Health records privacy between doctors

[Anonymous]

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Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

Just because a doctor wrote something down (or more likely clicked a box) does not make the thing written or clicked into an established fact that, if not mentioned, is “being withheld.”

Careful, I wouldn't want you to throw out your back with the gymnastics you're attempting in that post.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

It’s not providing it all automatically to every doctor ever seen (and their staff and vendors) for valid reasons discussed in this thread. The patient still provides all relevant information and chooses to share records for the particular situation.

It’s like the patient privacy rights have been trampled on because it’s simply easier that way.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

It’s not providing it all automatically to every doctor ever seen (and their staff and vendors) for valid reasons discussed in this thread. The patient still provides all relevant information and chooses to share records for the particular situation.

It’s like the patient privacy rights have been trampled on because it’s simply easier that way.

You're changing your story. You previously described not sharing your records with a new doctor when you weren't happy with the diagnosis/treatment of a previous doctor.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

It’s not providing it all automatically to every doctor ever seen (and their staff and vendors) for valid reasons discussed in this thread. The patient still provides all relevant information and chooses to share records for the particular situation.

It’s like the patient privacy rights have been trampled on because it’s simply easier that way.

You're changing your story. You previously described not sharing your records with a new doctor when you weren't happy with the diagnosis/treatment of a previous doctor.

PP, you just don't understand. When you don't get the answer you want from one doctor, you have to keep looking until the get it right. Or maybe they get the dose right, but they don't give you the medications or referrals you want -- of course you have to keep looking. How else are you going to get what you want?

If you tell them about other doctors then they are even less likely to take you seriously as a patient, because they will think you have already made up your mind and are just looking to get what you want. Obviously.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

It’s not providing it all automatically to every doctor ever seen (and their staff and vendors) for valid reasons discussed in this thread. The patient still provides all relevant information and chooses to share records for the particular situation.

It’s like the patient privacy rights have been trampled on because it’s simply easier that way.

You're changing your story. You previously described not sharing your records with a new doctor when you weren't happy with the diagnosis/treatment of a previous doctor.

PP, you just don't understand. When you don't get the answer you want from one doctor, you have to keep looking until the get it right. Or maybe they get the dose right, but they don't give you the medications or referrals you want -- of course you have to keep looking. How else are you going to get what you want?

If you tell them about other doctors then they are even less likely to take you seriously as a patient, because they will think you have already made up your mind and are just looking to get what you want. Obviously.

Yes, because that's obviously what's going on when you choose to hide information from your new doctors. No wonder they won't take you seriously.

[Anonymous]

Anonymous wrote:I agree, op. I dont like it

SAME!

[Anonymous]

I have a lot of physicians in my extended family, and I have a lot of respect for physicians.

But in this case, I'd like to respectfully point out that in some cases it's necessary to see several physicians or specialists. Sometimes a new set of eyes will be able to figure out what the correct diagnosis is. This happened with my sibling who turned out to have a very rare disease. It took several years to arrive at a correct diagnosis. So it's not always a matter of diagnosis shopping, or someone who wants opioid prescriptions from multiple physicians.

Come to think of it, perhaps there *should* be a database specifically dedicated for abused drugs. But for the vast majority of patients, this is not necessary and can actually present a privacy threat to the patient.

[Anonymous]

Anonymous wrote:The fact that EHR allows broader distribution of records has both positives and minuses. One minus is that there can be errors, particularly related to hospitalizations where reports are filed under time pressure and by doctors unfamiliar with the patient. Request your medical records and you may be stunned to read things in the notes which are not accurate. With other providers able to access them, those errors can have ripple effects.

+100 Privia, VHS and innova the worst with incorrect information in your medical file. Doctors have even lied at what I said!

[Anonymous]

Anonymous wrote:I think the public needs to demand reform.

We didn't agree to the sharing of this information and it is a violation of our privacy. Sure, maybe it's convenient - for the physicians. But at what price?

