Healthcare providers are moving to a system of electronic health records where an individual’s entire medical history, diagnoses, treatments, medications and other health information are maintained in a digital form.
In order to provide better and more timely health care to individuals, should physicians and other healthcare providers be able to freely access and share this information with each other without a patient’s consent?
I do not think physicians should have free access to a patient's records without consent. HIPAA exists for a reason after all. In order to make more timely health care, the process of physicians getting consent could be streamlined, with forms patients have to fill out agreeing to give multiple different access. But a patient's consent should always be required for their own security and privacy sake.
ReplyDeleteHIPPA exists primarily to restrict unauthorized access to a person's medical records by third-parties outside the hospital or health care provider. It does not prohibit doctors involved in the treatment of a patient from sharing information about the patient.
DeleteDigitization already speeds up the process of sharing records, now we can already send files at the speed of an email instead of physical mail. I'm not sure that physicians or other healthcare providers need to speed up the sharing of information any more. With a phone call my medial history from south Carolina can be used in Utah essentially instantly, and I dont really see why we would need to speed this up any further
ReplyDeleteJake: How could your medical history from South Carolina be used in Utah via a phone call? A phone call to you? to the health provider in South Carolina? What about the circumstances raised by Nate G? Does that cause you to reconsider your position?
DeleteAfter working in Primary Children's ER, I saw the immense difficulties that physicians and patients face when their EHR is not available. Without updated access to EHRs from other medical facilities, physicians often have to retest patients and potentially miss critical information from past medical history. Patients then incur further financial and health costs.
ReplyDeletePhysicians and healthcare providers are trained (and required) to respect patient privacy. Healthcare providers are only able to access patient information if they are in direct care or consult for the patient. This means that they can not look up patient information on everyone. Universal EMRs are already in use in places like Australia, France and the UK. I see universal access to EMR/EHR as a positive for patient outcomes if it's secure and balances privacy risks.
I really liked reading through your point of view! I answered no to this question, but I don't have experience working with health records and thus don't know as much as you do, so I really liked reading the response of someone who does have this knowledge and experience.
DeleteThanks, Andrew, for acknowledging a different perspective.
DeleteHannah: Good points, which gives background and context to real-world examples like what Nate G. experienced and explained in his comment.
DeleteNo. Consent should be the biggest priority, for an organization, especially that in healthcare, when accessing sensitive information about an individual. It is not only an invasion of privacy for healthcare workers to access this information without consent, or even have it readily available in the first place. It is a concern, and it should be addressed by prioritizing the rights and privacy of the patients at hand. While it can streamline the process and make it easier for healthcare workers to save lives, there is a fine line we must follow, and not supersede, in our pursuit of doing great things, we can fail to do good.
ReplyDeleteRyan: shouldn't saving lives be the first priority of a doctor even if they have to infringe on a patient's privacy?
DeleteNo. I think physicians and healthcare providers can totally access and share this information with each other if they have consent from the patient, but if there is no consent given, I don't think they should be able to. Patients should be able to trust their healthcare providers, and if these officials are sharing information without consent, there could be a loss of trust. There may be information that a patient may be comfortable sharing with their current physician but may not want others to know.
ReplyDeleteAs far as I know patients rarely disagree to share information with their doctors that they know is useful for maintaining their health. Patient consent should be necessary anytime their own health info is shared. Because sharing and keeping detailed information is much easier it's easier than ever to move this info between different healthcare providers so I don't think that removing patient consent from the equation would really speed things up in a significant way.
ReplyDeleteKai: what if the patient is unable to be reached or is incapable of giving consent?
DeleteNo. Any transfer of a patient's health data should be assented to by the patient. Should healthcare information be shared, even in a contained environment, without the consent of the patient it is far more likely that the patient can see negative results from it, like in the case of a leaker or breach of the data as it could possibly be in more databases. Furthermore, I don't believe that the time removed by not asking for consent would be significant.
ReplyDeleteWhat if the sharing of patient information among other doctors is limited to only those doctors who are directly involved in your care?
DeleteNo, I don't think physicians should be able to access patient records without consent. They should have to be the one actively treating the patient to access the records, otherwise I think it would be too easy to take advantage of the system and look up anyone's data. I also agree with what others are saying about how it wouldn't take that much time to gain consent.
ReplyDeleteAlex: Is your primary concern with the breadth of the word "healthcare provider"? Would you answer yes if a treating doctor could only share your medical information with other doctors who are also providing assistance in the patient's care?
DeleteI would feel better about this if the term "healthcare provider" was more clearly defined. There should also be some guidelines on what information can be shared. I can understand why my dentist might want access to my past dental records, but my optometrist doesn't need access to those records. I do still think that if consent can be obtained from the patient that it should be, but I can see how there might be certain circumstances where it would be logical for medical information to be accessible ahead of time.
DeleteNo. Physicians should not give information about their patient to other doctors with out the patient’s permission. The question does become more difficult when in extreme circumstances when the person cannot give in an answer. In that situation I think a family member, or guardian should then make the decision.
ReplyDeleteJaskehar: So the surgeon who is surgically repairing your broken leg cannot share your patient information with the anesthesiologist, the assisting nurse, the x-ray technician, the pharmacist who will prescribe you pain medication, the recovery room nurse and the physical therapist without your consent?
DeleteI say yes. When I broke my leg I had to go to both urgent care and the er, and had to pay for x-rays at both because they couldn’t send the records fast enough even with my consent, the urgent care just wasn’t able to pass it to a different service. If the er had been able to access my records then they would have been able to get my leg set faster and spend less time/money for x-rays. As Hannah said, doctors and other health care workers already have to practice patient privacy, and I don’t think that having the records be more readily available would be a bad thing.
ReplyDeleteThis is Nate G
DeleteThanks for sharing your story. This one of the many reasons why health care is so expensive in the U.S.
DeleteDue to there being a strict privacy standard in Healthcare (like Hannah and Nate brought up), I think records being accessible within Healthcare facilities would be greatly beneficial. As long as they are following the same standards for privacy introduced by HIPPA, then I think these institutions sharing this information with one another on a NEED basis would be very useful. However, maybe patients should be able to opt-in or out of this new system, as to allow proper consent and privacy considerations of the individual beforehand. Also, if I wanted to get a second opinion about a diagnosis I received but wasn't confident in, I wouldn't want the new doctor/facility to know, as it might affect their bias/decision making if another doctor had said differently.
ReplyDeleteGood point about the second opinion concerns!
ReplyDeleteThere should not be free and easy access without consent, but I do think that if a patient's physician changes or in extenuating circumstances, that should be a easy and efficient process to acquire their medical history. A shared system is a good idea so that everybody knows how to work it, and it can all be locked under a very private, verified database that still allows individuals to consent, change, and for emergency access. I think that healthcare privacy is very very important but there are just many complexities that should ensure flexibility and speed for emergencies and special conditions (comatose/unconscious, mental instability, etc.).
ReplyDelete