Page 1 of 8 Purpose: To provide information regarding the relationship between Phelps County Regional (PCRMC), Google Health PHR, and Microsoft HealthVault. Definition: Personal Health Record (PHR)- Compilation of health information that an individual owns, maintains and uses exclusively as a resource to make health decisions. Policy: Procedure: during Personal health records are valuable aids to individuals in maintaining health information about themselves and for use when making healthcare decisions. As such, we support the development and use of personal health records in structured form and will accept content derived from an electronic personal health record into our legal record. PCRMC will also, upon request and written authorization from the patient or authorized patient representative, send a limited set of personal health information from Meditech to the patient s Google Health PHR (operational only during 2011) and Microsoft HealthVault. A. PCRMC offered and sent PHI as requested to individuals Google PHRs 2011. Mid-2011 Google announced they were discontinuing this service. Information from PCRMC continued to feed new results to the linked PHRs until December 31 st, 2011 when Google froze the PHRs to no longer receive further information. B. Process defined for linking a Microsoft HealthVault PHR with PCRMC 1. Patients of PCRMC that would like to receive a limited set of personal health information from Meditech in a Microsoft HealthVault Personal Health Record should: a. Set up a Microsoft HealthVault PHR account at www.microsoft.com/en-us/healthvault/. b. Initiate a link request with PCRMC at www.pcrmc.com c. Complete the Authorization for Release of Information to Personal Health Record and mail, fax, or deliver to the Health Information Department. d. Once the above steps are completed the HIM Department will validate the request and an email will be sent to the patients email account. The email will contain a link that will connect the patient to
Page 2 of 8 their Microsoft HealthVault account. 1. Click on the link in the email. 2. The patient will be prompted to enter the answer to the security question they submitted when they initiated the link with PCRMC. 3. Confirm the profile you want the information linked to and verify that you want to link to PCRMC. e. The final step in the process is to log into the Microsoft HealthVault account to see the information. The information is not instantly there once linked. The amount of information and visits that the patient has will affect how long it takes for the information to upload. The initial upload will consist of information from your first visit in Meditech to the present. 2. Employees in the Health Information Department responsible for processing PHR requests will follow the outlined procedures. a. HIM personnel will monitor the PHR Maintenance Program daily Monday through Friday and process requests as they are received. b. Verify if the requestor is a patient of PCRMC and that they have completed a PHR Authorization for Release of Information. The patient will be called or emailed if clarification is needed or a release has not been received. c. Once all information is received and the requestor has been verified the patient will be created in the PHR Connect Administration routine. d. The information entered in the routine will be verified and validated against the master patient index as it is submitted. C. Patients are required to complete the Authorization for Release of Information to Personal Health Record prior to Health Information linking their information in the PHR Connect Administration Application. 1. All statements on the authorization requiring initials must be initialed for all patients in order for their information to be linked to their Microsoft HealthVault PHR. 2. Minor patients that are between the ages of 13 to 17 must co-sign the authorization. Patients in this age range may have information that is protected from their parents; however, by co-signing the authorization they are authorizing and noting they are aware that this information may be viewed in their PHR by their parents.
Page 3 of 8 3. The authorization must be signed within 6 months of submitting to the HIM Department for linking. 4. Once the authorization is submitted and accepted it is valid until the link is broken. D. Patients that want the link broken between PCRMC and their Microsoft HealthVault PHR must unlink the connection within their PHR account. Breaking the link will not pull back any information already sent from PCRMC. 1. If a patient breaks the link in their PHR they must sign a new authorization in order to have the link restored. E. The interface between PCRMC and Microsoft HealthVault does not have any filters or time delays on the information that is sent. All results are forwarded to Google Health for those tests and fields that are included in the interface. F. Only a limited data set of health information is available. PCRMC will be adding to this limited data set over time. Upon the patient s request a current list of the limited data set that is available to be sent to Google health will be provided to the patient. 1. Limited Data Set consists of: problem list (taken from abstracting), medications, allergies, lab results, and procedures list (taken from abstracting). G. PCRMC does not own or accept any liability for the information once it is uploaded to Google Health or Microsoft HealthVault PHR. Any access, release or disclosures of information from Google Health and Microsoft HealthVault PHR is solely within the responsibility and control of the individual patient or their designee. APPENDIX A: PCRMC Terms of Use for PHR Connect
