Being a Proactive Patient

Lynda CarlsonWellness FIG9/21/2011

Agenda

• Sources for gathering information • Rights as a NYS Resident• Advance Directives• Your Medical information• Personal Health Records

Gathering Information

• The type and sources of information you gather can help in making informed decisions about doctors and health care facilities

• It can expose you to different treatment options available

• It can provide resources for managing chronic diseases and preventing new diseases

Gathering Information

Quality• Has your doctor ever been sued?– http://www.nydoctorprofile.com/

• Has your doctor ever been disciplined?– http://w3.health.state.ny.us/opmc/factions.nsf

Gathering Information (cont.)

• What is the Report Card of your hospital?– http://www.healthgrades.com/– http://www.myhealthfinder.com/– http://www.hospitalcompare.hhs.gov/hospital-se

arch.aspx?AspxAutoDetectCookieSupport=1

• Licensing Requirements– http://www.op.nysed.gov/

Gathering Information (cont.)

• Resources– NYS Resources• NYSDOH: http://www.health.state.ny.us/• NYS website: http://www.ny.gov/• http://www.nyc.gov/html/doh/html/home/home.shtm

l

– Agency for Healthcare Research and Quality (AHRQ)• http://www.effectivehealthcare.ahrq.gov/index.cfm/gu

ides-for-patients-and-consumers/

Gathering Information (cont.)• Joint Commission– Accreditation for healthcare, like Middle States for

colleges– 2011-2012 Safety Goals

– http://www.jointcommission.org/standards_information/npsgs.aspx

– Sentinel Events• Hospitals strive to limit these events• http://www.jointcommission.org/sentinel_event_statistics_

quarterly/

Your Rights

• NYS Resources– NYS Website: http://www.ny.gov/• Click on Health then Patient Rights• Patient Bill of Rights

– http://www.nyhealth.gov/professionals/patients/patient_rights/docs/english.pdf

• Rights as a hospital patient– http://www.nyhealth.gov/publications/1449.pdf

Advance Directives

• Living Will• Health Care Proxy Law• Do not Resuscitate (DNR)• Do not Intubate (DNI)

Living Will

• A written statement about a person’s wishes regarding medical treatment

• http://www.nysba.org/Content/NavigationMenu/PublicResources/LivingWillHealthCareProxyForms/Living_Will_and_Heal.htm

• http://www.ag.ny.gov/media_center/2005/jan/jan31b_05.html

Health Care Proxy Law

• This law allows you to appoint a Health Care Agent

• This individual will make health related decisions if you are incapable of doing so– http://www.nyhealth.gov/professionals/patients/

health_care_proxy/index.htm– http://www.nyhealth.gov/forms/doh-1430.pdf

Health Care Agent

• Important topics to discuss include:– Donating organs– Do not Resuscitate (DNR) – Use of fluids or medication (e.g., morphine)– Pain management

• Be sure to provide a copy of the document to your primary care physician along with contact information for primary and secondary agent

Health Care Agent Vs. Living Will

• A living will allows a person to make their medical wishes known

• A health care agent makes medical decisions for an individual when he/she is unable to

• It is recommended that people have both documents

• http://www.nyc.gov/html/caregiver/legal_1b.html

DNR

• Do not resuscitate (DNR) means, for the patient in cardiac or respiratory arrest, NO chest compressions, ventilation, defibrillation, endotracheal intubation, or medications.

• http://www.health.state.ny.us/nysdoh/ems/policy/99-10.htm

Additional Resources

• http://www.ag.ny.gov/bureaus/health_care/pdfs/EOLGUIDE012605.pdf

Whatever you decide . . .

• Inform your doctors, family members, lawyers• Make copies for everyone• Be sure to include contact information

Your Information

• You own your medical information but the facility owns the media it is contained on (e.g., paper, Electronic Health Record)

• You can request your information – http://www.nyhealth.gov/publications/1443/

• Requesting sensitive information may have additional requirements

Your Information (Cont).

• You have access to your information• You can request copies but may be charged a

maximum of .75 in New York State• You cannot be denied copies if you cannot pay• You can request corrections to your

information, but it can be denied• http://www.hhs.gov/ocr/privacy/hipaa/under

standing/consumers/medicalrecords.html

Your Information HIPAA

• Notice of Privacy Practices (NPP)– You are asked to sign you have received the NPP

each time you visit a doctor– Very few people read it or are given an

explanationhttp://www.hhs.gov/ocr/privacy/hipaa/

understanding/summary/privacysummary.pdf

Notice of Privacy Practices (NPP)

The notice must describe:•How the covered entity uses and discloses protected health information and that the entity will get your permission, or authorization, before using your health records for any other reason•The covered entity’s duties to protect health information privacy

NPP (Cont.)

• Your privacy rights, including the right to complain to HHS and to the covered entity if you believe your privacy rights have been violated

• How to contact the entity for more information and to make a complaint

Your Information HITECH Act

• Breach Notification Requirements– Individual notice: contact via phone, email, or

mail; if more than 10 individuals, the entity must post on their website, major print, or broadcast media

– Media notice: if more than 500 individuals are impacted, the entity must utilize media outlets serving the state as well as contacting the individuals

Your Information HITECH Act (Cont.)

• Notice to the Secretary– If a breach occurs of >500 individuals, the entity

must notify the secretary to HHS; if <500, the entity can notify the secretary on an annual basis

• Business association (BA)– If a breach occurs the BA must notify the entity

within 60 dayshttp://www.hhs.gov/ocr/privacy/hipaa/

administrative/breachnotificationrule/index.html

Power of Your Medical Information

• When utilized appropriately, our medical information justifies medication, treatment, and other healthcare services

• Identity theft via the social security number• Medical identity theft– A person uses someone else’s insurance

information for healthcare services

Power of Your Medical Information (Cont).

• Medical identity theft– The fastest growing form of identity theft– 1.4 million have been victimized by medical

identity thefthttp://www.insurancefraud.org/

medicalidentitytheft.htm

Personal Health Records (PHR)

• A tool to collect, track and share past and current information about your health or the health of someone in your care

• You determine the information to be collected and shared

• You determine the method for collecting the information

Content of PHR

• Blood type and emergency contact• Dates and results of tests and screenings• Major illnesses and surgeries, with dates• A list of your medicines, dosages and how

long you've taken them• Allergies• Chronic diseases • History of illnesses in your family

Types of PHRs

• Format: paper, web, or software• Free or purchase

Benefits

The type of PHR will determine the benefits but generally:•Your medical information is preserved•You can communicate with your physician via the internet and manage chronic diseases•Viewing of statements, test results•Access to your information at all times

Additional Resources

• http://www.nlm.nih.gov/medlineplus/personalhealthrecords.html

• http://www.myphr.com/• http://www.myphr.com/resources/

choose.aspx• http://www.organizedrecords.com/

mypromedical_quicktour.asp• http://www.ahrq.gov/

questionsaretheanswer/

Thank You

Questions?