It's not just the physicians who have access to this information. Many, many people from the receptionist to the bill collector can snoop if they want to. This information falls into the wrong hands and there are repercussions.

I agree. This is a real problem which feels like it was sneaked up upon the patient, no warning or ability to "opt" out for privacy issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yes, and they'll share them via fax if they aren't in the same system.

Sorry, you'll have to try doctor shopping for drugs/diagnoses some other way. Opiate prescriptions are always reported to the state.

Oh my not why I’m asking at all. I think all prescriptions go into a database anyway. Quite the assumption you jumped to.

It’s the privacy of the visit itself as other pp said. They don’t have to have permission to share? Family member is receptionist at one office and I don’t really want her viewing my records from the other. It’s a new doctor I’m about to see and I noticed that the software is the same when I went to check in.

I'm a nurse at an outpatient practice. The front desk (receptionist etc.) cannot see as far into the records as the nurse can. I work at U of MD and I can see other U of MD notes (unless they are in a special category used for psych, addiction, maybe more sensitive areas like that). If a patient is at another hospital system that uses the same EMR as we do, I cannot see their notes. I can in the PDMP/ CRISP, though. Who gets access to CRISP? I do at this practice, but not sure most nurses would. And if you sign a Release of Information saying your doctor can share info with another, they will but not wholesale. Just whatever is pertinent to their shared treatment of you.

I truly believe I will be fired if I look at someone's EMR that I have no reason to look at. I hope this has been somewhat reassuring, at least so far as the receptionist looking at your records is concerned.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:I was annoyed that my PCP office's EMR (Epic) automatically shared records with my *dentist*.

OP, if your ex accesses your records without a legitimate reason, that's a HIPAA violation and he can get in trouble with his employer. The employer can see who has any accessed any records. If he's really unhinged, this might not stop him.

Dentist is bad, but how abt this!

I (a physician) went to see a specialist who a dr friend recommended. I dutifully (stupidly?) wrote her name “larla smith” in the “how did you learn abt our practice?” section (and NOT “dr larla smith” in the “were you referred by your physician?” Section) and she ended up getting a fulsome report of my entire visit mailed to her office, including a personal note from the doc to call him with any questions.

This.

In my community there's a ring of adult bullies who target and harass various individuals for their personal amusement. I wish I were exaggerating but unfortunately I am not. One of them was sued a few years ago for spreading slander about an individual they were harassing. The harasser is 100% capable of getting a friend working in a medical office to get him personal medical information with the intent to embarrass the person they're terrorizing. 100% capable.

The databases don't take into account the many ways a patient's personal medical information can be misused. These databases are dangerous.

Why couldn't the harasser get a friend to look at paper records?

Paper records are available only in your doctor's office (unless I'm mistaken).

An industry-wide database with ALL your information from ALL the physicians you've ever seen is available for snooping from ANY medical-related organization, not just doctor's offices.

Do you understand the implications contained in this fact, to include the high likelyhood of data breaches?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:Would they be able to access them, theoretically? Probably. Would they be allowed to, according to HIPAA, if you did not sign a form allowing them to share records with other providers? No. And regardless, sharing of records from, say, an OB to an Ophthalmologist would only happen if the ophthalmologist had a medical reason to need to see the notes, even if you technically signed that you were ok with it. If your eye doctor is reading about your C section 12 years ago just for fun , that’s not allowed.

You are not wrong...

HIPAA doesn't require consent for sharing between providers.

Even if it did require it how would they know if a dentist was reading ob-Gyn details of a patient? The thought of open access like that is unnerving. Plus most of us just sign the HIPPA paperwork without fully knowing what it all covers.

Specific to my immediate concern, I know my family member read my file because of a comment slip and I don’t want to provide the opportunity to breach again with new dr office. Info could just be pulled up by a name search?

