Read the original guide from the Oklahoma Hospital Association.
Hospitals and the news media have a responsibility and a joint interest in working together to see that the news is reported promptly and is readily available. There is sometimes a fine line between information that is confidential and information that the public has the right to know. The following guidelines are modeled after those established by the American Hospital Association, and are endorsed by the Oklahoma Hospital Association. They have changed significantly from past guidelines for releasing information on the conditions of patients, in order to comply with state and federal privacy laws, including the health information privacy standards of Administrative Simplification Provisions of the Health Insurance Portability and Accountability Act (HIPAA).
Understanding that the hospital’s first responsibility is to protect the confidentiality, health and legal rights of each patient, the following is a guide for the request and release of patient information:
Release of Patient Information
A hospital may release certain information about the patient that is included in what the HIPAA privacy standards call the hospital’s facility directory. As long as the patient is informed in advance, either orally or in writing, and does not object, either orally or in writing, a hospital may disclose the following information, ONLY to persons who inquire about the patient by name.
Hospital Directory Information
Patient Information, Condition & Location: What You CAN Release
Information about the condition and location of an inpatient, outpatient or emergency department patient may be released only if the inquiry specifically contains the patient’s name. No information is to be given if a request does not include a specific patient’s name, including inquiries from the media. Requests for information not containing the patient’s specific name are to be referred to the public entity (such as the coroner’s office, police, fire, or health department). If the person requesting information has provided the patient’s name, hospitals may release the patient’s one-word condition and location if the process set forth above regarding the hospital facility’s directory has been followed and the patient has not objected to the disclosure.
If the opportunity to object to a disclosure cannot be provided because of the patient’s incapacity or an emergency, the hospital may disclose this information if the disclosure is: 1) consistent with a prior, expressed preference of the patient, if any; and 2) in the patient’s best interest, as determined by the hospital, in the exercise of professional judgment. See “Location” below for exceptions on providing news media with the patient’s location.
If the patient is a minor, permission for release of any information must be obtained from a parent or the legal representative. Under certain circumstances, minors in Oklahoma can authorize disclosure of information without parental approval or notification. (Title 63 O.S. § 2602).
Definitions of Patient Conditions
- Condition – For the one-word condition, use one of the following five terms: “undetermined,” “good,” “fair,” “serious,” or “critical.”
- Undetermined: Patient is awaiting assessment.
- Good: Vital signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.
- Fair: Vital signs are stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.
- Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
- Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.
NOTE: “Stable” is not an official condition! A critical or serious condition means that at least some vital signs are unstable, so using “stable” with these conditions is inherently contradictory.
The patient’s location may be included in the hospital directory to facilitate visits by friends and family, as well as the delivery of flowers and gifts. However, as a matter of policy, the patient’s location should not routinely be given to the media.
Although the HIPAA privacy standards do not expressly prohibit disclosure of a patient’s room location to the media (because the media are accorded the same access to information as other callers), this omission was not intended as a loophole to give journalists access to patients who do not want them to have it. To safeguard patient privacy, it is recommended that hospitals adopt or maintain policies prohibiting disclosure to the media without patient permission. Furthermore, the media should not contact patients directly.
Beyond the One-Word Condition: Media Access to Patients
Media representatives and photographers must contact the hospital spokesperson for assistance in obtaining interviews and/or photographs of patients, employees and areas of the hospital. (See section titled “Photographs/Interviews/Videotaping by the Media” below.) Hospital policies require that a hospital representative accompany news personnel ANY time they are on hospital grounds. The following activities require written authorization (signed consent form) from the patient:
- Releasing a detailed statement (includes anything other than a one-word condition); the patient or his/her legal representative should approve written statements;
- Taking photographs (either video or stills) of the patient; and
- Media interviews with patients.
In general, if the patient is a minor, permission for any of these activities must be obtained from a parent or the legal representative. Under certain circumstances, minors in Oklahoma can authorize disclosure of information without parental approval or notification. (Title 63 O.S. § 2602)
When You Should NOT Release Any Information
- When the patient requests that NO information about him/her is released. A patient who was listed in the hospital directory can choose to stop the release of all information, including condition reports, by notifying the hospital spokesperson to no longer release the information;
- When knowledge of a patient’s location within the hospital could result in embarrassment for the patient.Examples include, but are not limited to, admission to a psychiatric or substance abuse unit; admission to an obstetrics unit following a miscarriage, ectopic pregnancy or other adverse outcome; or admission to an isolation room for treatment of an infectious disease;
- When knowledge of a patient’s presence or location in the hospital could place the patient, hospital employees and/or medical staff in danger (i.e., a stalker or abusive partner);
- When the hospital and/or members of the medical or nursing staff are, or may be, parties to litigation;
- When the patient is in the custody of the state (Department of Human Services, incarcerated or in psychiatric care); or
- When, in the judgment of the patient’s physician, the nursing staff or hospital official, an interview would aggravate a patient’s condition, or is inappropriate due to unique circumstances, hospital spokespersons are justified in denying access to the patient without seeking consent. As soon as circumstances permit, hospital public relations personnel should make the request for an interview to the patient.
The death of a patient must be reported to the authorities by the hospital as required by law. Typically, a report will be made after efforts have been made to notify next-of-kin. Information about the cause of death must come from the patient’s physician, and its release must be approved by a legal representative of the deceased. Before information confirming a death is released to the media or others, a written authorization from the next-of-kin or the decedent’s legal representative is advised.
If the death is subject to an investigation by the Oklahoma State Medical Examiner’s Office, inquiries or requests for details should be directed to the M.E.’s office, 405.239.7141.
Matters of Public Record
Matters of public record refer to situations that are reportable by law to public authorities, such as law enforcement agencies, the coroner or a public health officer. According to HIPAA privacy standards, patients who are involved in public record situations have the same privacy rights as all other patients, as far as the hospital is concerned. The mode of transportation by which a patient arrives at the hospital should have no bearing on the hospital’s approach to releasing information about the patient.
While law and/or regulations require health care facilities to report a variety of information to public authorities, it is not the responsibility of facilities to provide that information in response to calls or inquiries from the media or other parties. Once the patient’s name has been provided to the hospital spokesperson by the media, only the one-word condition should be given.
Requests for additional information should be directed to the appropriate public authority. The public entity will be guided by the applicable federal or state statutes as to whether or not it can release information.
Celebrity and public figures are not subject to different standards than other patients when it comes to hospital policies for releasing information to the media.
For many hospitals, this will represent a change from previous policies.
Photographs/Interviews/Videotaping by the Media
- Hospital policies require that a hospital representative accompany news personnel ANY time they are on hospital grounds.
- No photographs, audio/video recordings or interviews of patients may be taken within the facility or on hospital property without the patient’s prior written consent, or the written permission of a parent or legal representative. The release form should be obtained through the public/media relations office.
Even with permission, news media representatives should use good judgment when airing images or printing photographs of patients who are ill or injured. Deceased or unconscious patients are not to be photographed UNDER ANY CIRCUMSTANCE, regardless of whether they are in the hospital or on hospital property.