Monday, August 11, 2008

Who owns your medical history?

You may think that you own your medical history, but you may be mistaken. New trends in the medical field are changing the way patients medical records are stored and used. This promises to help millions of people each year and improve patient safety, but make sure you know who really owns your health history.

Hospitals and medical care providers are moving away from paper documents to keep patients records and are moving towards electronic records. Electronic medical records (EMRs), also known as electronic health records (EHRs), will allow for faster and more efficient transfers of patient data from the doctor to the pharmacy and to the health insurance company.

This move from paper to electronic has obvious advantages for the hospitals. The storage and retrieval of patient information is much cheaper and faster. The move will help many patients, too. In particular, the electronic transfer of prescriptions from the doctor’s office to the pharmacy promises to dramatically reduce the number of prescribing errors that occur due to misread doctors’ instructions.

We all know and have seen the chicken scratch abbreviated instructions that doctors often write on paper prescriptions. Errors in prescribing and taking medications pose a very serious problem. A 2006 report by the Institute of Medicine estimated that 1.5 million people are injured each year by medical errors including deaths. The cost of these errors is in the billions of dollars each year. Having electronic medical records will help alleviate the problems of misreading hand-written prescriptions. In addition, patient safety can be increased further if the electronic prescribing system can be linked to drug safety databases and personal medical records that could automatically check for a drug’s side effects and potential problems with a patient’s known allergies or other medications they may be taking. All these benefits have created a strong impetus to increase the use of electronic medical record systems. In fact, President Bush stated that he wanted every American to have an electronic medical record by the year 2014.

Electronic medical records are a wonderful advance for handling patients’ medical records, but do have some concerns. One problem is that they are only as good as the person entering in the information, so having a quality control system in place is important. Another large concern is the issue of confidentiality. Knowing who is looking at these electronic medical records can be problematic for patients.

Health and life insurance companies are starting to use these records to access the medical risks that an applicant poses. This in itself makes a lot of business sense, but other companies are in the business of selling medical records. Patient medical information is being packaged and sold to third party companies, such as insurance companies and other interested parties. In fact, if you aren’t careful, your medical information could be sold without your knowledge.

There are government rules for how electronic medical records can be used. The Health Insurance Portability and Accountability Act (HIPAA, pronounced “hip-ah”) sets rules and standards for how electronic medical records can be shared. It contains a Privacy Rule that instructs companies holding your electronic medical records to inform a customer about their policies for sharing electronic medical records. When you sign up for insurance or a health care plan, you should be presented with the company’s policies for sharing information. You may choose not to accept their policy, but your failure to consent could prevent you from getting approved. When signing these forms, pay attention to what their policies are.

For companies that sell medical records, the HIPAA rules require that they protect a patient’s identity. If you feel that your information has been misused, HIPAA protects your right to receive a report on who your information was shared with. If you think it has been improperly shared, you can file a complaint with your provider or insurer, or with the US government if you feel that your concerns are not being addressed.

The move to electronic medical records will save many lives and improve healthcare, but consumers need to pay attention to how their health information is shared, just as they would their financial information.

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