Patient Information Protection Assessment Form
Complete this assessment to evaluate your organization's practices for protecting patient information. No sensitive or identifying data is collected.
Does your organization have a documented policy for protecting patient information?
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Yes
No
In Progress
How frequently are staff members trained on patient information protection?
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Annually
Every 2 years
Only during onboarding
No formal training
Rate the effectiveness of your organization's current patient information protection measures.
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about patient information protection.
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Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Access to patient information is restricted to authorized personnel.
1
2
3
4
5
Policies regarding patient information are regularly reviewed and updated.
6
7
8
9
10
Physical and digital records are securely stored.
11
12
13
14
15
Staff know how to report a suspected data breach.
16
17
18
19
20
Which of the following methods are used to safeguard patient information? (Select all that apply)
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Password-protected systems
Physical file locks
Access logs and monitoring
Data encryption
Other
How would you describe your organization's response process for suspected breaches of patient information?
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Well-defined and tested
Written but not tested
Informal process
No process in place
How often does your organization review access to patient information systems?
*
Quarterly
Annually
When staff change roles
Rarely or never
What is your biggest challenge in protecting patient information?
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