Currently, in our verbiage, disclosure would mean that it was not for treatment, it was not for health care operations, which would be quality, for example. All of those disclosures would require a patient authorization, and the patient must specifically allow disclosures in those specific areas. In VA we would need a general disclosure, but for areas of drug, alcohol, sickle cell anemia, and HIV we would need a specific authorization from the veteran to allow that disclosure. That does not apply for those who are providing treatment, either on behalf of an employee of the VA or under contract to the VA.
So the veteran very much controls what we disclose externally, but does not have the same control internally of what other providers can see. If a patient in the VA is being seen in primary care, in mental health, and in orthopedics, those providers can see the information from the other sources.