Being a Proactive Patient

1. Being a Proactive Patient Lynda Carlson Wellness FIG 9/21/2011

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

3. 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

4. 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

5. 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-search.aspx?AspxAutoDetectCookieSupport=1 • Licensing Requirements • http://www.op.nysed.gov/

6. 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.shtml • Agency for Healthcare Research and Quality (AHRQ) • http://www.effectivehealthcare.ahrq.gov/index.cfm/guides-for-patients-and-consumers/

7. 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/

8. 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

9. Advance Directives • Living Will • Health Care Proxy Law • Do not Resuscitate (DNR) • Do not Intubate (DNI)

10. 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

11. 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

12. 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

13. 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

14. 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

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

16. Whatever you decide . . . • Inform your doctors, family members, lawyers • Make copies for everyone • Be sure to include contact information

17. 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

18. 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/understanding/consumers/medicalrecords.html

19. 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 explanation http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf

20. 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

21. 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

22. 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

23. 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 days http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/index.html

24. 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

25. 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 theft http://www.insurancefraud.org/medicalidentitytheft.htm

26. 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

27. 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

28. Types of PHRs • Format: paper, web, or software • Free or purchase

29. 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

30. 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/

31. Thank You Questions?