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Thinking Outside the Silos: Information Sharing in Medical–Legal Partnerships
Journal of Legal Medicine ( IF 0.417 ) Pub Date : 2021-04-02 , DOI: 10.1080/01947648.2020.1854135
Jessica Mantel, Leah Fowler

Abstract

Medical–legal partnerships (MLPs) allow providers to address patients’ health-harming legal needs through partnerships with lawyers. MLPs are most successful in addressing the complex needs of vulnerable populations when clinicians, social workers, and other care team members regularly communicate with the MLP lawyer. Privacy laws and professional rules of conduct governing patient/client confidentiality, however, potentially hinder this exchange of patient-client information. MLP attorneys may be reluctant to share relevant information about a client with the medical partner for fear that doing so would breach client confidentiality or result in an ill-advised waiver of attorney–client privilege. Similarly, privacy concerns may lead providers to limit MLP attorneys’ access to patients’ medical information.

Drawing on the real-world experiences of MLP professionals, this article explores whether legal and ethical obligations impede the sharing of patient-client information between MLPs’ medical and legal partners. Our research indicates that at present patient/client confidentiality rules generally do not pose a significant barrier to doing so. However, current legal and professional standards may frustrate emerging advanced care coordination models that pair MLPs with care teams that comprehensively address a broad range of social, economic, and behavioral health needs. We therefore recommend continued monitoring and discussion of the issue.



中文翻译:

孤岛之外的思考:医疗法律合作中的信息共享

摘要

医疗法律伙伴关系(MLP)允许提供者通过与律师的伙伴关系来满足患者健康方面的法律需求。当临床医生,社会工作者和其他护理团队成员定期与MLP律师沟通时,MLP最成功地满足了弱势群体的复杂需求。但是,隐私法律和支配患者/客户机密性的专业行为准则可能会阻碍患者-客户信息的这种交换。MLP律师可能不愿意与医疗伙伴共享有关客户的相关信息,因为担心这样做会破坏客户的机密性或导致不明智的放弃律师-客户特权。同样,隐私问题可能会导致提供者限制MLP律师访问患者医疗信息的权限。

借鉴MLP专业人员的真实经验,本文探讨了法律和道德义务是否会阻碍MLP的医疗和法律合作伙伴之间共享患者-客户信息。我们的研究表明,目前,患者/服务对象的保密规则通常不会对此构成重大障碍。但是,当前的法律和专业标准可能会挫败新兴的高级护理协调模型,该模型将MLP与护理团队结合使用,从而全面解决了广泛的社会,经济和行为健康需求。因此,我们建议继续对此问题进行监视和讨论。

更新日期:2021-04-02
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