We may also disclose information to doctors, nurses, technicians, medical students, and other hospital personnel for review and learning purposes. Also, we can disclose your protected health information for certain types of health care operations of another covered entity. If possible, we will remove information that identifies you.

D. Business Associates—We may disclose your protected health information to business associates who provide services or activities on our behalf. For example, we may contract with accreditation agencies, management consultants, quality assurance reviewers, billing and collection services, and accountants. To protect your health information, we require our business associates to sign a written agreement regarding privacy.

E. As Required by Law—We disclose protected health information about you when required to do so by federal, state or local law.

F. Appointment Reminders—We may use and disclose your protected health information to contact and remind you of your health care appointments at Lifespan entities.

G. Treatment Alternatives, Benefits and Services—We may use and disclose protected health information to tell you about or recommend possible treatment options, health related benefits, or services that may be of interest to you.

H. Fundraising—We may use or disclose your demographic information and the dates you receive treatment in order to contact you for our fundraising purposes. Each of our hospital affiliates has established a fundraising Foundation that solicits gifts. If you do not want us to contact you for fundraising you must notify the hospital's Foundation or the Lifespan Privacy Officer in writing. If you do not do this, we may use your information as described.

I. To Avert a Serious Threat to Health or Safety—We may disclose protected health information about you when necessary to prevent a serious and imminent threat to your health and safety or to the health and safety of the public or another person. As permitted by Rhode Island law, we may also release protected health information to the police in certain cases.

J. Public Health Activities—We may release your protected health information to appropriate authorities for public health purposes including, but not limited to, preventing or controlling disease, injury or disability; to report child abuse or neglect; to the Food and Drug Administration (FDA) for activities relating to quality, safety or effectiveness of FDA regulated products or activity. We may also release your protected health information for the public health purpose of alerting a person who may be at risk of contracting or spreading a communicable disease.

K. Disclosures About Victims of Abuse, Neglect, or Domestic Violence—As permitted by Rhode Island law, we may release your protected health information in a situation where we believe you have been a victim of abuse, neglect, or domestic violence. In some cases, we may be required by law to release such information. In other cases, we may not be required to release the information, but we may choose to release it to appropriate authorities or social service providers in order to prevent harm to you or another person. If possible, we will ask you for your permission before we make the disclosure, or tell you as soon as possible after we make it.

L. Organ and Tissue Donation—If you are an organ donor, we may release protected health information to organizations that obtain organ, eye or tissue for donation and transplantation.

M. Limited Disclosures for Research Purposes or For Purposes Leading Up to Research—We may use and disclose your protected health information within Lifespan as necessary to prepare for research studies. For example, a researcher might review your protected health information while he or she is thinking about how to design a research study. Also, after a patient's death, it is possible that his or her protected health information would be used for research purposes. In most other cases, we will not use your protected health information for research purposes unless we first explain the research to you and you consent to participate in the research and you give us permission to use your protected health information for the research. In some cases, though, we may use your protected health information for research without your permission. In order for this to happen, your information would have to be partially de-identified, or a committee of people who know about research, privacy and medical ethics would have to decide that use of your information was necessary and that it would be of low risk to you and your privacy.

N. National Security and Military—We may disclose your protected health information to authorized federal officials for conducting national security and other intelligence activities, including providing protective services to the President and other officials. If you are a member of the armed forces, we may release information about you as required by military command authorities.

O. Workers' Compensation—We may release protected health information about you for workers' compensation or similar programs that provide benefits for work-related injuries or illness.

P. Legal Proceedings—We may release protected health information about you during the course of legal proceedings if we are ordered to release the information by a court or judge, or in response to a subpoena issued in the name of a court if the requirements of Rhode Island law are met.

Q. Law Enforcement—We may release your protected health information to a law enforcement official for a law enforcement purpose under the following circumstances: (1) as required by law, or in response to certain types of court orders, warrants, subpoenas, demands, requests or other legal process; (2) if the law enforcement official needs limited information about you because of a reasonable belief that you pose a danger to yourself, a particular person or people, or if you are trying to obtain narcotics illegally; (3) if it is believed you have been the victim of a crime and Rhode Island law allows us to make the disclosure, although we will try to ask you before making the disclosure; (4) if you have died and we think your death involved a criminal act; (5) as permitted by Rhode Island law, if a crime occurs at Lifespan and we think your protected health information is evidence of the crime and (6) as permitted by Rhode Island law, in an emergency health care situation if necessary to report a crime.

R. Coroners, Medical Examiners and Funeral Directors—We may release protected health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person to determine the cause of death. Following the patient's death, we may also furnish funeral directors with a standard death certificate and the information required to go in the certificate.

S. Health Oversight—As permitted by Rhode Island law, we may disclose your protected health information to governmental agencies authorized by law to audit, inspect, or investigate the health care system, government benefit programs, other government programs and civil rights laws.

T. Inmates—If you are an inmate of a correctional institution or under the custody of a law enforcement official, we will release your protected health information only as permitted under Rhode Island law.

U. Questions of Capacity to Consent—In situations where you lack capacity to consent, we may use and disclose your protected health information as permitted by applicable Lifespan policies and by state law.

Section 4. Other Uses or Disclosures of Your Protected Health Information