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Patient Care Follow-up

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Emergency Medical Services (EMS) are required to have a quality assurance (QA) process in place, designed to improve the quality of care offered by Pre-hospital Care providers. Patient outcome information is essential to an effective QA process. Any EMS provider that was involved in the care of a patient brought to any St. Elizabeth Healthcare Emergency Department may request follow-up information.

Please Note: All requests must be made in writing and must include the following information:

  • Patient Name
  • Patient Date of Birth
  • Gender
  • Social Security Number
  • Chief Complaint or Mechanism of Injury
  • Date and Time of Run
  • Transporting Unit Along with Department’s QA Coordinator or Designee

Please click here to download a pdf version of the Patient Follow-up Request Form. All patient information will be sent to your department’s QA Coordinator or Designee.

Disclaimer: The Health Insurance Portability and Accountability Act of 1996 (HIPPA) helps to assure that citizens’ medical records are kept private. In some instances, HIPAA allows disclosure of health information without individual authorization, including disclosures between healthcare providers for “quality assurance” activities. Specifically, HIPAA provides that “a covered entity (including a hospital) may disclose protected health information to another covered entity (including an EMS provider) for healthcare operations’ activities of the entity that receives the information, if each entity either has or had a relationship with the individual who is the subjection of the protected health information being requested, the protected health information pertains to such relationship, and the disclosure is for conducting quality assessment and improvement activities.” Whenever information is released, HIPAA mandates that disclosures are restricted to the minimum amount necessary to accomplish the relevant purpose of the request.

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