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/ http://www.nydoctorprofile.com/ Has your doctor ever been disciplined? – http://w3.health.state.ny.us/opmc/factions.nsf 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.healthgrades.com/ – http://www.myhealthfinder.com/ http://www.myhealthfinder.com/ – http://www.hospitalcompare.hhs.gov/hospital- search.aspx?AspxAutoDetectCookieSupport=1 http://www.hospitalcompare.hhs.gov/hospital- search.aspx?AspxAutoDetectCookieSupport=1 Licensing Requirements – http://www.op.nysed.gov/ http://www.op.nysed.gov/

6. Gathering Information (cont.) Resources – NYS Resources NYSDOH: http://www.health.state.ny.us/http://www.health.state.ny.us/ NYS website: http://www.ny.gov/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/gu ides-for-patients-and-consumers/ http://www.effectivehealthcare.ahrq.gov/index.cfm/gu ides-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/np sgs.aspx http://www.jointcommission.org/standards_information/np sgs.aspx – Sentinel Events Hospitals strive to limit these events http://www.jointcommission.org/sentinel_event_statistics_ quarterly/ http://www.jointcommission.org/sentinel_event_statistics_ quarterly/

8. Your Rights NYS Resources – NYS Website: http://www.ny.gov/http://www.ny.gov/ Click on Health then Patient Rights Patient Bill of Rights – http://www.nyhealth.gov/professionals/patients/patient_righ ts/docs/english.pdf http://www.nyhealth.gov/professionals/patients/patient_righ ts/docs/english.pdf Rights as a hospital patient – http://www.nyhealth.gov/publications/1449.pdf 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/NavigationMe nu/PublicResources/LivingWillHealthCareProx yForms/Living_Will_and_Heal.htm http://www.nysba.org/Content/NavigationMe nu/PublicResources/LivingWillHealthCareProx yForms/Living_Will_and_Heal.htm http://www.ag.ny.gov/media_center/2005/ja n/jan31b_05.html http://www.ag.ny.gov/media_center/2005/ja n/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/professionals/patients/ health_care_proxy/index.htm – http://www.nyhealth.gov/forms/doh-1430.pdf 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 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/p olicy/99-10.htm http://www.health.state.ny.us/nysdoh/ems/p olicy/99-10.htm

15. Additional Resources http://www.ag.ny.gov/bureaus/health_care/p dfs/EOLGUIDE012605.pdf http://www.ag.ny.gov/bureaus/health_care/p dfs/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/ 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/under standing/consumers/medicalrecords.html http://www.hhs.gov/ocr/privacy/hipaa/under standing/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/understandi ng/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/administrati ve/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/medicalidentitythef t.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/persona lhealthrecords.html http://www.nlm.nih.gov/medlineplus/persona lhealthrecords.html http://www.myphr.com/ http://www.myphr.com/resources/choose.asp x http://www.myphr.com/resources/choose.asp x http://www.organizedrecords.com/mypromed ical_quicktour.asp http://www.organizedrecords.com/mypromed ical_quicktour.asp http://www.ahrq.gov/questionsaretheanswer / http://www.ahrq.gov/questionsaretheanswer /

31. Thank You Questions?