Sometimes when people hear the word "confidential", they assume that no one will need to know any information about them or that they have interacted with an organization or treatment provider in any way. Ideally, that would be possible. However, there are usually reasons that may limit the degree of confidentiality.
According to the American Medical Association Code of Medical Ethics, confidentiality is the concept of protecting personal health information that is shared between a patient and physician. Usually, patients can determine who can access this information through a consent process, though there are some exceptions. The exceptions include sharing of information between providers taking care of the same patients (like when the medical record is available for any of your providers in the same hospital system), billing, reporting required by law (such as in the cases of child or elder abuse), or concerns of harm to self or others. The consent process consists of signing a form called a release of information (ROI).
The privacy rule regarding confidentiality of medical records is outlined in HIPAA regulations (Health Insurance Portability and Accountability Act). It applies to health care providers, health plans, and healthcare clearinghouses (such as billing companies).
At OhioPHP, the standard is even higher because we follow federal regulations called 42 CFR Part 2, which have stricter guidelines regarding how information can be shared. This regulation was created to protect information related to treatment for substance use disorders. It is the reason why a loved one can call a treatment facility to check on someone and there is no acknowledgement that their spouse or child is even being treated at that facility. Once the individual signs a release of information to allow the treatment facility to speak with the family member, there can be open communication. However, it is up to the individual to make that decision and allow for any type of disclosure.
At OhioPHP, we have several partnerships with the healthcare regulatory boards to administer safe haven programs (or for the State Medical Board of Ohio, the confidential monitoring program). These programs are a way to seek and obtain help for substance use disorders or mental health conditions that are potentially impairing and could affect a healthcare worker’s ability to work. When a licensee seeks help and is getting the treatment they need, there is no need for the regulatory boards to know about their medical diagnoses or treatment details. The information is kept confidential from the board and there is no disciplinary action on the licensee’s record.
Programs like this encourage licensees to seek help sooner because it decreases the fear related to losing their license for getting treatment. Sadly, this is something that has happened in the past and we are trying our best to show that a safe haven or confidential monitoring program works better than disciplinary action to get people back on track and back to work safely and protect the public. However, if there are concerns about public safety or the healthcare worker does NOT seek treatment for their condition(s), the regulatory board may get involved. OhioPHP has a responsibility to help healthcare professionals seek care and to protect the public.
Even within the safe haven or confidential monitoring program, there may be others that need to be a part of the licensee’s overall treatment experience. During the process of a wellbeing screening which OhioPHP does internally, we may need to get information from people close to the licensee to get a full picture of how they are doing. The licensee gives permission/consent to do this by signing an ROI form, so they will decide and be fully informed on who we reach out to. We need this information to make the most educated and appropriate recommendations for the licensee.
What about my job?
There are also times when an employer may need to be aware of the licensee’s situation. This could include if an employer refers the individual to OhioPHP because of concerns of impairment at work or if the employer needs to help the individual regarding time off from work. At OhioPHP, we encourage licensees to be transparent with their employers so that we can coordinate together. Substance use and mental health disorders are all medical conditions that qualify for FMLA, which helps protect the licensee’s position while they are in treatment. We also encourage employers to be supportive of their employees during these times so that the licensees can come back to work safely and be healthier and happier in the process.
When it comes down to it, there are different ways confidentiality applies to an individual’s health information. As the monitoring agency that runs safe haven/confidential monitoring programs for many of the state healthcare regulatory boards, OhioPHP is helping healthcare workers get linked to the treatment that they need to stay well while also keeping them confidential from the regulatory board and avoid disciplinary action that would lead to public disclosure. OhioPHP also operates under the 42 CFR Part 2 federal regulations that are stricter than HIPAA, which is the privacy law overseeing the majority of personal health information of most people.
OhioPHP supports confidential and compassionate care for all healthcare professionals with illnesses that may impact their health and well-being. OhioPHP supports the use of confidential services whenever possible in lieu of regulatory awareness in order to eliminate fear of punishment, disciplinary action, embarrassment, or professional isolation.
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