What information about your medical care does MIT share with other people?
On the whole, remarkably little is shared without your consent; MIT withholds most information unless you give the Institute written consent. This tight-lipped approach protects student privacy, but it can cause hassles when different parts of MIT want to work together.
Confidentiality at MIT’s Mental Health Services is governed by a number of federal and state laws, including the Health Insurance Portability and Accountability Act. This act defined privacy measures to regulate the disclosure of a person’s Personal Health Information. The act also sets forth administrative, physical, and technical safeguards to protect patients’ electronic personal health information.
A curious quirk of HIPAA specifically excludes all educational records that are covered by the Family Educational Rights and Privacy Act, which includes a student’s individual medical records. Medical records of non-students are regulated by the privacy restrictions set in HIPAA.
Mental Health Services will only release personal information with a patient’s written permission, in compliance with Massachusetts state law. This written permission is required even for release to a patient’s primary health care provider or to a support dean in Student Support Services.
There are exceptions to this requirement, such as when the person is in danger of physical harm by suicide, if someone else is in danger, or if abuse or neglect of a child or elderly person is involved.
Medical and mental health records are stored apart
In addition, Chief of Mental Health Services Alan E. Siegel said that a person’s health records at MHS are kept separately from the records of MIT Medical. According to Siegel, this policy is not required by law, but MIT has chosen to follow it.
As a result, when a person comes to MIT Medical for urgent care, medical personnel must ask MHS to see if they have any information relevant to the patient’s medical care, such as the medications the patient is taking.
In extreme emergencies, medical personnel can engage in a process called “breaking the glass,” where they look at a patient’s mental health records using a standard called presumed consent.
This procedure is used very rarely, according to Siegel; he said he can’t remember it being used in the past year and a half.
Medical information kept from families
“MIT students are not considered minors, regardless of age,” according to MIT Medical’s policy.
Parents and family members of patients are not notified of the patient’s care unless there is a life-threatening medical condition or the patient cannot make decisions regarding their own health.
MHS does not communicate directly with the patient’s family,
When a student is hospitalized or in the emergency room, inpatient units are supposed to engage with the students directly and work to let their housemasters know, Siegel said.
If psychological problems are suspected, the staff at MIT Medical will inform the support deans at Student Support Services, who can talk with MHS.
Separation can cause anxiety
Does MIT’s privacy-centered approach reduce the amount of communication that could happen between doctors and the patient’s support group?
Matthew A. Dawson G, a graduate resident tutor from MacGregor, said that although MIT’s privacy policies provide legal protection for the Institute, they may also be hurting students. Medical privacy rules make it hard for him to find out about his residents’ well-being, he said.
After one of Dawson’s students was hospitalized this year, Dawson received an e-mail saying that the student was there, but he would’ve liked to know more. “It didn’t say whether it was a serious condition,” Dawson said. “It’d be nice if they said ‘They’re in the hospital, alive, in stable condition.’”
“The other time[s], my students went to the hospital, I was not contacted,” Dawson said.
Dawson said that after he takes a student to get counseling or medical help, he receives no follow-up information from the Institute on that student’s status. Asking students themselves about their treatment is awkward and seems to take the GRT-student relationship too far, he said.
If students routinely filled out waivers during Orientation, GRTs might be more able to help their students, Dawson said.
Institute committees need consent
The Committee on Academic Performance and the Committee on Discipline will only receive mental health information with students’ consent, Siegel said.
MHS usually receives a list of students who are going to be reviewed by those committees, and the staff at MHS asks those students if they would like MHS to provide information on their behalf.
“CAP is not privy to confidential information about a student’s mental health, unless the student signs a release which allows the medical department to comment on the student’s case,” wrote Kai von Fintel, Chair of the CAP, in an e-mail.
Jessica T. McKellar ’09, a student member of CAP, said that representatives from Medical and S^3 are present at the end of term meetings. “Medical still can’t give away privileged information. They can mostly just confirm that a student’s statements of FOO, BAR, and BAZ happening is accurate based on their records,” she said in a zephyr, referring to the common placeholder terms used by computer scientists.