Confidentiality and Security Agreement
REV 6/19
Bon Secours Mercy Health (BSMH) has a legal and ethical responsibility to safeguard the privacy of all patients, residents, and clients and to
protect the confidentiality of their personal health information. BSMH must also protect the confidentiality of organizational information
that may include, but is not limited to, human resources, payroll, fiscal, research, internal reporting, strategic planning, communications,
computer systems, and management information from any source or in any form including, without limitation, paper, magnetic or optical
media, conversations, electronic, and film. For the purpose of this Agreement, all such information is referred to as “Sensitive Data.”
I UNDERSTAND AND HEREBY AGREE THAT:
1.
During my employment/affiliation with BSMH, I understand that I may have access and exposure to Sensitive Data.
2.
I will access and / or use Sensitive Data only as necessary to perform my job-related duties and in accordance with BSMH’s
pol
icies and procedures.
3.
My User-ID and password are confidential, and in certain circumstances may be equivalent to my
LEGAL SIGNATURE,
and I will
not
disclose them to anyone. I understand that I am responsible and accountable for all entries made and all information
accessed under my User-ID.
4.
I will not copy, release, sell, loan, alter, or destroy any Sensitive Data except as properly authorized by law or BSMH policy.
5.
I will not discuss Sensitive Data so that it can be overheard by unauthorized persons. It is not acceptable to discuss information
that can
identify a patient in a public area even if the patient’s name is not used.
6.
I will only access and / or use systems or devices I am authorized to access and will not demonstrate the operation or function of
systems or devices to unauthorized individuals.
7.
I have no expectation of privacy when using BSMH information systems. BSMH has the right to log, access, review,
and otherwise use
information stored on or passing through its systems, including e-mail.
8.
I will never connect to unauthorized networks through BSMH’s systems or devices.
9.
I will practice secure electronic communications by transmitting Sensitive Data in accordance with approved BSMH
security
standards.
10.
I will practice good workstation security measures such as never leaving a terminal unattended while logged in to an application,
locking up removable media when not in use, using screen savers with activated passwords appropriately, and positioning
screens
away from public view.
11.
I will:
a.
Use only my assigned User-ID and password.
b.
Use only approved licensed software.
c.
Use a device with virus protection software.
d.
Not attempt to learn or use another’s User-ID and password.
e.
Not store sensitive data that is not in accordance with BSMH policy and standards.
12.
I will disclose Sensitive Data only to authorized individuals with a need to know that information in connection with the
performance of
their job function or professional duties.
13.
Unauthorized or improper use of BSMH’s information systems and / or Sensitive Data, is strictly prohibited and may not be
covered by BSMH’s insurance or my personal professional malpractice insurance.
Any such violation may subject me to
personal liability
as well as sanctions for violation of state and federal law.
14.
I will notify my manager, BSMH Privacy Officer, IS Security, or other appropriate
Information Services personnel if my password
has been seen, disclosed, or otherwise compromised.
15.
Upon termination of my employment / affiliation / association with BSMH, I will immediately return or destroy, as appropriate, any
Sensitive Data in my possession.
16.
Violation of this Agreement may result in disciplinary action, up to and including civil or criminal action, termination of
employment / affiliation / association with BSMH, and suspension and / or loss of medical staff privileges in accordance with
BSMH’s policies.
17.
My obligations under this Agreement will continue after termination of
employment / affiliation / association with BSMH.
By signing this document, I acknowledge that I have read this Agreement, and I agree to comply with all the terms and conditions
stated above.
Signature Date
Printed Name
Non-BSMH Organization Name
click to sign
signature
click to edit
![]()
