Health Information

12 Health Information Privacy Code Rules

1. Only collect health information if you really need it.
2. Get it straight from the people concerned.
3. Tell them what you’re going to do with it.
4. Be considerate when you’re getting it.
5. Take care of it once you’ve got it.
6. People can see their health information if they want to.
7. They can correct it if it is wrong.
8. Make sure health information is correct before you use it.
9. Get rid of it when you’ve done with it.
10. Use it for the purpose you got it.
11. Only disclose it if you have a good reason.
12. Only assign unique identifiers when permitted

Health Information Privacy Statement

I understand the following:

Access to my health information

I have the right to access (and have corrected) my health information under Rules 6 and 7 of the Health Information Privacy Code 1994.

Visiting another GP

If I visit another GP who is not my regular doctor I will be asked for permission to share information from the visit with my regular doctor or practice.

If I have a High User Health Card or Community Services Card and I visit another GP who is not my regular doctor, he/she can make a claim for a subsidy, and the practice I am enrolled in will be informed of the date of that visit. The name of the practice I visited and the reason(s) for the visit will not be disclosed unless I give my consent.

Patient Enrolment Information

The information I have provided on the Practice Enrolment Form will be:

• held by the practice
• used by the Ministry of Health to give me a National Health Index (NHI) number, or update any changes
• sent to the PHO and Ministry of Health to obtain subsidised funding on my behalf
• used to determine eligibility to receive publicly-funded services. Information may be compared with other government agencies but only when permitted under the Privacy Act.

Health Information

Members of my health team may:

• add to my health record during any services provided to me and use that information to provide appropriate care
• share relevant health information to other health professionals who are directly involved in my care

Audit

In the case of financial audits, my health information may be reviewed by an auditor for checking a financial claim made by the practice, but only according to the terms and conditions of section 22G of the Health Act (or any subsequent applicable Act). I may be contacted by the auditor to check that services have been received. If the audit involves checking on health matters, an appropriately qualified health care practitioner will view the health records.

Health Programmes

Health data relevant to a programme in which I am enrolled (e.g. Breast Screening, Immunisation, Diabetes) may be sent to the PHO or the external health agency managing this programme.

Other Uses of Health Information

Health information which will not include my name but may include my National Health Index Identifier (NHI) may be used by health agencies such as the District Health Board, Ministry of Health or PHO for the following purposes, as long as it is not used or published in a way that can identify me:

• health service planning and reporting
• monitoring service quality
• payment

Code Of Rights

The Ten Rights of Patients in the Health and Disability Code

Right 1 — To be treated with respect including respect for personal privacy.
A non-judgemental approach is required in all cases. Examining one’s own feelings and possible prejudices and recognising them as the first step to treating everyone in a non-judgemental fashion. However care also needs to be taken that we are not victims of deceit or unreasonable requests in an attempt to be ‘neutral’. Personal privacy will be achieved through the practice’s privacy policies and procedures.

Right 2 — Freedom from discrimination, coercion, harassment and exploitation.
Patients will be treated based on clinical grounds regardless of race, gender, age, socioeconomic status or sexual orientation.

If there are reasonable grounds to assume that the practice or its staff are being exploited by any particular patient then the appropriate response is not based on any particular characteristic of that individual but rather on the actual circumstances of the problem that has arisen.

The Practice has a complaints officer who has the responsibility of monitoring, educating staff and dealing with any issue where discrimination in provision of service has taken place.

All reasonable efforts to provide facilities for those with disabilities will be made by the practice. Such disabilities may include: impaired literacy, intellectual impairment, dementia, impaired hearing or vision or a physical handicap.

Right 3 — To be treated with dignity and independence.
All patients need to be given the benefit of the doubt about their sincerity and genuineness unless there is good reason to believe that they are not acting in good faith. If that is suspected then the evidence for that conclusion needs to be strong and consideration should be given for documenting that. A way to test whether any patient is not being treated with the appropriate dignity and state of independence is to consider;

1. How your colleagues would treat this patient or
2. Whether your treatment is of a standard that you would wish for yourself or your family if you were that individual.

Through following these principles it is thought all patients will be afforded the dignity and independence they are entitled to.

Right 4 — Services of appropriate standards.
Appropriate standards are maintained through ongoing professional development and benchmarking against any minimum standards set by professional bodies such as the Medical Council and the Nursing Council, colleagues as well as setting one’s own standards high. All legal and professional and ethical standards will be adhered to.

The practice will operate on a CQI (continuous quality improvement) philosophy in order to be always ready to correct errors if they occur and improve service where possible. Services will be provided tailored to the individual’s needs in a patient centred approach. Patients will be involved as much as possible in their care and decisions regarding their care. The practice will foster a team approach working together to achieve the best outcomes possible. Continuity of care is an important principle to strive for.

