@@About Us^Patient Rights & Professional Ethics@@Guidelines for the Disclosure of Medical Information at National University Hospitals
Patient Rights & Professional Ethics
Guidelines for the Disclosure of Medical Information at National University Hospitals
- 1. Purpose
Providing medical information is an important duty for medical providers. The purpose is to provide open and quality medical care by sharing information and building positive relationships with patients.
- 2. Types of Information
Information that can be provided are the records that medical professionals create for medical purposes such as clinical records (charts), nursing records, prescriptions, test records, test result reports and X-ray photographs (hereinafter referred to as medical information). However, the following information is not included; information from a third party such as referral letters from other hospitals and information regarding education and research associated with medical care.
- 3. Intended Recipients
In principle, the disclosure of medical information shall be undertaken by the patients' own request. However, the disclosure of medical information is not implemented in the following cases.
- 1. When patients cannot make rational decisions.
- 2. When there is a possibility for the disclosure of medical information to work to the detriment of the third party except the relevant medical staff.
- 3. When there is a possibility for the disclosure of medical information to work to the detriment of patients from a medical standpoint.
- 4. Methods
- 1. A party wishing to request access is asked to provide such information as address, name (signature and seal), date of birth, the type of information, intended periods together with the reason why it is necessary to attain this information, by filling out a request form and submitting it to the director of the hospital. However, the release of medical information can be implemented without certain reasons. If s/he is of age and cannot make a rational decision, his/her statutory representative or primary-care giver can make a request.
If s/he is under age and cannot make a rational decision, his/her statutory representative can make a request. If s/he is under age and can make a rational decision, s/he and his/her statutory representative makes a request in their joint names in principle. However, if not, either make a request with the reason. When accepting the request, verification of applicants should be done carefully.
- 2. The director should examine the case; if the type of information and the applicant are appropriate and if any disruption would occur by contacting the relevant clinical department if necessary, and should notify the result to the applicant.
- 3. In principle, access and photocopy are appropriate for disclosure, however, creating an objective summary is possible depending on the situation of each hospital.
- 4. Hospitals appoint the place for access and photocopying. On the patients' request, doctors should provide the explanation on the released information. Medical information is for internal use only.
- 5. In the perspective of privacy data protection, it is important to promote an awareness of information management to the recipient of the information.
- 5. Fees
To make an access request, a service fee is charged to the applicant. The rate is set by the president of the university based on Article 12 of the Ordinance on school fees and other expenses of national schools. (by the Ministry of Education, Science and Culture No. 9, 1961)
- 6. Information Disclosure Committee
For the smooth disclosure of medical information, committees should be established as an advisory panel to directors at all the national university hospitals. The committees set up concrete guidelines and examine each case equally and carefully.
- 7. Environmental Arrangement for the Disclosure of Medical Information
- 1. Hospitals should provide medical staff with systematical training to acquire knowledge and communication skills in the disclosure of medical information. Hospitals should also continue to engage in the improvement of information disclosure by standardizing recording methods and the language of medical information.
- 2. Hospitals should secure adequate human resources for information disclosure since specialists (health information manager) need to be hired.
- 3. Hospitals should promote the computerization of medical records as it is essential in improving medical care quality such as the sharing of information, efficiency in storing and managing, and cooperation between hospitals.
- 8. Management on the Disclosure of Medical Information
- 1. Information on access requests, minutes concerning the patients, and notifications of decisions should be maintained as medical information.
- 2. These guidelines should also be applied to the release of the information on the sequence of access request listed in the preceding paragraph.
- 9. Others
These guidelines shall be evaluated and reviewed as appropriate.
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