these court house counsel my name is karen jones and i'm representing southern illinois hospital services in this matter this founder is before the court on a discovery order compelling the production of certain documents in the trial  court the hospital presented the trial court with a number of documents labeled the group exhibits a through and asserted various privileges the trial court found in all of those documents for the docket bresson's applications are privileged pursuant to the healthcare professionals credential data collection act alternatively we are asking that we be allowed if the court finds that the application is not privileged under that prior to the enactment of the credentials data collection act each hospital has their own specific form for doctors to apply for privileges to practice within its facility the credentials data collection act was enacted and signed into law in  hundred nine and through that act the department public health has created a standard form that all hospitals are made are required to use to use and all hot doctors are required to complete and submit additionally that statute provides for that that application will be confidential but specifically section fifty eight of the act says that any financial data collected or obtained by the hospital shall be doesn't create a privilege is that right but your honor it's my position that if you look at the intent of the legislation the language use and also consider empowering materia with the medical studies act including the regulator and the read disclosure it should be given the fact the credentials are actually given the same effect as the medical studies act which in addition to saying that the information obtained under the credentials under the medical studies act is confidential also says it's not  you you don't disagree that confidentiality and privilege are separate concepts group in a general sense and in terms of maybe other things such as for instance the freedom of information act where that act starts with the concept that everything is open and then i have this can be exempted from that openness pursuant to the statutory provision i would agree with that but where the legislature in this case the civically provides per process through which the hospital must use must collect certain data and the doctor must answer certain data with the understanding that the documents will be confidential and will not be read disclosed went out and last there is a specific exception or exemption to that confidentiality i would disagree with that that in this particular case and in this particular statutory language providentially ality means privilege  records reviews exaggerate gathered and used by medical studies that are by the credentialing committee to determine privileges are are confidential same as as in here but eight twenty zero two as the additional language non discoverable and non admissible and the regulations under the credentialing act states confidential information in the uniform orms in this part are confidential as provided by law including but not limited to part twenty one of article seven of the code a civil procedure which is the medical studies act which incorporates twenty one of two so the the court has the legislature realizing that this is an on this is a multiple step process and credentialing the doctor has created the same privilege and the same confidentiality provisions for both sections the application is just simply the first step and potentially the doctor after that application is submitted on the form or fired by the state and under the premise that it is confidential that for that application is then the principle of statutory construction of him pari materia dismissed before you go further i wanted s i miss jones i mean i wanted to ask you a question on section fifteen age there is an exception to non disclosure isn't there there are several exceptions right to nondisclosure and of course that also leaves if you look at the rules a statutory construction and i wanted to ask this that does this mean then the hospital can disclose information whereas here it is being sued for negligent credentialing so if there so what is an exception for if it isn't for that your honor no in fact if you look at the language of the exceptions it would exclude this type of it does not include this type of with that is the statutory language identifies the specific individuals to which that confidentiality cannot be used to invoke or deny their right to obtain that information those individuals include the health care professional health care and eddie the health care health care plan or a hospital so that the legislature has recognized an exception for challenge and for the doctor to challenge whether he was properly granted or not granted privileges it does not although the legislature could have done so allow third party litigants filing  hospital and that case which was a two thousand and fourteen case from the second district the court the skill asked the the purpose and the end the reasoning for and acting not just the medical studies act but also the data accuracy for honest peer review they then discuss the medical studies act which has similar purposes and has been found to to ensure that members of the profession would effectively engage in self evaluation of their peers and an professionals both occasions that the data collected is inaccurate incomplete or not of today and they then concluded that the obvious risk of incomplete or in great information is the credentialing and  a qualified health care professionals which would affect the quality of health care that patients receive by regular regulating and standardizing their credentials or exemption process the credentials act was designed to prevent this sort of injury so the  that this court has found that in part materia applies were two statutes are two parts of one statute concerning the same subject must be considered together in order to produce a harmonious whole the statutes clearly have the same purpose at the b it provides a confidential information in the uniform forms in this part a confidential as provided by law including but not limited to part twenty one of article seven of the code of civil procedure and otherwise may not loop which were promulgated pursuant to authority of the l in the legislature the court has the legislature has or the illinois department public health has said that the documents submitted i e the applications that are submitted are required to be submitted on the form that was promulgated by the illinois department of public health is to be given the same protection as the documents submitted to the peer review committee generated by the peer review committee or  obtained by the peer review committee under the medical studies considered to be one one spirit and they say in the single policy they are to be considered in priory material for purposes of statutory construction and this and they must and must be presumed that the legislature intend said ok it's all part of the same prevention process you have patients admitted to the peer review committee who then or evaluates that application and all of the other information that they gather such as documents from the national practitioner databank which they're required to obtain third party assessments of ability these are all things that the you know are covered by the medical studies out there which they acquire to evaluate a doctor the application part of clear if i can about what it is really going on here and what it is they are really asking and just heard i think you got it when you specifically asked about steps that we have to take here even if you do those things though within the medical studies show that you don't get the information the reason that you don't get the information is because we are process for better or for worse this is information