Patient Success Stories

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Submitter's Name*

First Last

Care Guide

Client Name

Program Description (HRRP, No-Show, Cancer, etc)

Demographics

Age*

Gender*

Race*

Patient's Zip Code*

Condition

Diagnosis/Condition*

Protocols/Surveys

Any Additional Clinical Notes or Insights (Physician notes, Social work, additional diagnoses etc. )

Problem/Challenge

Issues*

Barriers*

Guideway Care Solution

Action/Intervention

Clinical Escalation (if needed)

Outcome

Results

Patient Testimonial

Examples of Successful Past Submissions

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Health information such as diagnoses, treatment information, medical test results and prescription information are considered protected health information under HIPAA, as are national identification numbers and demographic information.

Under the HIPAA Privacy Rule, covered entities may use or disclose protected health for research purposes either with individual authorization as required at 45 CFR 164.508, or with a waiver of individual authorization as permitted at 45 CFR 164.512(i).

The HIPAA Privacy Rule requires valid, written authorization from a patient before publishing any testimonial involving that patient on a website, social media platform, or through any other medium of communication.