There will a staff training record which all staff training within and outside the practice will be recorded. New staff will have adequate training to ensure they comply with the Code of Rights. Training will take place annually either by in house discussion or using external trainers.

Right 5 — Effective Communication
Effective honest communication is strived for by all staff for all and mechanisms for dealing with poor communication as evidenced by complaints or poor outcomes or significant adverse events are addressed in other policies (complaints management and significant events management).

Details of translation services for as many languages as possible will be kept at the surgery. The local DHB offers a free interpreter service for general practices. Disabled patients e.g. with hearing difficulties or sight problems will need special consideration about how best to effectively communicate with them. E.g. written information or engaging a signer. Fax machines and Texting provide a possible solution to some communication problems.

Right 6 — To be fully informed.
This is part of effective communication and staff will be required to give as full an explanation to patients regarding their health problems and possible treatment options as the context requires. There is a practice policy for informing patients of their test results. Patients may allow a nominated representative to receive health information about them. All new patients will be routinely given a copy of the practice information leaflet. This is available at reception.

Where able staff will direct patients to sources of information or provide written material such as leaflets that are relevant to their health problem or disability. Patients must be given all the information that a reasonable patient would expect to receive to enable them to make an informed decision, including (but not limited to):

• an explanation of their condition and the treatment options available to them including information about the expected risks, side effects, benefits, and costs of each option;
• advice on the estimated time within which they will be treated;
• details of any proposed participation in teaching or research; and
• the results of tests and procedures.

It is the health professional who is to provide services to the patient who must obtain the patient’s consent. The practice has a form for obtaining consent. This form should be tailored to the particular case. Details of specific and significant risks discussed must be recorded on the form.

Patients have the right to ask questions and to receive honest and accurate answers to their questions, including questions about:

• the identity and qualifications of the person who will be treating them;
• how to obtain a second opinion; and
• the results of research.

Patients also have the right to receive a written summary of any information that has been provided to them if such a request is made.

Right 7 — To make your decision (informed choice & informed consent)
Staff are trained to be aware of the concept of the need to be as patient centred as possible appropriate to each set of circumstances that arises, and the medical staff attempt to act as examples of this. Patients are assumed to be competent to make an informed choice and give informed consent unless there is good reason to think otherwise. Hence, decisions will hopefully be made with patients in an informed way and consent given freely. The practice has a consent form for more non routine treatment or more significant and invasive procedures for patients to sign.

When a patient has diminished competence, the patient still has the right to make informed choices and give informed consent to the extent that the level of competence allows.

When a patient is not competent to make an informed choice or give informed consent, and there is no-one available to consent on the patient’s behalf, staff can treat the patient if the treatment is in the patient’s best interests, staff have taken steps to ascertain the patient’s views, and either:

• staff believe that the patient would have consented to the treatment if he/she was competent given the views that the patient has expressed; or
• staff have not been able to ascertain the patient’s views, but have taken into account the views of other suitable persons who are interested in the patient’s welfare.

Right 8 — To be supported by another if wished. At all times patients are free to have any support person they wish to have as long as it does not detract from the effectiveness of the consultation and clinical outcomes, or compromise the rights of another patient. Where this may be the case the patient will be advised of this and given the choice as to whether to have the support present still. Furthermore there will be freely available material and posters displayed about the advocacy services available. The patient may need to be asked in private whether they wish to have a support person present with them or not.

Right 9 — To participate or decline participation in teaching and research Participation in research is a patient’s prerogative and will never be forced. Explicit informed consent will always be obtained where students are taught in the practice. Patients will be offered the choice of whether they wish the student to be present.

Right 10 — To "complain"/give feedback in order to help improve services. See the information below for more details on the complaints procedure.

Right To Have A Support Person Present

Our clients and patients are welcome to bring along whanau or support people to their appointments if they wish.

At all times patients are free to have any support person they wish to have as long as it does not detract from the effectiveness of the consultation and clinical outcomes, or compromise the rights of another patient. Where this may be the case the patient will be advised of this and given the choice as to whether to have the support present still. Furthermore there will be freely available material and posters displayed about the advocacy services available. The patient may need to be asked in private whether they wish to have a support person present with them or not.

Complaints

Everyone consumer has the right to “complain”/give feedback in order to help improve services.