that everybody is required to provide these are the forms that you have to fill out everybody's got to give the same information and everybody has the same discovered you actually parked about that and that became an issue in the one hope case which was another discussion about privileges and this issue with respect to privileges but for protecting patients with their different points in the process they are different points in the process and what effectively they're talking about here when they are talk about a chilling effect and i don't understand really what that chilling effect is i get it with respect to the study check and i get it in part because the legislature makes it very very clear that these are the things that we are certain about and this is why it's not what exactly is the chilling effect are we concerned that doctors are going to be less honest on their applications if they think that it could potentially lead to that wishing prevention or some other  it's tantamount to medical records the medical education that's what they're saying and the net effect of what they're saying and what they are advocating what is holding what he is i don't know how i could make change i don't know sake of argument the knowledge in your distinctions between admissibility discoverability confidentiality if your position is upheld how does confidentiality under this statute play out what's to be protected  proceeding before you are an adult to that information so the presumption of confidentiality remains there but there's also a presumption of force in the state of there's a presumption that everything relevant is discoverable unless the legislature specifically says so the legislature specifically says so in the medical studies the legislature  one of his honest as possible and make sure that that obvious which is used to save future patients lives prospected patients lives can not come back and be used against here with respect to data collection act in the earlier in this process we're talking about those prospective patients who we don't want to suffer that hoard it's going to lead to that conference that's wired so we specifically discussed the medical studies act in the context of the data collection day he specifically observed that when one it's closely related and they are interrelated when one provides or protection or at the very uses three distinct concepts which i believe they correctly inferred means more protection and the other only uses one of those three then there must be a reason we've got to presume that the legislature was aware of the medical studies that when they passed the data collection act we've got to presume that one is related to the other  that these documents generated all of this stuff generated can potentially be used in a type of the law if they are aware of that fact and they are completely silent with respect to that same issue here if we examine those two we can just leave that other patients alone i want to clarify that the other thing is that with respect to the health care quality improvement and the argument by somehow batch what starting point is that's the exception and that's the period decision with respect to this case but we don't go with the documents or and that's why it is that we did go because it's the same reason you're not permitted to participate in a public flogging you know hearing of course now with respect to what it is it was forfeited and what was rush otherwise you just least be honest i'm not sure exactly what it is that she wore referring to i do apologize for that i know that the first time it did that patient privilege being another reason to generate some protection for these documents the data collection was all over the world other things were all working below the only thing that was raised from the first time to their found were not village were not relevant and not subject to discovery because they occurred after the treatment provided to claim me and therefore those documents didn't play any part or any to sit in any consideration by the potentially should the church determination as to whether he should be credentialed credentialed and of course negligent prevention claim is before i was injured he should have granted privileges we did only raise that and the first time we raised the relevancy argument with regards to those particular applications that were submitted after her injury was in a motion to reconsider that is the only argument that the court found was forfeited on appeal and all the other arguments with regard that we are have presented and all the arguments we're presenting today before this court word heard and and ruled upon by the trial court and the appellate court with the exception has pointed out we've we've raised the alternative argument protected by the physician patient privilege we've acknowledged in archaeology that we did not raise that in any time before but of course is this court knows waiver is restriction on the parties and not on this court and accordingly this court would have authority issue if you don't first if you first decide that the applications are not otherwise privilege and what i address a couple of the other points counsel pointed out  interpret these matters together they consider both statute proper that is they violated impairing much material because they very material requires that two statutes that are have of the same subject be considered together and produce a harmonious whole and as a pointed out what the court did was create inconsistency between two statutes that are disposed to be interpreted the other and that they've created inconsistency in the face of a regulation that was propounded out of the credentialing act that states that they are to be given the same protection and also makes a lot of arguments regarding the fact that there should be different texan based on different procedures that the the application process is the first step in the process through which the doctors prevention you can't separate that out any more than you can separate out the credentialing committees request for  a confidential third party assessment of the doctors that ability it is all part of the credentialing process and should have the same protection and the court i'm sorry in the legislature has found that it should have the same protection i don't like to point out that prior to the enactment of the data collection the courts had held that the application was not for didn't have it wasn't covered by the medical studies act so the credentialing act in fact changed this you know it was definitely would need to say that it's confidential and further indicate in the apple in the statute that there is no exception for medical malpractise litigation or negligent credentialing claims players council doesn't like the fact that they are the legislature has determined that the entire process of credentialing the doctor from the start which is the submission of an application on or on a required form to the end when the doctor actually gets of the the peer review process that this doctor was incompetent or incapable of performing his job furthermore if he were if he wants to have the legislature create exceptions for litigation such as this then that's an issue that should be taken up with the legislature who can act that the statute and specifically did not provide such an exception so how do you not render the entire act meaningless if you allow disclosure in spite of the language of confidentiality contained within the statute i'd also like to point out or allegedly harms them the the public policy of protecting the general public from doctors and by making all the information for that confidential  public policy otherwise the courts wouldn't or the legislature would have adopted the medical studies act or the credential data collection would ask this court find the applications to be privileged and