John A. Schmidt, Jr., M.D. LLC

By John A. Schmidt, Jr., M.D.

Appropriate use of your personal health information (PHI) is my most powerful tool in promoting your health. Your PHI consists of all the information that is critical to our partnership including but not limited to your demographic information (date-of-birth, address, employer, insurance plan, pharmacy, etc.), your medical history, including family and social history, physical examination results, laboratory results, diagnoses, treatments, and prognoses. On the one hand, it is incumbent on me to collect, analyze, interpret and act on these data to provide you with superb care. On the other hand, it is the obligation of everyone in the Practice to keep your PHI confidential so that it does not fall into the hands of those who might use it inappropriately.

It should be obvious upon reflection that in order for the Practice to render you excellent and cost-effective care, we must share some or all of your PHI with a large number of individuals and organizations including pharmacists, consultants, insurance companies, government agencies such as Medicare, nursing homes and less commonly, public health departments, emergency care workers, police, and persons whom you identify to make medical decisions on your behalf, i.e., your health care proxy. How do we do this while carefully protecting your confidentiality? There are four guiding principles. First, we generally share information only with those who are under the same obligation to protect your confidentiality as we are. The comprehensive term often applied to this circle of licensed caregivers is your “medical home”. Second, we share your PHI on “a need to know basis”. This means that we only share the kinds of information necessary to render a given service. For example, we give your pharmacist your date-of-birth, medication list, and drug allergies but we generally do not share the results of your physical examination and laboratory results. Third, we keep you anonymous whenever possible. For example, when we run a quality report to see how the practice is performing against certain benchmarks, we may use some of your PHI without attaching data that would allow recipients to track the results back to you. Fourth, we store your PHI on a secure computer (“server”) using software that is certified by government-approved agencies (such as CCHIT) to be compliant with rigorous privacy standards established by the government.

Please understand that once you have been given this Notice and you sign the Acknowledgment indicating that you have read it, this Privacy Practice becomes our default policy. That is, we will proceed as described without asking your permission every time we share your PHI within your extended medical home. When someone outside of your medical home requests access to your PHI, we will ask your written permission beforehand. In this regard, you will be provided with a form entitled “Patient Disclosure Instructions” on which you may identify one or two individuals outside of your medical home with whom we may share your PHI. If you state “none”, we will not share your PHI with your spouse, close friend, relative, business associate, etc. On the same form please tell us how you wish to be contacted (home/work/cell phone, home/work answering machine, home/work email). If you wish to restrict sharing of your PHI within your medical home, you must notify the practice in writing and specifically describe (a) the PHI you wish to restrict and (b) with whom your PHI may not be shared. Upon receipt of such written notification, we will generally observe your instructions unless, in my sole medical judgment, I believe we must share your PHI to safeguard your life or the lives of others. Please be advised that you have the right to file complaints with government authorities without risk of retaliation. The Practice will provide you with the information to do so, upon written request. You also have the right to request in writing a summary of your PHI, as well as a summary of your PHI disclosures. Please speak with Dr. Schmidt if you have any questions about this Notice.

Health Information Exchange – We, along with other health care providers in New Jersey, participate in Jersey Health Connect, a health information exchange (HIE) which allows patient information to be shared electronically through a secured network that is accessible to the providers treating you. We may disclose your medical information to Jersey Health Connect HIE, unless you opt-out of participating in the HIE.

Personal Health Record – Certain portions of your medical record are available electronically to you in a PHR which is accessible at Enrollment is required. We may disclose your medical information to the Jersey Health Connect HIE for purposes of adding your medical information to your Personal Health Record (PHR).

Download a PDF of Our Privacy Policy
Privacy Acknowledgement Form