Question

Consider for the following subquestions a university medical services department.

- Consider a university medical services department. Describe what could be the typical information items that are kept within the information system of such a department.

-What details should be included in a typical physical vital records inventory specifically for at least one type of data records at such a medical services department which is needed for business recovery planning.

-Describe the typical functions of a university medical services department with respect to public health issues.

Answer 1

University Health Services is part of the Division of Student Affairs. It provides healthcare and public health leadership to support students in reaching their optimal health so they can achieve their academic and personal potential. To that end, University Health Services provides: (1) a broad range of professional medical services for the prompt diagnosis and treatment of illnesses and injuries; (2) a variety of disease prevention programs and public health initiatives, including the promotion of a healthy campus; (3) immunizations for vaccine-preventable diseases; and, (4) other public health services such as responding to certain infectious diseases on campus.

For a detailed discussion of benefits and services offered, see the University Health Services website.

The Executive Director and Chief Medical Officer

1. The executive director and chief medical officer is responsible for all clinical services, initiatives, and programs; provides organizational oversight, campus leadership, and strategic planning activities of University Health Services; and reports to the associate vice president for student affairs.
2. The executive director and chief medical officer is responsible for serving as a liaison to campus leaders and media and for planning for and responding to campus public health emergencies.
3. The executive director and chief medical officer is responsible for establishing the clinic structure and specifying functional relationships among organizational components of clinical and clinic support operations, providing for the orderly development and management of the unit, supporting a policy on patients’ rights and responsibilities, maintaining a program that evaluates the quality of care provided, and appropriately addressing identified problems.
4. The executive director and chief medical officer is responsible for providing consultation in matters concerning the delivery of healthcare services and emerging public health issues affecting the University of Texas at Austin.

. Medical Clearance Requirements for New and Returning Students, Fees, Payment for Services, Eligibility for University Health Services

Medical Clearance Requirements

1. Unless exempted as described in this paragraph, all entering students who will be under the age of 22 on the first class day of the semester in which they are enrolling must submit documentation that they have received a meningococcal disease (bacterial meningitis) vaccine administered within five years of and at least ten days before the first class day of the semester in which they are enrolling. This includes transfer students and students who previously attended the university or another institution of higher education, or private or independent institution of higher education and who are entering the university following a break in enrollment of at least one fall or spring semester. Students age 22 or older or who are enrolled only in online or distance courses are exempt from the meningococcal vaccine requirement. Additional medical clearance requirements for entering international students are described in Sec. 4-301(b).
   
   Acceptable documentation includes a certificate signed by a healthcare practitioner or an official immunization record showing the month, day and year the meningococcal vaccination was administered (e.g. school record, medical record, immunization card signed by a health practitioner, etc.).
   
   Entering students who are not exempted and who have not provided documentation of an exclusion as described in Sec. 4-301(c) will not be allowed to register for classes until they comply with the meningococcal vaccine requirement. Students should go to the University Health Services website for instructions on how to submit their documentation. Students should submit vaccine-related documentation at least two weeks before their intended registration date to allow for sufficient processing time.
   
