he next time you have a heart-to-heart with your doctor, consider who may, in effect, be "listening
in." No one else may be in the room. But the information that ends up in the medical record your health-care provider
keeps may pass before more eyes than you think.
"People assume that doctor/patient privilege protects their medical records," says Zoe Hudson, policy analyst for the Health Privacy Project at Georgetown University, Washington, D.C. "In fact, that's not true. There are many users of that information, both legitimate and suspect."
It's wise to know who all those parties are with potential access to your health informationand to take what steps you can to try to protect your privacy.
no federal law
exists to set
may pass before
than you think.
|What's in your medical record?|
Any time you visit a health-care professionaldoctor, dentist, psychiatrist, or chiropractorinformation about the examinations, tests, and treatments you receive goes into your medical record. It also lists illnesses you've had, medical procedures and surgeries you've undergone, and prescriptions you've taken. And it contains your family medical history and lifestyle-related health information, such as how much alcohol you typically consume and whether you indulge in bungee jumping or other high-risk activity.
Your medical record serves multiple purposes. Health-care providers need the information to provide you optimum care, and your record allows sharing of information among your various caregivers. It provides documentation of care you've received. It verifies which services and treatments your insurance covers. And medical record information can provide useful data for health research and planning that may benefit many people.
Who owns your record? It's the property of the health-care provider or facility that compiles it. State laws vary as to how much access patients have to their own health information. Usually you can gain access by contacting your health-care provider, who may ask you to put the request in writing. Some providers charge a fee for locating and copying your record.
Who can see your medical record?
In theory, you must grant permission for anyone to look at your medical information. But people often sign blanket waivers or general consent forms, making their health records available to more parties than they realize. Here's a list of the entities that may gain access to your health information.
|How can you protect privacy?
Currently a patchwork of state laws assure varying degrees of privacy protection for medical records. "What's missing is a federal law," Hudson says. "There are no minimum standards for the country."
Congress failed to meet an Aug. 21, 1999 deadline for passing a federal health privacy law, as required by the 1996 Health Insurance Portability and Accountability Act. That law stated that if Congress didn't act by the deadline, the Department of Health and Human Services (HHS) would have to issue regulations by Feb. 21, 2000. Congress still could pass a law at any time, however, that would override HHS regulations.
Passing a law is no easy task. Privacy advocates cite abuses resulting in personal damage, such as job loss. Still, opinions vary widely about how to protect privacy while also enabling access to information vital to public health, research, and law enforcement.
Until a comprehensive law exists, you can boost privacy protection of your health information:
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