1. Every consumer has the right to complain about a provider in any form appropriate to the consumer.
2. Every consumer may make a complaint to:
   The individual or individuals who provided the services complained of; and
   Any person authorised to receive complaints about that provider; and
   Any other appropriate person, including -
   a) An independent advocate provided under the Health and Disability Commissioner Act 1994; and
   b) The Health and Disability Commissioner.
3. Every provider must facilitate the fair, simple, speedy, and efficient resolution of complaints.
4. Every provider must inform a consumer about progress on the consumer's complaint at intervals of not more than 1 month.
5. Every provider must comply with all the other relevant rights in this Code when dealing with complaints.
6. Every provider, unless an employee of a provider, must have a complaints procedure that ensures that
   The complaint is acknowledged in writing within 5 working days of receipt, unless it has been resolved to the satisfaction of the consumer within that period; and
   The consumer is informed of any relevant internal and external complaints procedures, including the availability of -
   a) Independent advocates provided under the Health and Disability Commissioner Act 1994; and
   b) The Health and Disability Commissioner; and
   c) The consumer's complaint and the actions of the provider regarding that complaint are documented; and
   d) The consumer receives all information held by the provider that is or may be relevant to the complaint.
7. Within 10 working days of giving written acknowledgement of a complaint, the provider must, -
   Decide whether the provider -
   a) Accepts that the complaint is justified; or
   b) Does not accept that the complaint is justified; or
8. If it decides that more time is needed to investigate the complaint, -
   Determine how much additional time is needed; and
   If that additional time is more than 20 working days, inform the consumer of that determination and of the reasons for it.
9. As soon as practicable after a provider decides whether or not it accepts that a complaint is justified, the provider must inform the consumer of -
   The reasons for the decision; and
   Any actions the provider proposes to take; and
   Any appeal procedure the provider has in place

Repeat Prescriptions

Seeing your registered provider or Doctor to discuss and monitor your ongoing medical conditions is the best way to obtain a repeat prescription of your long term medications. Providing repeat prescriptions without seeing you is at the discretion of your doctor.

WE DO NOT NOT ROUTINELY CONTACT YOU AFTER A SCRIPT REQUEST.

We will contact you if an appointment with your doctor is needed or if we require any further information to issue the prescription. If we do not contact you within 24 hours (1 working days) the prescription will be ready. (There will be a delay over weekends and public holidays).

YOU NEED TO SEE THE DOCTOR BEFORE THE PRESCRIPTION IS ISSUED IF:

• you have not reviewed your use of this medication with your Doctor in the last 6 months OR
• been in the hospital since you have last seen your doctor OR
• your medication was altered at your last visit by your doctor OR
• you have seen a specialist and medications were altered OR
• you are requesting an antibiotic, sleeping pill or medication that is not classified as one of your long term medications

TO REQUEST A REPEAT PRESCRIPTION

• Log on to our Patient portal to request a repeat prescription

OR

• Call the clinic and leave a message on the Nurse phone line.

Please allow 72 hours for your prescription to be ready, if you require an urgent prescription you will need to make an appointment to see the Doctor.

Recall & Reminder Policy

This practice uses a “Recall and Reminder” system to provide preventive care for its enrolled patients.

This will assist in ensuring that important health checks are not forgotten. You will be reminded when it is time to visit your doctor or nurse for a check-up or as a follow-up to health risks that have previously been found. The reminder system will include checks to help in the prevention or early detection of certain conditions such as diabetes, high blood pressure, high cholesterol and forms of cancer – particularly cervical and prostate cancer, and immunisation follow-up.

We will use information from your health record to tell us the check-ups for which you are due and when you should visit the clinic to discuss the tests that are recommended for you.

By allowing us to send you these reminders, you will help us to detect serious conditions early and to monitor known conditions. This can significantly improve the long-term outcome for you. We will send these reminders either via text or letter.

Even when you agree to be included in the Recall and Reminder system, you should remember when you should be tested for certain conditions and should always contact your doctor or nurse to get the results of a test that has been performed. We may not always be able to reach you, especially if you have moved and the contact information on your record has not been updated.

Below is an example of the types of reminders you may receive if you are registered with us.

Cervical Smears

• Registered Funded Patient age 20 – 70 yrs.
• National screening Unit recalls high risk patients
• Recalled accordingly to result / histology recommendations and national cervical screening guidelines.

Mammography

• Registered Funded Patient age 40-70 yrs unless high risk family history.
• Enrolled in Breast Screen if qualifies age 45-70 yrs.
• Recalled according to result and risk factors

Immunisation

• As per national schedule, loaded on enrolment
• Recalled as per schedule

Blood Pressure

• Minimum 3 monthly checks for at risk patients
• Recalled as per schedule

Cardiovascular Disease Risk Assessment

• As per the New Zealand Recommendation Guidelines

Diabetes

• Three monthly to annual blood tests and doctor visits

Blood Test Reminder

• Screened opportunistically or long term monitoring of medical conditions such as Diabetes

Test Result Notification

Please allow 3 to 7 working days for your results to return.

A Doctor or Nurse will contact you, if any follow up is required. Please check your contact details are correct at Reception.

If you are registered with our Patient Portal, you may check your results online by logging in. Please allow 7 working days.

Should you have any concerns about your results please phone the clinic to speak to a Nurse or alternatively you can make an appointment with your Doctor to discuss your results.