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Your electronic health documents

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Last week on the AgingOptions radio show Jerry asked some questions about electronic medical records.  I thought I’d try to answer a few questions here. 

Electronic records are a way to keep your medical records confidential while also allowing the ability to securely share your records with other providers.  The benefits are that electronic records can help lower the chances of medical errors, eliminate duplicate tests and hopefully improve your overall quality of care.  The information about your condition, treatments, test and prescriptions is up-to-date.

Whenever you visit a doctor you give that doctor information about you, your family and your family’s health history.  A typical form might ask for your social security number, your mother’s maiden name, or your address for the last 10 years but it might also ask questions about certain diseases and other pieces of information you might want kept private.

Your health information is protected by federal law under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  The HIPAA Privacy Rule gives you rights over your health information and sets rules and limits on who can access your health information.  The law covers all forms of information, whether electronic, written or oral.   The entities that must follow HIPAA regulations include:

  • Health Plans such as insurance companies, HMOs, company health plans and certain government programs such as Medicare and Medicaid.
  • Most Health Care Providers such as doctors, clinics, hospitals, psychologists, chiropractors, nursing homes, pharmacies and dentists.  This includes any organization you might hire to help an aging parent or yourself with things like medication reminders, baths, companionship etc.  It also includes organizations that handle electronic billing for any of the above organizations.
  • Health Care Clearinghouses that process nonstandard health information that they receive from another entity to be processed into a standard electronic format or vice versa.

Some government organizations that have access to your records that you might not be aware of are any government agency that pays for your care such Medicare, Medicaid, workers compensation, Social Security disability, Occupational Safety and Health Administration and department of Veterans Affairs for instance.  If your care of children is questioned, the local child protective services may ask to see your child’s medical records.  Prescription databases have records of all prescription drugs you have purchased over the last five or more years and that information can be used by life insurance or disability insurance companies.

Here’s a document that outlines what rights you have.

In general, your health information cannot be given to your employer, used or shared for things like sales calls or advertising, or used or shared for many other purposes unless you give your permission by signing an authorization form. This authorization form must tell you who will get your information and what your information will be used for.

So who can look at your medical documents?  Your health information may be used and shared with doctors and hospitals, with family, friends, relatives or others that you specify, with the police in cases of gunshot wounds and with government agencies that report on the incidences of various illnesses.  Your health care provider may use it but only in the manner in which they have already disclosed to you.  Generally, your health care information cannot be used or disclosed unless HIPAA explicitly allows it.  This means that your provider generally cannot provide the information to your employer or share the information for marketing or advertising purposes or share private notes about your health care.

Jerry asked if he couldn’t just put his medical files on a removable drive like a thumb drive and take it from doctor to doctor. already has a secure way to create a downloadable file that a doctor can access.  It’s called Medicare’s Blue Button.  It allows you to download your data to a secure location or save it to a flash drive or CD.  It will be up to you to encrypt your information if you save it to an external drive.  You can then send your encrypted file to your physician via e-mail or bring the removable to the doctor’s office.  You can find information on the Blue Button here or begin downloading your information here.

Electronic Medical Records may be a good idea but we are definitely in the growing stages with it yet.  Instead of seeing cost savings, many medical personnel complain it takes longer to see patients and some critics complain that electronic records make it easier to bill fraudulently.  Typical of any new system, electronic records are subject to crashes and there are problems with one medical provider uses a different application than another.  We are a long way from the expected benefits of moving to electronic records.

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