WASHINGTON – Family, friends and clergy will soon find it more difficult to get information about hospital patients under health privacy rules that give patients new power to keep their conditions secret.

Years in the making, the rules represent the first comprehensive federal protections for health privacy. They will prohibit disclosure, without patient permission, of information for reasons unrelated to health care, and there will be new civil and criminal penalties for violators.

For most organizations, they take effect April 14.

In response, hospitals across the country are revising a spectrum of policies, including those governing patient directories that have long provided basic information about conditions to anyone who asks for it.

In some hospitals, the change will mean a delay in releasing information; in others, information once readily available will be shut down.

“If you call about Aunt Sally, they’re not going to be able to tell you anything. It will be a big change,” said Wilda Stanfield, spokeswoman for Centre Community Hospital in State College, Pa.

The rules will have a particular impact on news organizations that routinely call hospitals to learn the condition of people injured in crimes, car accidents and other noteworthy events. Information will be available only if a patient agrees. If the patient is not available to say yes or no – say, in emergency surgery – most hospitals plan to keep information confidential.

The rules also will affect members of the clergy, who often check hospital directories for members of their congregations. A delay, some warn, could make it more difficult for patients who receive daily communion and may depend on a visit from a priest or pastor.

“It will certainly reduce the amount of visitation that’s done in the hospital,” said Lerrill White, the chaplain at St. Luke’s Episcopal Hospital in Houston and liaison to the Department of Health and Human Services for the Association of Professional Chaplains. In most hospitals the rules should be workable, he said, but patients may need to adjust their expectations.

“Patients basically expect their minister, priest or rabbi is going to show up to pay their respects, offer help and prayers,” he said.

Congress directed HHS to write the massive privacy regulation – which affects every hospital, doctor’s office, insurance company and pharmacy in the country – after lawmakers were unable to resolve differences over the issue.

Under the new rules, hospitals must inform patients if they have directories and give them the opportunity to opt out. No information – including even that a patient is in the hospital – may be released if a patient objects.

Even if a patient should agree to a general listing, hospitals may release only limited information without specific authorization. They may disclose only where the patient is in the hospital and give a one-word condition such as good, fair, serious or critical. Hospitals may tell callers that a patient has died, but they cannot give the time or cause of death without permission from next of kin.

“The rules are clearly going to mean less information, not more information, is available,” said Alicia Mitchell of the American Hospital Association, which last week sent guidelines for interpreting the rules to its 5,000 members.

The federal rules give hospitals flexibility for patients who have not yet had an opportunity to express a preference. HHS guidelines interpreting the regulation say the hospital may disclose information about a patient’s condition if “the disclosure is in the individual’s best interest as determined in the professional judgment of the provider.”

Given that, most hospitals plan to withhold the information if they don’t have a clear go-ahead.

“I don’t want to guess what the patient’s preference is,” said Greg McGarry, vice president for public relations at Albany Medical Center in New York. “If I don’t know the patient’s preference right away, I probably am not going to release it.”

That will sting many reporters who are trying to gather quick information about patients injured in newsworthy events, where the hospital has not had a chance to seek consent.

“Our members are reporting that they are already having trouble getting information from hospitals,” said Barbara Cochran, president of the Radio-Television News Directors Association.

Cochran worries that information that could calm the public during a crisis, such as a terrorist attack or a school shooting, could now be withheld, although hospitals have more leeway in these cases.

“It would be essential to get out accurate, clear information as rapidly as possible in order to prevent a crisis from turning into a full-blown panic situation,” she said.

For everyday matters, it’s hard to argue that “grave consequences” will result if information about car accidents and fires is withheld, said Douglas Clifton, editor of The Plain Dealer in Cleveland and head of the Freedom of Information Committee of the American Society of Newspaper Editors. Still, he said: “The components of community understanding are predicated on knowing those small things.”