Confidentiality and Consent

The confidentiality of all records and other medical information about patients at HUHS is protected to the full extent of the law and follows the ethical practice guidelines of the medical, psychiatric, and psychological professions. Patient records from the Mental Health Service and student records from the Bureau of Study Counsel are kept separate from general medical records (see also Bureau of Study Counsel). Records of all types are kept in secure locations and are available only to the HUHS staff members directly involved in a specific case. Written authorization from the student is necessary to release record information to any third party except in highly unusual circumstances as required by law, or as indicated in the following paragraphs. More specific information about the privacy and security of medical records held by HUHS can be found in the HUHS Notice of Privacy Practices, www.huhs.harvard.edu/privacy. Any questions or concerns about issues of confidentiality or patient rights at HUHS should be addressed to the Patient Advocate at 617-495-7583 or patadvoc@huhs.harvard.edu, and students can also consult the Harvard Student Health Insurance Handbook on this topic.

The College may call upon professional staff at HUHS or the Accessible Education Office (AEO) for consultation regarding the impact of a student’s physical or emotional health on residence, on the necessity of a medical leave of absence, or on special academic or residential arrangements or accommodations (see also Effect of Health Issues on Dormitory or House Residence, Medical Clearance for Return to Residence, and Attendance, Absences, Reading Period, Examinations, and Extensions). If, as part of the consultation, the College requests medical information from HUHS about a student, then that information may be provided, in ordinary circumstances, only with the student’s permission. Where permission is given, only relevant information about the impact of a physical illness, disability, emotional difficulty, or other health condition on a studen'’s residential and academic life is discussed; information that is not relevant to the arrangements of residential and academic adjustments under consideration will not be disclosed. When a student chooses not to allow HUHS to provide such information to the College regarding pending academic or residential arrangements or accommodations, then the College will proceed to make decisions in the absence of this information. It is also always possible for students to initiate a consultation between their health care providers at HUHS and College administration.

In certain circumstances it may not be possible or advisable for professional staff at HUHS or AEO to obtain a student’s consent to a disclosure of medical or mental health information. Three such circumstances worthy of note include the following:

Danger to self or others

One exception to obtaining a student’s consent is the rare instance in which a student’s medical condition or behavioral disturbance poses a danger to the student or threat to others or to the community. HUHS or AEO professional staff may then disclose any relevant information to any appropriate person, including College officials, for the purpose of protecting the student, others, or the community from harm. Generally, even in this situation, every effort is made to notify the student of the need to disclose and the reason for such disclosure.

Stillman Infirmary

It is generally useful for the College to know when a particular student has suffered a serious injury or illness for such purposes as arranging academic relief or assuring that the student can return safely to residence. For this reason, it is the College’s policy that HUHS will normally inform the College (via the student’s Resident Dean or other responsible administrator) when a student is admitted to or discharged from Stillman Infirmary. Only information regarding the fact of the admission/discharge, general medical condition, and prospects for return to residence is shared; information regarding diagnosis or treatment is not shared. This procedure is intended to alleviate the concerns of College officials as to a student’s whereabouts and safety, and to allow communication with parents in the event that the parents have been unable to locate the student.

Rarely, a student may go to HUHS for urgent care who refuses to disclose his or her name for fear of privacy concerns. HUHS will make every effort to assure that student that the confidentiality of any medical records generated by such care will be fully safeguarded. If admission to Stillman is medically indicated but the student refuses to divulge his/her identity, HUHS will be unable to admit that student to Stillman. In such circumstances, the student will be transferred to a local emergency department. Thereafter, the student will need to follow the standard University policy on return to residence.

Treatment at area hospitals or medical facilities

It is HUHS’ policy to notify the College of student transfers to local emergency departments. Such notification is provided to the appropriate Resident Dean, and is documented at HUHS in the Transfer Tracking Log. Exceptions to this rule include transfers for the purpose of services that cannot be provided at HUHS (e.g., suturing of lacerations or obtaining radiographs after hours) or the need for collection of evidence by a Sexual Assault Nurse Educator (in which case notification is provided to the Office of Sexual Assault Prevention and Response rather than to the Resident Dean). If a Resident Dean, other residential official, or College administrator has reason to believe that a student is not in residence and may be in a medical facility, he/she may contact HUHS regarding a student’s whereabouts. The HUHS clinician will disclose only that the student is safely in care. When, in a HUHS clinician’s medical judgment, a student is in a life-threatening condition, or is medically or psychologically unstable, or has sustained an illness or injury that will likely result in a hospital admission or require care after discharge, that clinician will notify the student’s Resident Dean, residential official, or College administrator. Only information regarding the fact of the admission/discharge, general medical condition, and prospects for return to residence is shared; information regarding diagnosis or treatment is not shared. Students returning from emergency care or hospitalization at area facilities ordinarily will be referred to HUHS for assessment regarding suitability to return to residence, and to AEO for consultation regarding the need for follow-up services and accommodations.

When a student who has been hospitalized or received emergency treatment decides to leave a medical facility against medical advice, a HUHS clinician may apprise that student’s Resident Dean or other appropriate College official of this decision, if in the clinician’s judgment the student’s decision may pose a significant risk of physical or emotional danger to the student, to roommates or suitemates, or to members of the residential community. Depending upon the circumstances, the clinician may inform a College official of the student’s location, decision to leave a facility against medical advice, risk of further injury or relapse, or possible threat to the student’s own safety or to that of others.