Page 4 of 8 Recommended by: Reviewed by: Authorized by: Sharon Clayton, RHIA Director of Health Information Hal Wagher Corporate Compliance Officer David Dawdy Chief Information Officer
Page 5 of 8 Appendix A: TERMS OF USE To use the Phelps County Regional PHR Connect (at http://www.pcrmc.com/healthvault/)(referred to herein as PCRMC PHR Connect) you must accept the terms and conditions set forth in this user agreement by clicking "I Accept" below. If you do not agree to the terms of use, you will not be permitted to use PCRMC PHR Connect. The services provided on this website include the sending and receiving of personal health information to and from your Microsoft HealthVault Account, as authorized by the patient or patient s authorized representative. This information includes, but is not limited to a limited data set of information consisting of problem list, medications, allergies, lab results, and procedures list. Phelps County Regional (referred to herein as PCRMC) in its sole discretion may restrict access to or terminate the link from PCRMC PHR Connect to your Microsoft HealthVault account for any reason without any prior notice. Further, you agree that PCRMC shall not be liable to you or any third-party for any termination of your registration or access to PCRMC PHR Connect. Use of Protected Health information PCRMC PHR Connect allows you to transfer your personal health information from your interactions with PCRMC to your Microsoft HealthVault account. Once PCRMC sends this information to your account, the use and disclosure of your personal and medical information from your Microsoft HealthVault account to third parties is governed by the terms and conditions of your HealthVault user agreement with Microsoft, including Microsoft 's Privacy Policy. PCRMC will collect security questions and answers for each patient who requests linking through PCRMC PHR Connect. PCRMC will use this information plus the required signed authorization to verify members' identities in order to prevent unauthorized access to members' personal health information. This information is restricted to a minimal number of PCRMC personnel and personnel at our third-party technology vendor. This information is accessed only when necessary to provide members with online account-related information, provide technical support to members, or diagnose or repair problems with the software and is not otherwise disclosed to anyone, other than the member or his or her designee, unless compelled by law. When you use PCRMC PHR Connect to store or retrieve personal and medical information, all of the data is stored in your Microsoft HealthVault Account with the exception of the information and security questions required to create the link between PCRMC PHR Connect and Microsoft HealthVault. All personal and medical information you enter into PCRMC PHR Connect is governed by the terms and conditions of your HealthVault user agreement with Microsoft, including Microsoft 's Privacy Policy. Personal Login Information Users of PCRMC PHR Connect and Microsoft HealthVault must keep their personal login information confidential. This information provides direct access to your personal health information that has been sent to or entered by you into your Microsoft HealthVault PHR account. PCRMC is not liable for any
Page 6 of 8 harm caused by or related to the theft, misappropriation, disclosure, or unauthorized use of your personal login information. You should contact PCRMC immediately if you become aware of or believe there is or may have been any unauthorized use of your Personal Login Information, or otherwise wish to deactivate your Personal Login Information due to security concerns. Content Usage and Third Party Links Unless otherwise indicated, all information contained in PCRMC PHR Connect is for information purposes only. Third party contents, such as graphics, images, articles, links, applications and all other materials (referred to herein as Content") are provided for reference only and do not claim to be complete, exhaustive or to be applicable to any particular individual's medical condition. Users should always consult with a qualified and licensed physician or other medical care provider. Users are warned to follow the advice of their physicians without delay regardless of anything read in this Content. PCRMC assumes no duty to