§ 2805-M — Confidentiality

§ 2805-m. Confidentiality. 1. The information required to be collected\nand maintained pursuant to sections twenty-eight hundred five-j and\ntwenty-eight hundred five-k of this article, reports required to be\nsubmitted pursuant to section twenty-eight hundred five-l of this\narticle and any incident reporting requirements imposed upon diagnostic\nand treatment centers pursuant to the provisions of this chapter shall\nbe kept confidential and shall not be released except to the department\nor pursuant to subdivision four of section twenty-eight hundred five-k\nof this article.\n 2. Notwithstanding any other provisions of law, none of the records,\ndocumentation or committee actions or records required pursuant to\nsections twenty-eight hundred five-j and twenty-eight hundred five-k of\nthis article, the reports required pursuant to section twenty-eight\nhundred five-l of this article nor any incident reporting requirements\nimposed upon diagnostic and treatment centers pursuant to the provisions\nof this chapter shall be subject to disclosure under article six of the\npublic officers law or article thirty-one of the civil practice law and\nrules, except as hereinafter provided or as provided by any other\nprovision of law. No person in attendance at a meeting of any such\ncommittee shall be required to testify as to what transpired thereat.\nThe prohibition relating to discovery of testimony shall not apply to\nthe statements made by any person in attendance at such a meeting who is\na party to an action or proceeding the subject matter of which was\nreviewed at such meeting.\n 3. There shall be no monetary liability on the part of, and no cause\nof action for damages shall arise against, any person, partnership,\ncorporation, firm, society, or other entity on account of the\ncommunication of information in the possession of such person or entity,\nor on account of any recommendation or evaluation, regarding the\nqualifications, fitness, or professional conduct or practices of a\nphysician, to any governmental agency, medical or specialists society,\nor hospital as required by sections twenty-eight hundred five-j,\ntwenty-eight hundred five-k and twenty-eight hundred five-l of this\narticle or any incident reporting requirements imposed upon diagnostic\nand treatment centers pursuant to the provisions of this chapter. The\nforegoing shall not apply to information which is untrue and\ncommunicated with malicious intent.\n 4. (a) Hospital sepsis data submitted to the department, shall for the\ninitial phase of data collection be considered a "pilot phase", the\npurpose of which is to ensure the completeness and accuracy of reporting\nby hospitals.\n (b) For data reported during the pilot phase, hospital identifiers\nshall be encrypted by the department in any and all public databases and\nreports. The department shall provide each hospital with an encryption\nkey for that hospital only to permit access to its own performance data\nfor internal quality improvement purposes. Hospital specific public\nreporting of sepsis data including, but not limited to risk adjusted\nsepsis mortality rates, may require up to, but no more than, two years\nof "pilot phase" collection depending on the validity and reliability\noutcomes of the data collected.\n (c) As described in the regulations pertaining to the submission of\ndata on sepsis to the department, consultation with appropriate\nnational, hospital and expert stakeholders will assist in determining\nthe appropriate public release of hospital performance.\n (d) The department shall issue regular reports as needed to hospitals\nassessing the accuracy of the data submitted during the pilot phase and\nprovide guidance for improving the accuracy of data reporting.\n (e) After the pilot phase is completed, all data submitted under this\nsection and compiled in the database established herein and all public\nreports derived therefrom shall include hospital identifiers.\n (f) Clinical performance data, including but not limited to individual\nhospital mortality rates adjusted for potential differences in risk\nfactors and comparisons with state (or national, if available) averages,\nshall be developed and posted on the department's web site.\n