Some health plans and medical groups are now making patients’ medical records available through private, secure web links, and some employers are providing a free, online medical record system to their employees. These online records represent a revolution in our health care system, and we will be the winners.
It wasn’t long ago that a person had no right to see his or her own medical record. That record was considered the property of the physician or hospital that cared for the patient. In most states a patient could not get access to his or her own records, even to correct an error. That changed with the Health Insurance Portability and Accountability Act (HIPAA), so that the right to request medical records was federally protected, and the revolution started.
For the first time anyone could see his or her diagnoses, look at the lab results or X-ray reports and evaluate the care they had received. Thanks to the explosion of medical information on the Internet, you can now evaluate for yourself whether the diagnosis makes sense and whether the care you received was appropriate. You can decide what other steps might be taken for your benefit. Effectively, this enables you for the first time to take charge of your own health care and to partner with your physician in determining your course of care. This has been a difficult transition for some physicians, but ultimately it acts to empower us as genuine medical consumers with knowledge and confidence, and that results in better outcomes.
But just as the Web has changed so many other areas of our lives, the changes have not stopped there. Some health plans are making medical records available online electronically, so you can see your lab results, often before your physician does. Since your medical information is now in a portable format, online and not buried in paper copies, you can easily share the information you want with experts anywhere in the world to get a second opinion or find other treatment options.
We are not far from the day when all of these results can be compiled to determine the best treatment for each medical condition, something that today is often based on guesswork. It will be possible to really measure how well a physician performs by the results his or her patients experience. We will also be able to support them through expert systems to bring the best and the latest information to your care.
We have already seen this kind of information revolution in banking and financial services – remember your savings account passbook? The promise is even greater in health care. Stay tuned.
#1 by David on February 4th, 2007
While I agree in the premise of the article, in that it would be a great aid in this day and age of “consumerism” and the “empowered medical consumer”. I am afraid that in the litigious society we live in, no one will take on the issue on a large-scale (national) basis. I have had discussion among different stakeholders in the healthcare areana (medical providers, insurers, third-party administrators etc…) None is prepared or willing to face the regulatory restrictions and assumption of liability that would go hand in hand with creating a database of personal medical data. My question is who will step forward and collect, house and report this data? How will they be protected from liability associated with potential HIPPA violation and who will pay for the infrustructre costs that will be incurred to build appropriate safe-guards and systems? The academic discussion of the availability of on-line data is a great first-step. How do we make this real?
#2 by Dr.+Christopher+Coulter on February 5th, 2007
I agree with many of your comments. Progress is often “two steps forward, one step back,” and bringing medical practice into the 21st century is no exception. I also agree that HIPAA privacy concerns and liability issues give pause to physician offices, hospitals, and health plans who contemplate placing medical records online. Incidentally, this is also one reason why physicians have been slow to adopt email as a way to communicate with their patients, despite overwhelming demand. But organizations are moving ahead with online medical records, and there are compelling reasons for them to face the privacy and liability issues. First, it promises a significant competitive advantage with patients and health plan members. Second, organizations who “stake out turf” in the world of online medical records will have an head start on owning the databases which will drive quality, marketing, and economic decision making. And third, this can actually help avoid litigation over “failure to inform” and other negligent practice lawsuits. The fact is that a number of health plans, including Kaiser and Aetna, are already making online records available to plan members, and plan to roll out national programs this year and next. A coalition of employers has also announced that they will provide their employees with an online medical record system, so they can own their own medical information. There is no shortage of those who wish to provide the service, and while potential liability issues have slowed the adoption of online medical records, I believe that the train has already left the station.