correct or update the Content nor to resolve or clarify any inconsistent information which may be a part of the Content. Reliance on any Content is solely at the User's risk, PCRMC makes no guarantee to the quality, accuracy, completeness or timeliness of Third Party Content. Publication of information or reference to specific sources such as specific products, procedures, physicians, treatments, or diagnoses are for information only and are not endorsements of PCRMC. When using PCRMC PHR Connect, you may sometimes be linked to third party websites. PCRMC is not responsible for the information or materials contained on any third party web sites, or on web sites that provide links to PCRMC PHR Connect. Links from PCRMC PHR Connect are provided for convenience only and are not intended as an endorsement by PCRMC for the organization or individual operating the third party website or application or a warranty of any type regarding either the third party website or application, or the information on the third party web site or application. PCRMC shall not be liable, directly or indirectly, for any damage or loss caused or alleged to be caused by or in connection with the use of or reliance on any content, products or services available on or through such third party websites or applications. Notice Regarding Minors PCRMC does not allow minors to register and request a link to their Microsoft HealthVault Account without the proper authorization executed by a parent or guardian unless the said minor patient has become emancipated. Furthermore, parents requesting a link to a minors record that is between the ages of 13 to 17 must have the said minor co-sign the authorization that they are aware of the PHR. Parents may be asked to present proper paperwork from the court that grants them custodial rights or visitation rights to the said minor. DISCLAIMER OF WARRANTY YOU ACKNOWLEDGE THAT THE INFORMATION IN PCRMC PHR CONNECT IS PROVIDED "AS IS" AND AS AVAILABLE. IT IS NOT INTENDED, OR TO BE CONSTRUED, AS MEDICAL ADVICE, DIAGNOSIS AND TREATMENT, AND IS NOT A SUBSTITUTE FOR CONSULTATIONS WITH QUALIFIED HEALTH PROFESSIONALS WHO ARE FAMILIAR WITH YOUR INDIVIDUAL MEDICAL NEEDS. PCRMC MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EITHER
Page 7 of 8 EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, WARRANTIES OR CONDITIONS OF TITLE OR IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. ALTHOUGH PCRMC BELIEVES THE CONTENT TO BE ACCURATE, COMPLETE, AND CURRENT, PCRMC DOES NOT REPRESENT OR WARRANT THAT THE INFORMATION ACCESSIBLE ON THIS SITE IS ACCURATE, COMPLETE, OR CURRENT. PCRMC MAKES NO REPRESENTATION, WARRANTY OR GUARANTEE THAT YOUR ACCESS TO PCRMC PHR Connect WILL BE UNINTERRUPTED, TIMELY, SECURE OR ERROR FREE, OR FREE OF VIRUSES OR OTHER HARMFUL ELEMENTS, AND SUCH WARRANTIES ARE EXPRESSLY DISCLAIMED. LIMITATION OF LIABILITY PCRMC PROVIDES PCRMC PHR Connect "AS IS" AND AS AVAILABLE WITH ALL FAULTS AND MAKES NO WARRANTIES OR GUARANTEES OF ANY KIND, AND EXPRESSLY DISCLAIMS ANY AND ALL WARRANTIES OF ANY KIND OR NATURE, WHETHER EXPRESS, IMPLIED, OR STATUTORY REGARDING PCRMC PHR Connect, INCLUDING BUT NOT LIMITED TO THE ACCURACY, COMPLETENESS, CORRECTNESS, TIMELINESS OR USEFULNESS OF ANY INFORMATION, PROGRAMS, PRODUCTS, OR SERVICES, OR OTHER MATERIAL PROVIDED THROUGH PCRMC PHR Connect, OR OF RELIABILITY, NON-INFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. PCRMC MAKES NO REPRESENTATION, WARRANTY OR GUARANTEE THAT YOUR ACCESS TO PCRMC PHR Connect WILL BE UNINTERRUPTED, TIMELY, SECURE OR ERROR FREE, OR FREE OF VIRUSES OR OTHER HARMFUL ELEMENTS, AND SUCH WARRANTIES ARE EXPRESSLY DISCLAIMED. IN NO EVENT WILL PCRMC OR ITS AFFILIATES, AND ITS AND THEIR OFFICERS, DIRECTORS, EMPLOYEES, CONTRACTORS, VOLUNTEERS, SPONSORS AND AGENTS BE LIABLE TO YOU, ANYONE CLAIMING BY THROUGH OR UNDER YOU, OR ANYONE ELSE FOR (i) ANY DECISION OR ACTION TAKEN, OR NOT TAKEN, IN RELIANCE UPON THE INFORMATION CONTAINED OR PROVIDED THROUGH PCRMC PHR Connect, (ii) CLAIMS ARISING OUT OF OR RELATED TO PCRMC PHR Connect, (iii) YOUR USE OF PCRMC PHR Connect, (iv) USE OR DISCLOSURE OF YOUR PERSONAL OR MEDICAL INFORMATION OR (v) FOR ANY INCIDENTAL, INDIRECT, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO, POSSIBLE HEALTH SIDE EFFECTS, LOSS OF REVENUES, PROFITS OR SAVINGS, EVEN IF PCRMC KNEW OR SHOULD HAVE KNOWN OF THE POSSIBILITY OF SUCH DAMAGES, CLAIMS, DEMANDS OR ACTIONS. GOVERNING LAW This user agreement, and your use and access of PCRMC PHR Connect is governed by the laws of the State of Missouri, without regard to its conflict of laws rules jurisdiction and venue for any cause of action arising under this agreement shall be in Phelps County, Missouri. These Terms of Use may be amended by PCRMC at any time without notice. The most up to date version of the Terms of Use will be available at http://www.pcrmc.com/healthvault/ By clicking I Accept I am agreeing to the foregoing terms and conditions governing my use of PCRMC PHR Connect.
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