Chapter 151-D: Ambulatory Care Clinics

In this chapter:

I. "Ambulatory care clinic" means any institution or organization, publicly or privately owned, for-profit or not-for-profit, which is engaged in the operation of, or formed for the purposes of operating, an ambulatory health care facility, licensed by the state of New Hampshire, in which health care services are offered to the public on an outpatient basis by or under the direction of physicians licensed by the state of New Hampshire and licensed health care professionals. The term "ambulatory care clinic" shall also include medical facilities operated by the division of medical and psychiatric services, department of corrections.

II. "Records" means records of interviews, internal reviews and investigations, and all reports, statements, minutes, memoranda, charts, statistics, and other documentation generated during the activities of a quality assurance program. Records shall not mean original medical records or other records kept relative to any patient in the course of the business of operating an ambulatory care clinic.

III. "Quality assurance program" means a comprehensive, ongoing organization-wide system of mechanisms for monitoring and evaluating the quality and appropriateness of the care provided, so that important problems and trends in the delivery of care are identified and that steps are taken to correct problems and to take advantage of opportunities to improve care.

I. Records of an ambulatory care clinic's quality assurance program, including those of its functional components and committees as defined by the organization's quality assurance plans, organized to evaluate matters relating to the care and treatment of patients and to improve the quality of care provided, and testimony by members on the board of directors of the ambulatory care clinic, medical and clinical staff, employees, or other committee attendees relating to activities of the quality assurance program shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil or administrative action merely because they were presented to a quality assurance program, and any person who supplies information or testifies as part of a quality assurance program, or who is a member of a quality assurance program committee, may not be prevented from testifying as to matters within his or her knowledge, but such witness may not be asked about his or her testimony before such program, or opinions formed by him or her, as a result of committee participation. Further, a program's records shall be discoverable in either of the following cases:

(a) A judicial or administrative proceeding brought by an ambulatory care clinic, its quality assurance program, or its board of directors, to revoke or restrict the license, certification, or privileges of a physician or staff member; or

(b) A proceeding alleging repetitive malicious action and personal injury brought against a physician or staff member.

II. An ambulatory care clinic board of directors or trustees, or in the case of the division of medical and psychiatric services, the commissioner of the department of corrections, may waive the privilege under this section and release information or present records of the quality assurance program by discovery, subpoena, or admission into evidence in any judicial or administrative proceeding.

III. No owner, director, trustee, medical or clinical staff, employee, or other attendees of the quality assurance program shall be held liable in any action for damages or other relief arising from the providing of information to a quality assurance program or in any judicial or administrative proceeding.