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System
Access Request
Physicians
& Office Staff
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Please complete all fields marked with asterisk (*) ? Required Fields. |
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PART
1: Access Type |
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PART
2: *
Access Role |
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Affiliations |
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*Primary Privileges |
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Terms of Agreement (please read and sign below) |
User
name and password confidentiality
The purpose of your user name and password is to authenticate your
identity to the computer systems. Sharing of your user name and
password is prohibited by Medical Staff rules and regulations, Information
Systems policies and procedures (230-1A and 2B), Memorial Hermann
Hospital Medical Records Documentation Standards 2.11.4, Texas State
Law and federal regulations (HIPAA). HCFA defines abuse of electronic
signature: "that the physician has allowed another person or
persons to use his/her personally assigned identifier".
Confidentiality of Information
All information contained in MHHS computer systems is confidential,
and must not be disclosed
Examples of misuse of computer information systems:
The following list includes some examples of improper use of the
privilege of using the information system:
· Accessing patient information not related to current work
responsibilities
· Using another person's user name and password to gain access
to any computer system
· Allowing another person to use a user name and password
assigned to you
· Failing to sign off at the end of a session thus allowing
another user to access data and perform actions in your account.
· Using a computer program when another user is signed on
Consequences of misuse of MHHS computer systems
· Individuals who improperly use electronic signatures or
confidential information contained in a computer system will be
referred to the Credentials Committee. Disciplinary action may include
loss of hospital privileges.
· In the event that I misuse the electronic signature option,
I understand that my use of it will be terminated.
· Legal action may be initiated by MHHS
By signing this document, I agree to the following:
· If I suspect that another person knows my password, I will
immediately change my password and report the suspicion to the Support
Center at 713-704-DOCS (3627).
· The use of my username and password is equivalent to my
electronic signature for medical records documentation purposes.
· I understand that it is my responsibility to immediately
notify MHHS at 713-704-DOCS (3627) of any staff terminations under my control
so that their access to the MHHS or MH OneSource will be cancelled.
· I agree that for confidentiality and security reasons,
patient medical information will not be transmitted via unsecured
e-mail.
*I understand that if I do not use my OneSource
username and password within 90 days that my account will be disabled
and access to OneSource will cease. I will have to contact the
Support Center at 713-704-DOCS (3627) to re-activate my account. |
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