2. International students entering for any semester must also provide proof of the following, certified by a physician or nurse, before they will be allowed to register for classes:
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   1. Proof of immunity to measles, mumps, and rubella as documented by:
      1. two doses of Measles/Mumps/Rubella (MMR) vaccine with the first dose administered on or after the first birthday and the second dose administered at least twenty-eight days after the first dose, or
      2. two doses of measles vaccine and mumps vaccine, with the first dose being administered on or after the first birthday and the second dose being administered at least 28 days after the first doses AND one dose of rubella vaccine administered on or after the first birthday, or
      3. a positive blood test (titer) showing protective antibodies to all three diseases (must include a copy of the official lab report).
   2. Proof of a tuberculosis (TB) screening test administered on or after the date listed at Medical Clearance Requirements for International Students. If either test (below) is positive, documentation of a chest x-ray performed in the U.S. on or after the same date is required, regardless of a history of previous treatment. TB screening tests must be documented by
      1. A PPD (Mantoux) skin test administered and interpreted in the United States and reported in millimeters (MM), regardless of a prior BCG vaccination or
      2. Results of an IGRA blood test (may be performed outside of the United States). Must be documented in English AND a copy of the official lab report must be included
   3. International students must complete and return a TB and Vaccination History for International Students form to University Health Services prior to registration. The form is available at the University Health Services website. If a student’s healthcare provider cannot complete and sign the form, other types of official documentation of the medical clearance requirements can be submitted
3. Exclusion from immunization requirements in Sec. 4-301(a)(b) may be allowed for medical contraindications or reasons of conscience, including religious conflict. Instructions for how to submit an affidavit for an exclusion can be found here. Any student requesting a waiver of the requirements must provide either:
   1. An affidavit or certificate signed by a physician duly licensed under the Medical Practice Act, stating that in his or her opinion as a physician the required immunization(s) could be injurious to the student’s health, or
   2. For reasons of conscience, including a religious belief, a completed and notarized original Texas Department of State Health Services Vaccine Exemption Affidavit Form (signed by the student's parent or guardian, if a minor). Students can request this form at the Texas Department of State Health Services website. During emergencies or epidemics declared by the commissioner of health of the State of Texas, disasters, or other emergencies, exemption on the basis of reasons of conscience, including religious conflict, may be denied.

Sec. 4–302. Fees

University Health Services is funded by tuition paid by students and by charges for supplies and services. There are charges associated with University Health Services clinic visits. A charge applies for missed appointments or appointments not canceled in the specified time frame for the appointment type. The complete University Health Services Charges Statement, as well as a schedule of selected discounted charges for uninsured or underinsured students or students with Medicare or Medicaid, is posted online.

Sec. 4–303. Payment for Services

Any student who incurs a charge for services rendered by University Health Services must pay the charges owed, but they do not have to pay for services on the date they are provided, except for students who have health insurance and request that a claim not be filed with their insurance company. University Health Services can assist a student in making arrangements for a payment plan. If payment is not received or arrangements for payment are not made within ten days of the date charges are posted to "What I Owe," a financial bar will be placed on the student’s record. Transcripts, diplomas, and/or continued registration will be withheld until outstanding charges have been paid.

University Health Services can file claims for payment with most health insurance plans; however, health insurance is not required to use University Health Services.. For more information, including types of plans with which claims can and cannot be filed, go to the University Health Services website.

By providing their insurance information, a student authorizes University Health Services to file a claim with the student's insurance company for services rendered. A student who does not want an insurance claim to be filed for medical services must let University Health Services know at the time of their appointment.

A student's insurance company may determine that some or all charges incurred at University Health Services are not covered. The student is responsible for learning what their insurance covers.

For students who do not have health insurance and cannot or prefer not to pay at the time of service or who have health insurance that does not pay for a part or all of their charges, University Health Services will post their balance to "What I Owe." Discounted rates are available for students who do not have insurance, who are underinsured, or who are covered by Medicare or Medicaid.

Sec. 4–304. Eligibility for University Health Services

1. An individual may use University Health Services if:
   1. the person is a currently enrolled student at the university;
   2. the person has been admitted to the university and needs required or recommended immunizations or medical tests in order to matriculate;
   3. for Urgent Care services only, the person is participating in university-sponsored short-term activities such as seminars, institutes, and workshops, provided the sponsoring agency has entered into an agreement with University Health Services by properly completing the Request to Use University Health Services form and paying the associated agreement fee; the sponsoring department is responsible for any unpaid charges incurred by program participants;
   4. the person is a university faculty or staff member who is participating in a public health or immunization program; faculty and staff members are not eligible for regular services, with the exception of travel-related immunizations, nutrition services, physical therapy, certain campus outreach and educational programs, and services arranged and paid for by Interdepartmental Transfer by a university department;
   5. the person has paid a University Health Services Service Extension Fee and was registered during the semester immediately preceding the semester when services are requested (excluding university students who have graduated or who withdrew from the university before the twelfth class day of the prior semester);
   6. the person has been admitted to the university, has paid a University Health Services Service Extension Fee, and will enroll the semester following the time services are requested;
   7. the person has paid a University Health Services Service Extension fee and is a visiting scholar/researcher who is not officially registered for classes at the university, a post-doctoral fellow, or a person enrolled in the English as a Second Language Program; or,
   8. the person is a student from another University of Texas System institution that has entered into an agreement with the university, otherwise called a Contractual Student.
2. Registered students become eligible to use University Health Services the day university residence halls open for that semester, with the exception of International Students who become eligible on the first day of coverage of the student health insurance plan. Students remain eligible for services until the day before residence halls open for the subsequent semester. Specific eligibility dates are given in the Academic Calendar published in the General Information Catalog and at the registrar website.

