Re: Rel. of Information - Secondary release (fwd)

[James Brady <jbrady@freenet.columbus.oh.us>]

Jim typing at all.

---------- Forwarded message ----------
Date: Mon, 5 Aug 1996 19:21:28 -0500
From: James Brady <jbrady@freenet.columbus.oh.us>
To: jbrady@freenet.columbus.oh.us
Subject: Re: Rel. of Information - Secondary release

On Mon, 5 Aug 1996, eabonifa wrote:

\ Hi,
\ 
\ I need your thoughts on the following scenario involving  re-release of
\ information:

.snipped. 

\	Periodically, we receive requests for medical records for episodes
\	of care at our clinic or our hospital AND for any records received
\	from other facilities. 
\
\	My question is this :  Can we re-release medical records received
\	from other hospitals?  

Yes.  The wise custodian, IMO, would include a disclaimer to indicate that
the records YOU released were second or higher generation to alert the
recipient that you all have made copies of something that had been copied
somewhere else and furnished to you. 

There are those who can and will opine:

	"golly.gee.whiz.jim.we.can't.do.that.we.ain't.never.done.that.before"


\	Example, a patient called the clinic to request that a copy of his
\	records be sent to his physician in another state.  He did not
\	want his records from his office visits here, but rather the
\	records we received from his doctor in Baltimore. 

You've furnished an outstanding example of WHY a patient may ask YOU to
send such records.  (New mail from Bernice Childs re your request came
here as I type.) It could well be that the Baltimore are not readily
available.  In the example you cite, the patient apparently triggered the
action that put copies of his records in YOUR file and the PATIENT is now
asking you to furnish those copies to his new physician.  In conversations
that I have had with my family physician, there would be no problem
provided I have signed a release. 

I still recall with vivid clarity a "second generation" situation wherein
I encountered a widower whose wife had been treated by Dr "A" and then had
those records sent to Dr "B"; Dr. A's records were by now in storage since
deceased had stopped going to him, but records were in contestable time
window.  Not only did widower sign a release to allow ALL (a powerful
word) medical data to be released, he waxed redundant and added a note to
a letter to Dr. B specifically asking her to furnish the insurance company
copies of Dr. A's records on his late wife.  

The deceased's chart was pulled then put pack in file w/o copying ...
apparently in error.  About nine (9) days later, when I traced the office
by phone, Dr B eventually got on the phone and it appeared that this was
the first she knew of the records request. She apparently was reading the
letter signed by both patient and I and Dr B stated she could not release
copies of Dr A's records. 

	(I do not have a cot down at the Ohio Medical Board, but I
	consistently "stay in touch" to avoid surprises by new rules,
	legislation, etc; I had checked with it on such subject matter
	within two week before speaking to Dr B.)

When I advised Dr. B that there was no such prohibition as she suggested,
she immediately countered with the claim that her attorney had told her
she could not do so.  

I then asked for the name of her attorney [*].  

	(I figured that Dr. B: 
		
		(1) did not correctly understand what her attorney had said, 

		(2) her attorney did not correctly understand Ohio law on the
		subject (which happens once in a while)
 
		(3) Dr B was being less than accurate about what her
		attorney had told her re release of information and release of
		second generation information.)

But I did NOT delineate any part of the above three thoughts.


[*] IGNITION ... WE HAVE LIFT OFF!  DR B WENT BALLISTIC!! 


\	How are people handling re-release of information? 
\

Based on my past contacts, some release it (most) ...

and some (one in 23+ years) go ballistic :+)

I'm in Ohio and do not know how MI handles situations such as you have
described.

\	Thanks in advance!!! 
\	Elizabeth
\	MIchigan

You're welcome.  Thanks for putting the question up and making us don our
thinking caps once again.

Jim typing for Jim, reserving all rights, denying all wrongs.

jbrady@freenet.columbus.oh.us