Privacy of Medical Records

Study Guide

Catalyst

Most people require a certain amount of privacy. Everyone holds a certain information about themselves to be personal and to be shared with only people whom they trust. This is the major cause of medical privacy issues. Because doctors’ offices and hospitals keep records on each of their clients, the issue becomes, who has a right to access these records? The widespread use of databases and other technology to maintain this data has caused the medical privacy issue to blow up at an even greater rate. Now, not only do insurance companies and billing agencies have access to your medical records, but hackers can now access them also.

Content of Medical Records

Medical Records may include your medical history, details about your lifestyle such as smoking or involvement in high-risk sports, and family medical history. In addition, your medical records contain laboratory test results, medications prescribed, and reports that indicate the results of operations and other medical procedures. Your records could also include the results of genetic testing used to predict your future health. And they might include information about your participation in research projects. Information you provide on applications for disability, life or accidental insurance with private insurers or government programs can also become part of your medical file. So, it is easy to see why people consider information about their health to be highly sensitive.

Accessibility

Medical records are shared by people both in and out of the health care industry. These include:

Insurance companies
Government agencies
Medical Information Bureau(MIB)
Employers
Subpoenaed for court

Generally, access to your records is obtained when you agree to let others see them. In reality, some situations offer no choice but to agree to the sharing of your health information in exchange for care and to qualify for insurance. Other places where identity may or may not be disclosed are:

Health care operations, or the evaluations of hospitals or individual physicians
Public health agencies for health research
Direct marketers when you participate in informal health screenings

Electronic Medical Records/Electronic Health Records

An electronic medical record (EMR) is a medical record in digital format. In health informatics an Electronic Medical Records(EMR) are considered by some to be one of several types of EHRs (electronic health records), but in general usage EMR and EHR are synonymous.

Adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States. Less than 10% of American hospitals have implemented health information technology, while a mere 16% of primary care physicians use EHRs. The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on health information technology, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%. The following issues are behind the slow rate of adoption:

Laws

Medical laws have been put into place for patient privacy protection. Under the Clinton Administration, the Health Insurance Portability and Accountability Act of 1996 was administered. Since then, there have been man amendments to the act, the most noteable being one of Clinton’s last actions as president. On Dec. 28, 2000, Clinton administered changes to the HIPAA of 1996. These changes gave patients unprecedented rights to track their medical files. It implemented new criminal and civil sactions for improper disclosure of medical records and it protects against unauthorized use of medical records for employment purposes. Although this last act gave patients unprecedented access and control of their medical records, some are not satisfied.

Genetic Mapping

More than 40 U.S. states have laws requiring hospitals to make available to insurance companies and researchers certain information about each visit they receive. With this information, hospital records can be obtained and all sorts of genetic testing can be done. This becomes extremely controversial because the laws are vague about what constitutes a research group.