processes to enhance the maintenance of confidentiality is beyond the scope of this project but recommends that organizations consider these practices and implement them as appropriate, if they have not already done so.

The committee encourages health care organizations to adopt provisions that are practicable in their circumstances. Comprehensive policies for all uses of personal health information will avoid issues of how to oversee activities that are in the gray zone between research and QA or QI. If a comprehensive policy is in place, a QA or QI project will have strong confidentiality safeguards that make the risk to patients minimal.

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