Privacy Act: [F044 AFSG C]...

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   and reports, electrocardiographic tracings and reports, laboratory 
   test results and reports, blood gas analysis reports, occupational 
   health records, dental radiographic reports and records, automated 
   cardiac catheterization data and reports, physical examination 
   reports, patient administration and scheduling reports, pharmacy 
   prescriptions and reports, food service reports, hearing conservation 
   tests, cardiovascular fitness examinations and reports, reports of 
   medical waivers granted for flight duty, and other inpatient and 
   outpatient data and reports. They may contain information relating to 
   medical/ dental examinations and treatments, inoculations, 
   appointment and scheduling information, and other medical and/or 
   dental information. Subsystems of the Automated Medical/Dental Data 
   System include: Air Force Clinical Laboratory Automation System 
   (AFCLAS); Automated Cardiac Catheterization Laboratory System 
   (ACCLS); Computer Assisted Practice of Cardiology (CAPOC) System; 
   DATA STAT Pharmacy System (formerly PROHECA); Occupational Health and 
   Safety System; Patient Appointment and Scheduling System (PAS); Tri-
   Laboratory System (TRILAB); Tri-Pharmacy System; Tri- Radiology 
   System (TRIRAD); Health Evaluation and Risk Tabulation (HEART).
     Authority for maintenance of the system: 
       10 U.S.C. 55, Medical and Dental Care, and E.O. 9397 (SSN).
   Purpose(s): 
       Used as a record of patient's medical/dental health, diagnosis, 
   and treatment and disposition while authorized care.
       Used to help determine individual's qualification for duty, for 
   security clearances and for assignments.
       Used by an individual or his legal representative for further 
   medical care, legal purposes, or other uses such as insurance 
   requests or compensation and other health care providers for further 
   care of the patient, research teaching, and legal purposes.
       Used by medical treatment facility staff for evaluation of staff 
   performance in the care rendered; for preparation of statistical 
   reports; for reporting communicable diseases and other conditions 
   required by law to federal and state agencies.
       Used by Army, Navy, Department of Veterans Affairs, Public Health 
   Service or civilian hospitals for continued medical care of the 
   patient.
       Used by insurance companies, (only with the patient's written 
   consent for release, except as authorized in 10 U.S.C. 1095; for 
   arbitrating insurance claims.
       Used by other federal agencies such as Department of Veterans 
   Affairs and Department of Labor (workmen's compensation) for 
   adjudication of claims; for reporting communicable diseases or other 
   conditions required by law.
       Used to provide input to other DOD medical records systems 
   including the Medical Record System (F168 AF SG C), the Dental 
   Personnel Actions (F162 SG A), and other DOD agencies (e.g., Army 
   Navy) when such agency is normally the primary source or repository 
   of medical information about the individual.
     Routine uses of records maintained in the system, including 
   categories of users and the purposes of such uses: 
       In addition to those disclosures generally permitted under 5 
   U.S.C. 552a(b) of the Privacy Act, these records or information 
   contained therein may specifically be disclosed outside the DoD as a 
   routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
       The `Blanket Routine Uses' published at the beginning of the 
   agency's compilation of record system notices apply to this system, 
   except as stipulated in `Note'  below.
       Information from the inpatient or outpatient medical records of 
   retirees and dependents may be disclosed to third party payers in 
   accordance with 10 U.S.C. 1095 as amended by Pub. L. 99-272, for the 
   purpose of collecting reasonable inpatient/outpatient hospital care 
   costs incurred on behalf of retirees or dependents. In addition, 
   records may be disclosed to:
       (1) Officials and employees of the Department of Veterans Affairs 
   in the performance of their official duties relating to the 
   adjudication of veterans claims and in providing medical care to 
   members of the Air Force.
       (2) Officials and employees of other departments and agencies of 
   the Executive Branch of government upon request in the performance of 
   their official duties relating to review of the official 
   qualifications and medical history of applicants and employees who 
   are covered by this record system and for the conduct of research 
   studies.
       (3) Private organizations (including educational institutions) 
   and individuals for authorized health research in the interest of the 
   Federal government and the public. When not considered mandatory, 
   patient identification data shall be eliminated from records used for 
   research studies.
       (4) Officials and employees of the National Research Council in 
   cooperative studies of the National History of Disease; of prognosis 
   and of epidemiology. Each study in which the records of members and 
