Authorization for Health Information Exchange (HIE)
The HIE system is a secure computer system that brings your health information from different healthcare locations into one nationwide electronic health record.
The HIE system network provides participating practitioners access to past and present medical information to make better decisions and better coordinate care across your care teams.
The HIE system takes your privacy and security very seriously. The HIE system does not store any of your health/clinical data and uses end-to-end encryption to help ensure your data is secure when sending data. Only those involved in your care can look at your information.
The State of Connecticut participates in the Health Information Exchange
, meaning that medical health information (e.g. immunizations, medications, physical examinations, etc.) is shared with other medical providers unless a specific opt-out is received.
Sensitive PHI is PHI that is "subject to heightened confidentiality requirements in compliance with all federal and state laws as amended from time-to-time (HIV, substance abuse and mental health records)."
Patients must specifically authorize disclosures of sensitive PHI.
By signing below, I understand and acknowledge the following:
My sensitive health information will be available to providers using The HIE system.
I understand that refusal to sign this authorization form will not affect my right to obtain present and future services. I also understand that I may opt-out of HIE by notifying Child and Family Agency of the named recipient in writing.