Prior to screening it is critical to disclose any limits of confidentiality so that the patient can decide what she would like to discuss. Disclosing limits of confidentiality can be done quickly and builds respect and rapport between the patient and provider. This is particularly important in states that have reporting requirements for IPV.
See Getting Started: Reporting for a review of your state’s law on mandatory reporting.
Click here for a sample script to disclose limits of confidentiality.
Click here for provider tips on discussing conditional confidentiality.
Confidentiality of Medical Records
Advocates have long emphasized the importance of detailed documentation of abuse in medical records and the importance of maintaining the confidentiality of charts and electronic medical records. Documentation provides vital evidence for victims who seek future legal recourse including custody disputes, stay-away/restraining orders, or other civil or criminal proceedings.
Proper documentation also improves quality of care by drawing connections between violence and other health issues. If providers do not document abuse they may not recognize its role in other health conditions, and may be less able to intervene to improve the health status of victims and their children.
To ensure that the benefits of health care intervention are achieved, privacy concerns must be adequately addressed. Who has access to medical records? What are the consequences of any breach of confidentiality to medical records by health care staff? For victims of IPV, this is not just an issue of privacy but also one of safety. Clinicians and administrators must create an environment that prioritizes the safety of victims including respecting the confidentiality, integrity and authority of each victim over their own life choices.
Click here to learn more about Health Privacy Principles for Protecting Victims of Domestic Violence.
Click here to learn more about the Health Insurance Portability and Accountability Act (HIPAA).
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