   former members of the Air Force are used must be approved by the 
   Surgeon General of the Air Force.
       (5) Officials and employees of local and state governments and 
   agencies in the performance of their official duties pursuant to the 
   laws and regulations governing local control of communicable 
   diseases, preventive medicine and safety programs, child abuse and 
   other public health and welfare programs.
       (6) Authorized surveying bodies for professional certification 
   and accreditation.
       (7) The individual's organization or government agency as 
   necessary when required by Federal statute, Executive Order, or by 
   treaty.
       NOTE: Records of identity, diagnosis, prognosis or treatment of 
   any client/patient, irrespective of whether or when he/she ceases to 
   be a client/patient, maintained in connection with the performance of 
   any alcohol/drug abuse treatment function conducted, requested, or 
   directly or indirectly assisted by any department or agency of the 
   United States, shall, except as provided herein, be confidential and 
   be disclosed only for the purposes and under the circumstances 
   expressly authorized in 42 U.S.C. 290dd-2, and 5 U.S.C. 552. These 
   statutes take precedence over the Privacy Act of 1974 in regard to 
   accessibility of such records except to the individual to whom the 
   record pertains. The Air Force `Blanket Routine Uses' do not apply to 
   these records.
     Policies and practices for storing, retrieving, accessing, 
   retaining, and disposing of records in the system: 
     Storage: 
       Data maintained primarily on magnetic tape or disks. May also be 
   maintained in file folders, in computers and on computer output 
   products, punch cards, and on roll microfilm or microfiche.
     Retrievability: 
       Retrieved by Social Security Number. May also be retrieved by 
   sponsor's Social Security Number in combination with the family 
   member prefix; by name, or by inpatient register number, laboratory 
   accession number, or pharmacy prescription number.
     Retention and disposal: 
       Computer files are retained for variable lengths of time 
   depending upon the type of information involved and the size and 
   mission of the medical treatment facility. Retention time may vary 
   from one day to ten years. Records are disposed of by erasure of the 
   magnetic computer records and destruction of the computer related 
   worksheets on paper, film, or other media by tearing, shredding, 
   pulping, burning or other destructive methods. Identical medical/
   dental information may be retained for longer periods of time in 
   other medical records systems (such as inpatient or outpatient 
   charts), including the Medical Record System (F168 AF SG C) and 
   Dental Personnel Actions (SG 162 SG A).
     System manager(s) and address: 
       Major command and field operating agency headquarters and Air 
   Force Medical Service Center; commanders of United States Air Force 
   medical centers; United States Air Force School of Health Care 
   Sciences; Aerospace Medical Division, Brooks Air Force Base, TX, and 
   the United States Air Force School of Aerospace Medicine, Brooks Air 
   Force Base, TX. Official mailing addresses are published as an 
   appendix to the Air Force's compilation of systems notices.
     Notification procedure: 
       Individuals seeking to determine whether this system of records 
   contains information about themselves should address inquires to the 
   appropriate system manager. Official mailing addresses are published 
   as an appendix to the Air Force's compilation of record systems 
   notices.
     Record access procedures: 
       Individuals seeking access to records about themselves contained 
   in this system should address requests to the appropriate system 
   manager. Official mailing addresses are published as an appendix to 
   the Air Force's compilation of record systems notices.
       Requests should include complete name (including maiden name), 
   sponsor's name, Social Security Number or Service Number of person 
   through whom eligibility is established, category of record desired, 
   year in which treatment was provided, whether treatment was inpatient 
   or outpatient. If the individual establishes eligibility through a 
   sponsor other than self, the request should include the relationship 
   to the sponsor, e.g., spouse, second oldest child, parent, etc.
     Contesting record procedures: 
       The Air Force rules for accessing records and for contesting 
   contents and appealing initial agency determinations are published in 
   Air Force Instruction 37-132; 32 CFR part 806b; or may be obtained 
   from the system manager.
     Record source categories: 
       Information is obtained directly from the individual whenever 
   practical and possible; from other individuals when necessary, e.g., 
   when the patient is a child or is in coma; from other medical 
   institutions; from automated systems interfaces; from medical 
   records, and from patient interactions with physicians and other 
   health care providers.
     Exemptions claimed for the system:
       None.