Subchapter 4–400. General Administrative Policies

Sec. 4–401. Informed Consent

The parent or guardian of a minor student must give appropriate consent for treatment before care can be provided at University Health Services, except when a minor student meets State of Texas criteria to consent for their own care or in cases where immediate medical care is required to stabilize a patient for transfer to an emergency facility.

Sec. 4–402. Medical Withdrawal from the University

Requests for withdrawal from the University for medical reasons may be initiated at the request of a student. Applications to request consideration of a medical withdrawal should be submitted to Services for Students with Disabilities. Services for Students with Disabilities will involve University Health Services or the appropriate dean’s office, as indicated by the student’s particular circumstances.

Sec. 4–403. Course Load Reduction

Approval of requests for course load reductions are always the prerogative of the academic dean when medical reasons are given. Applications to request consideration of a course load reduction should be submitted to Services for Students with Disabilities. Services for Students with Disabilities will request a recommendation from the University Health Services executive director and chief medical officer. Once the executive director and chief medical officer signs the application, University Health Services will submit it to the appropriate dean's office for a final decision.

Sec. 4–404. Responsibility of University Health Services

Any intentional action on the part of the student that is against the advice of a University Health Services health care provider abrogates all responsibility on the part of University Health Services.

Sec. 4–405. Requests to Administer Medications

Requests to administer medications ordered by a private physician must be within the scope of services offered at University Health Services, meet the standard of care provided by University Health Services medical staff, be supported by appropriate medical documentation from the prescribing physician, and be approved by the executive director and chief medical officer.

Sec. 4–406. Routine, Urgent, and Emergency Care Services

1. University Health Services is not equipped to manage medical emergencies. In the case of a medical emergency, students should call 911.
2. For routine health concerns, students may schedule appointments by calling (512) 471-4955 during posted weekday business hours. Students can also schedule many types of appointments online.
3. Students who need prompt medical attention for illnesses or injuries may be asked to come to University Health Services for an urgent care visit not requiring an appointment.
4. Regular operating hours, as well as those for the summer semester, holidays, and semester breaks are posted on the University Health Services website.

Sec. 4-407. 24-hour Nurse Advice Line

The University Health Services Nurse Advice Line (512-475-6877) is available for students 24 hours a day, every day of the year. Advice Line nurses can help students determine whether and how soon they need medical care or can provide self-care advice for illnesses and injuries when appropriate

Sec. 4–408. Treatment at Other Facilities

1. University Health Services assumes no financial responsibility for a student’s care at another medical facility.
2. A student who goes to or is taken to another medical facility for emergency or other treatment, regardless of geographical location or other circumstantial factors, is responsible for all resulting costs.

Sec. 4–409. Personal Property

1. University Health Services is not responsible for a student’s personal belongings; the student is responsible for arranging for the safekeeping of these articles.
2. In instances when it is necessary for University Health Services to maintain custody of a patient’s property or when a patient leaves personal possessions in waiting rooms or clinics, University Health Services will exercise all prudent means of securing and returning such property to the owner but cannot be held responsible for losses through theft.

Sec. 4–410. Medical Records

All original medical records (whether electronic or paper) and other records of treatment, whether originating within University Health Services or another facility or provider, are the property of University Health Services. Medical information may be disclosed as required by state or federal law. Additional information from patient records will be released only with informed written consent. Students have the right to review, inspect or request copies of their medical records.