MEMORIAL HERMANN HEALTHCARE SYSTEM
Prior to the clinical assignment at Memorial Hermann hospitals, the following requirements must be completed and submitted.
Review the following PowerPoint and Orientation packet:
(To view PowerPoint, click link, open document, select slideshow, and select from beginning.)
HIPAA PHI, Password and Phishing PowerPoint
MHHS Student Orientation Packet
Review and sign the following documents:
- Standard Verification (must be completed by school/institution, submitted typed, do not PDF and submitted per semester)
Vaccine-QPSIC Flu Instructions (must be reviewed prior to completing the Flu Registration spreadsheet)
Vaccine-QPSIC Flu Registration (must be completed by school/institution, submitted typed, do not PDF, to be used only during the flu season (10/1 to 3/31), and submitted in addition to the standard verification form)
- Care 4 Password Request - System MH (excluding TMC/Children's) - (complete if requesting access to the EMR, submitted typed, do not PDF)
- Care 4 Password Request -TMC/Children's only - (complete if requesting access to the EMR, submitted typed, do not PDF)
- HIPAA Attachment E
- Supplement to Attachment E
- Joint Commission National Patient Safety Goals and Acknowledgement
- Requirements for Clinical Placement
- Confidentiality Acknowledgement
- Student Attestation to Core Expectations
- MHHS False Claims Policies and Standards of Conduct and Attestation (review linked documents)
- HIPAA and Security Student Completion Verification
- Submit a copy of your current professional license, if applicable.
- Check List of Completion for Clinical Requirements
- HIPAA Attachment C (for contracted and agency personnel, not students) HIPAA C
- HIPAA Attachment D (for Volunteers, NOT STUDENTS) HIPAA D
- Standards of Conduct Volunteer Acknowledgement (for Volunteers, NOT STUDENTS)
- Media Consent for Orientation (for Volunteers, NOT STUDENTS)
For educational experiences (clinical and non-clinical) within the Memorial Hermann System, the following additional HIPAA requirements must be met:
For students without Care4 / EMR access: The HIPAA modules 1-4 must be reviewed, quizzes 1-4 successfully completed; submit the Answer Sheet and HIPAA Modules 1-4 Attestation.
Module 1 - HIPAA Release of Information Not Requiring Consent, Authorization or Opportunity for Objection.
Module 2 - HIPAA Release of Information to the Media and HIPAA/Complaints/Incident Reporting.
Module 3 - HIPAA Employee Corrective Action Process for Breach of Patient Confidentiality.
Module 4 - HIPAA Release of Patient Information to Law Enforcement.
HIPAA Module 1 Quiz
HIPAA Module 2 Quiz
HIPAA Module 3 Quiz
HIPAA Module 4 Quiz
Answer Sheet for HIPAA Modules 1-4 Quizzes
HIPAA Modules 1-4 Attestation
For students with Care4 / EMR access: The same HIPAA modules 1-4 (listed above) are in PiL with an additional 5th module which serves as the attestation. (HIPAA & Security Validation/Attestation)
If a faculty member will be on the campus, having student oversight during the clinical rotation the same documents as the student's apply to the faculty and must be completed and submitted prior to the assignment.
Guide to the Intranet
Memorial Hermann Orientation Process
How to Access PiL from outside the MH facilitywith a Care4 sign-in & password