Physician Responsibility

 

For the reasons discussed below, all or some of a particular patient's information may not always be available through the Clinical Health Record (CHR).  You, as the patient's physician, have the ultimate responsibility for obtaining your patient's complete medical history.  When treating your patients, always consult them about prior treatments, diagnoses and medications prescribed.

 

Member Participation

 

As long as a patient has active coverage with a Shared Health paying entity, their information will remain available through the CHR.  However, patients with a lapse in coverage with a Shared Health paying entity will result in gaps of information available in the CHR.  

 

Problem List

 

The Problem List is created by grouping all pertinent patient data (i.e. claim diagnosis and procedure codes, labs, eRx, etc.) and associating them with a chronic disease or acute problem. Because Shared Health may not have access to all patient data, the Problem List should only be considered as a baseline for discussion with the patient.

 

Care Opportunities

 

Care Opportunities are created by evaluating the Problem list as well as patient wellness criteria against the known patient data (i.e. claim diagnosis and procedure codes, labs, eRx, etc.) utilizing evidence-based medicine guidelines to generate suggested treatment interventions. Care Opportunities are generated when Shared Health is unable to confirm a treatment intervention has occurred. Because Shared Health may not have access to all patient data, Care Opportunities should only be considered as a baseline for discussion with the patient.

 

Sensitive Information

 

Various state and federal regulations require additional protections on the use and disclosure of health information without the authorization of the patient.  For patients participating in the CHR , certain categories of health information have been identified as sensitive and therefore will not be available through the CHR.  

 

For additional detail concerning information availability by State, see below:

 

Tennessee

 

For patients participating in the CHR in Tennessee, the following categories are not available:

 

• Treatment and diagnosis of sexually transmitted diseases (STD) rendered by a state of Tennessee health department.
• Treatment and diagnosis of HIV.
• Treatment and diagnosis of family planning (i.e. contraceptives, abortion, etc) rendered by a state of Tennessee health department for members under 21 years of age.
• Treatment and diagnosis of substance abuse rendered by a federally funded treatment facility.  Treatment includes the use of the following prescriptions: naxolone, antabuse and methadone.
• Diagnosis of genetic testing.  (The presence of genetic testing will be available; however, the result or diagnosis of testing will be reflected as “sensitive” in the CHR).

 

As required by law, claim information that meets any of the definitions above is sensitive information protected by state or federal privacy regulations.  Sensitive information will not be available to any authorized user of the CHR.

 

If your patient has a medical history that could include one of the above categories of sensitive information, please consult with the patient for additional information.

 

NOTE:  The drug-drug and drug-allergy safety alerts do not include or compare other medications prescribed with the following medications: Naxolone, Antabuse, Methadone, contraceptives, or HIV-specific medications.