I understand that the Hospital or business entity (the "Hospital") for which I work, volunteer, observe or provide services manages health information as part of its mission to treat patients. Further, I understand that the Hospital has a legal and ethical responsibility to safeguard the privacy of all patients and to protect the confidentiality of their patients' health information. Additionally, the Hospital must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers (collectively, with patient identifiable health information, "Confidential Information"). In the course of my Shadow/Observer Program at the Hospital, understand that I may come into the contact with this type of Confidential Information. I further understand that must sign and comply with this Agreement in order to obtain authorization to participate in the Shadow/Observer Program.
General Rules:
1. I will act in the best interest of the Hospital and in accordance with its Code of Conduct at all times during my relationship with the Hospital
2. I understand that I should have no expectation of privacy when using Hospital information systems. The Hospital may log, access, review, and otherwise utilize information stored on or passing through its systems, including email, in order to manage systems and enforce security.
3. I understand that violation of this Agreement may result in disciplinary action, up to and including termination of employment, suspension, and loss of privileges, and/or termination of authorization to work within the Hospital, in accordance with the Hospital's policies.
Protecting Confidential Information:
1. understand that any Confidential Information, regardless of medium (paper, verbal electronic, image or any other), is not to be disclosed or discussed with anyone outside those supervising, sponsoring or directly related to the learning activity.
2. I will not disclose or discuss any Confidential Information with others, including friends or family, who do not have a need to know it. I will not take media or documents containing Confidential Information home with me. Case presentation material will be used in accordance with Hospital policies.
3. I will not publish or disclose any Confidential Information to others using personal email, or to any internet sites, or through internet blogs or sites such as Facebook or Twitter. I will only use such communication methods when explicitly authorized to do so in support of Hospital business and within the permitted uses of Confidential Information as governed by regulations such as HIPAA.
4. In the term of my Shadow/Observer Program, I may need to orally communicate health information to or about patients. I will take reasonable safeguards to protect conversations from unauthorized listeners. Whether at the School or at the Hospital, such safeguards include, but are not limited to: lowering my voice or using private rooms or areas (not hallways, cafeterias or elevators) where available.
5. I will not make any unauthorized transmissions, inquiries, modifications, or purgings of Confidential Information. I will not access data on patients for whom I have no responsibilities or a need-to-know the content of the PHI concerning those patients.
6. I will not transmit Confidential Information outside the Hospital network.
Use of Electronic Devices:
1. I understand that I cannot possess any electronic device that records, films or photographs in any patient areas.
2. I will be required to place all electronic devices in the designated area (office, breakroom, locker room) provided during my shift.
3. I can access my electronic devices in the designated area or while on break in non-patient areas.
By signing this document, I acknowledge that I have read this Agreement and agree to comply with all the terms and conditions stated above.