   #..F044 AF SG E

   #....System name: 

       Medical Record System.
     System location: 
       Headquarters, United States Air Force, Surgeon General (HQ USAF/
   SG), medical centers, hospitals and clinics, medical aid stations, 
   National Personnel Record Centers, Air National Guard activities, and 
   Air Force Reserve units. Official mailing addresses are published as 
   an appendix to the Air Force compilation of systems notices.
     Categories of individuals covered by the system: 
       Persons treated in an Air Force medical facility and active duty 
   members for whom primary care is provided.
     Categories of records in the system: 
       Inpatient and outpatient records of care received in Air Force 
   medical facilities. Documentation includes, but is not limited to, 
   patient's medical history; physical examination; treatment received; 
   supporting documentation such as laboratory and x-ray reports; cover 
   sheets and summaries of hospitalization; diagnoses; procedures or 
   surgery performed; administrative forms which concern medical 
   conditions such as Line of Duty Determinations; physical profiles, 
   and medical recommendations for flying duty. Secondary files are 
   maintained such as patient registers, nominal indices, x-ray and 
   laboratory files, indices and registers.
     Authority for maintenance of the system: 
       10 U.S.C. 55, Medical and Dental Care, 10 U.S.C. 8013, Secretary 
   of the Air Force; powers and duties; delegation by, and E.O. 9397 
   (SSN).
   Purpose(s):
       Used to document, plan, and coordinate the health care of 
   patients; aid in preventative health and communicable disease control 
   programs; determine eligibility and suitability for benefits for 
   various programs; adjudicate claims; evaluate care rendered; teach 
   compile statistical data, and conduct research.
     Routine uses of records maintained in the system, including 
   categories of users and the purpose of such uses:
       In addition to those disclosures generally permitted under 5 
   U.S.C. 552a(b) of the Privacy Act, these records or information 
   contained therein may specifically be disclosed outside the DoD as a 
   routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
       Information from the inpatient or outpatient medical records of 
   retirees and dependents may be disclosed to third party payers in 
   accordance with 10 U.S.C. 1095 as amended by Public Law 99-272, for 
   the purpose of collecting reasonable inpatient/outpatient hospital 
   care costs incurred on behalf of retirees or dependents. Records are 
   used and reviewed by health care providers in the performance of 
   their duties. Health care providers include military and civilian 
   providers assigned to the medical facility where care is being 
   provided. Students participating in a training affiliation program 
   with a USAF medical facility may also use and review records as part 
   of their training program. In addition, records may be disclosed to: 
   (1) Officials and employees of the Department of Veterans Affairs in 
   the performance of their official duties relating to the adjudication 
   of veterans claims and in providing medical care to members of the 
   Air Force. (2) Officials and employees of other departments and 
   agencies of the Executive Branch of government upon request in the 
   performance of their official duties relating to review of the 
   official qualifications and medical history of applicants and 
   employees who are covered by this record system and for the conduct 
   of research studies. (3) Private organizations (including educational 
   institutions) and individuals for authorized health research in the 
   interest of the Federal government and the public. When not 
   considered mandatory, patient identification data shall be eliminated 
   from records used for research studies. (4) Officials and employees 
   of the National Research Council in cooperative studies of the 
   National History of Disease; of prognosis and of epidemiology. Each 
   study in which the records of members and former members of the Air 
   Force are used must be approved by the Surgeon General of the Air 
   Force. (5) Officials and employees of local and state governments and 
   agencies in the performance of their official duties pursuant to the 
   laws and regulations governing local control of communicable 
   diseases, preventive medicine and safety programs, child abuse and 
   other public health and welfare programs. (6) Authorized surveying 
   bodies for professional certification and accreditations. (7) The 
   individual's organization or government agency as necessary when 
   required by Federal statute, E.O., or by treaty.
       The `Blanket Routine Uses' published at the beginning of the Air 
   Force's compilation of record system notices apply to this system, 
   except as stipulated in `Note' below.
       NOTE: Records of identity, diagnosis, prognosis or treatment of 
   any client/patient, irrespective of whether or when he/she ceases to 
   be a client/patient, maintained in connection with the performance of 
   any alcohol/drug abuse treatment function conducted, requested, or 
   directly or indirectly assisted by any department or agency of the 
   United States, shall, except as provided herein, be confidential and 
   be disclosed only for the purposes and under the circumstances 
   expressly authorized in 42 U.S.C. 290dd-2. These statutes take 
   precedence over the Privacy Act of 1974 in regard to accessibility of 
   such records except to the individual to whom the record pertains. 
   The `Blanket Routine Uses' do not apply to these types of records.
     Policies and practices for storing, retrieving, accessing, 
   retaining, and disposing of records in the system: 
     Storage: 
       Maintained in paper and machine-readable form.
     Retrievability: 
       By name, Social Security Number, or by Military Service Number.
     Safeguards: 
       Records are accessed by commanders of medical centers, hospitals, 
   and clinics; by custodian of the record system, and by person(s) 
   responsible for servicing the record system in performance of their 
   official duties and by authorized personnel who are properly screened 
   and cleared for need-to-know. Records are stored in locked rooms and 
   cabinets.
     Retention and disposal: 
       While on active duty, the Health Record of a US military member 
   is maintained at the medical unit at which the person receives 
   treatment. On separation or retirement, records are forwarded to 
   National Personnel Records Center/Military Personnel Records (NPRC/
   MPR) or other designated depository, such as Commandant, US Coast 
   Guard for that agency's personnel, to appropriate Department of 
   Veterans Affairs (VA) Regional Office if a VA claim has been filed. 
   Records of non-active duty personnel may be handcarried or mailed to 
   the next military medical facility at which treatment will be 
   received or the records are retained at the treating facility for a 
   minimum of 1 year after date of last treatment then retire to NPRC or 
   other designated depository, such as, but not limited to, Medical 
   Director, American Red Cross, Washington, DC 20006 for Red Cross 
   personnel. At NPRC records for military personnel are retained for 50 
   years after date of last document, for all others 25 years.
     System manager(s) and address: 
       The Surgeon General, Headquarters United States Air Force. Chief 
   of Air Force Reserve, Headquarters United States Air Force. Director 
   of Air National Guard, Headquarters United States Air Force. 
   Commanders of medical centers, hospitals, clinics, medical aid 
   stations; Commander, Air Force Manpower and Personnel Center. 
   Official mailing addresses are published as an appendix to the Air 
   Force's compilation of system notices.
     Notification procedure: 
       Individuals seeking to determine whether this system of records 

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