Understanding Your Rights to Health Information at Duke University
Duke University and its affiliated healthcare entities (collectively referred to as "DHE") are dedicated to protecting the privacy of your health information. This article explains your rights regarding your health information, as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other applicable laws. Health information, for the purposes of this article, refers to any information that identifies you or can reasonably be used to identify you, and relates to your past, present, or future health, healthcare services, or payment for those services.
How Duke University May Use and Disclose Your Health Information
DHE uses and discloses health information for various purposes, including treatment, payment, and healthcare operations. Here's a breakdown of these categories:
Treatment
Your health information may be used to provide, coordinate, or manage your healthcare and related services. This includes communication between healthcare providers involved in your care. For instance, a doctor treating a broken leg may need to know if you have diabetes, as it can affect healing. Similarly, different DHE departments may access your information to coordinate services like prescriptions, lab work, and x-rays.
Payment
DHE may use and disclose your health information to bill and collect payment for the treatment and services you receive. This includes sharing information with your health plan to obtain prior approval or determine coverage. Your information may also be shared with billing departments, insurance companies, and consumer reporting agencies for payment collection. For example, if you have a broken leg, your health plan may receive information about your condition, the supplies used (medications or crutches), and the services you received (x-rays or surgery).
Healthcare Operations
DHE may use and disclose your health information for activities that improve the quality of care and reduce healthcare costs. This includes cooperating with outside organizations that assess the quality of care, evaluate healthcare providers, or review DHE's activities.
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Contacting You
DHE may use your health information to contact you regarding appointments, prescription reminders, clinical instructions, surveys, billing, or general communications.
De-identified Health Information
DHE may use your health information to create "de-identified" information that cannot be linked to any individual, in accordance with HIPAA regulations. This de-identified data may be shared with outside parties to discover new ways to diagnose and treat diseases, and to improve care.
Limited Data Set
DHE may create a "limited data set" by removing certain identifying information from your health data. This limited data set may be used and disclosed for research, public health, or healthcare operations purposes, and may be shared with outside persons and companies for these purposes.
Treatment Alternatives
Your health information may be used to inform you of treatment alternatives and other health-related benefits that may be of interest to you, including information about other healthcare providers, services, and products.
Electronic Health Information Exchange (HIE) and Other De-identified Data Partnerships
DHE may participate in HIEs, allowing healthcare providers and entities like your health plan to share your health information for treatment, payment, and other legally permitted purposes. DHE also collaborates in the nference de-identified data partnership, which allows researchers to use de-identified information for medical advancements. You can request that your health information not be contributed to an HIE or nference.
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Business Associates
DHE utilizes business associates to perform certain services. In such cases, your health information may be disclosed to these companies so they can perform their assigned tasks.
Fundraising Activities
DHE may use your contact information, department of service, treating physician, outcome information, health insurance status, and dates of treatment to contact you for fundraising purposes. You have the right to opt out of receiving these communications.
Hospital Directory
While you are a patient at a DHE hospital, certain limited information about you, such as your name, location, general condition, and religious affiliation, may be included in the hospital directory. This information, except for religious affiliation, may be released to people who ask for you by name. Your religious affiliation and other directory information may be given to clergy members, even if they do not ask for you by name.
Individuals Involved in Your Care or Payment for Your Care
DHE may share your health information with family members, relatives, friends, or other individuals you identify who are involved in your care or payment for your care. DHE may also disclose information to notify a family member, personal representative, or other responsible person of your location, general condition, or death, and to entities assisting in disaster relief efforts.
Circumstances Where Consent Is Not Required
There are several circumstances in which DHE may use and/or disclose your health information without your consent, authorization, or the opportunity to object. These include:
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As Required by Law
DHE will disclose your health information when required by federal, state, or local law, or in response to judicial or administrative proceedings.
To Avert a Serious Threat to Health or Safety
DHE may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Public Health Risks
DHE may disclose your health information to appropriate government authorities for public health activities, including reporting suspected abuse, neglect, or domestic violence.
Health Oversight Activities
DHE may disclose your health information to health oversight agencies for activities authorized by law.
Law Enforcement
DHE may release health information to law enforcement officials for certain law enforcement purposes, such as reporting a gunshot wound.
Coroners, Medical Examiners, and Funeral Directors
DHE may release health information to coroners or medical examiners to identify a deceased person or determine the cause of death.
Organ and Tissue Donation
DHE may release health information to organizations involved in organ and tissue donation and transplantation.
Research
Under certain circumstances, DHE may use and disclose health information for research purposes, after the research project has been approved through a specialized approval process.
Specialized Government Functions
DHE may disclose health information for specialized government functions, such as national security, intelligence activities, and protective services for the President and other officials.
Workers’ Compensation
DHE may release your health information for workers’ compensation or similar programs.
Inmates
If you are an inmate of a correctional institution or under the custody of a law enforcement official, DHE may release your health information to the correctional institution or law enforcement official.
Your Rights Regarding Your Health Information
You have the following rights regarding your health information:
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your health information. DHE will respond to your written request within 30 days.
Right to Amend
You have the right to request that DHE amend clinical, billing, and other records used to make decisions about you. Your request must be in writing and explain your reason(s) for the amendment. If DHE accepts your request, they will make reasonable efforts to inform others of the amendment.
Right to an Accounting of Disclosures
You have the right to receive a written list of certain disclosures DHE has made of your health information, up to six years prior to your request.
Right to Request Restrictions
You have the right to request that DHE restrict the use and disclosure of your health information. DHE is generally not required to agree to your requested restrictions, except they will honor your request to not disclose to your health plan if the disclosure is for payment or healthcare operations purposes (and is not otherwise required by law) and the health information pertains solely to items or services for which you have paid out of pocket in full.
Right to Request Confidential Communication (Alternative Ways)
You have the right to request confidential communications about your health information, specifying how and where DHE should contact you. DHE will accommodate reasonable requests, but may condition that accommodation on you providing information regarding payment arrangements and an alternative address or method of contact.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice upon request.
Other Important Information
North Carolina Law
In the event that North Carolina law requires DHE to give more protection to your health information than stated in this Notice or required by federal law, DHE will provide that additional protection. DHE will comply with additional state law confidentiality protections relating to treatment for mental health and drug or alcohol abuse. Unless you object in writing, DHE may release health information related to your mental health to other health care providers for treatment, quality assessment and improvement activities, and other permitted purposes. In accordance with federal law, DHE will generally obtain your written consent before disclosing health information that would identify you as a patient for substance abuse services, with certain exceptions.
Changes to Your Directory Information
Changes to your directory information at Duke University, such as last name, marital status, org unit, title, or department, are typically handled by your HR/Payroll representative. To edit your directory listing, click on the appropriate function (internal or external). Note that interoffice addresses will not have an option for a phone number, as they are used for package delivery only. Allow 24-48 hours for the information to update across all directories.
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