They would know because in EHRs, admins can see who has accessed what information and when. For health privacy violation purposes. Health info in an EHR is on a need to know basis. As a doc, I’m not allowed (per HIPAA) to read a patients social work note from when a social worker met with them in the ER one time a few years ago, unless I actually need that information. And if I click on it and read it, and one day the patient calls our facility and goes “I just have a hunch that Dr B is reading my private psychiatric health info even though Dr B is my dermatologist”, the facility can very easily check and see that yes I absolutely read my patients social work and psych notes. And I’d be fired.

Doctors don't even get fired for removing the wrong body part in a surgery. They're certainly not getting fired for a HIPAA violation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Would they be able to access them, theoretically? Probably. Would they be allowed to, according to HIPAA, if you did not sign a form allowing them to share records with other providers? No. And regardless, sharing of records from, say, an OB to an Ophthalmologist would only happen if the ophthalmologist had a medical reason to need to see the notes, even if you technically signed that you were ok with it. If your eye doctor is reading about your C section 12 years ago just for fun , that’s not allowed.

HIPAA doesn't require consent for sharing between providers.

Even if it did require it how would they know if a dentist was reading ob-Gyn details of a patient? The thought of open access like that is unnerving. Plus most of us just sign the HIPPA paperwork without fully knowing what it all covers.

Specific to my immediate concern, I know my family member read my file because of a comment slip and I don’t want to provide the opportunity to breach again with new dr office. Info could just be pulled up by a name search?

They would know because in EHRs, admins can see who has accessed what information and when. For health privacy violation purposes. Health info in an EHR is on a need to know basis. As a doc, I’m not allowed (per HIPAA) to read a patients social work note from when a social worker met with them in the ER one time a few years ago, unless I actually need that information. And if I click on it and read it, and one day the patient calls our facility and goes “I just have a hunch that Dr B is reading my private psychiatric health info even though Dr B is my dermatologist”, the facility can very easily check and see that yes I absolutely read my patients social work and psych notes. And I’d be fired.

Doctors don't even get fired for removing the wrong body part in a surgery. They're certainly not getting fired for a HIPAA violation.

You are not wrong.

[Anonymous]

Anonymous wrote:I have a lot of physicians in my extended family, and I have a lot of respect for physicians.

But in this case, I'd like to respectfully point out that in some cases it's necessary to see several physicians or specialists. Sometimes a new set of eyes will be able to figure out what the correct diagnosis is. This happened with my sibling who turned out to have a very rare disease. It took several years to arrive at a correct diagnosis. So it's not always a matter of diagnosis shopping, or someone who wants opioid prescriptions from multiple physicians.

Come to think of it, perhaps there *should* be a database specifically dedicated for abused drugs. But for the vast majority of patients, this is not necessary and can actually present a privacy threat to the patient.

For opioids there's CRISP/PDMP.

Getting a second on opinion from someone with more expertise is not diagnosis shopping.

Seeking additional opinions from other similarly skilled doctors, while hiding previous records, test results, and diagnoses from them, because you didn't like what you were initially told is diagnosis shopping.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In theory, having records all connected should be good for patient care but there are valid reasons a patient doesn’t want every dr they see to know who else they have seen, what was discussed, etc and every other medical issue they have or have had.

Such as?

Read the thread.

It's usually because of diagnosis shopping. Sometimes drug seeking. Is that what you meant?

Read the thread. Drug seeking is an issue, absolutely, and it’s a problem, but I don’t think all patients should be penalized for it - as someone who is loath to take anything stronger than an Advil I also don’t like the automatic connectivity. Sometimes it is hard to get good advice and assistance with an issue and you as the patient want several opinions on how to proceed or what a problem may be. I don’t think it’s anyone’s business who else I’ve consulted. Also you don’t want the dr prejudging the situation and letting reports from other doctors color their thinking.

That's called diagnosis shopping.

Yeah, not necessarily. You may have a diagnosis of some kind and want different opinions on how to treat. And why is diagnosis shopping necessarily bad? If you aren’t sure what’s going on for some reason with a health issue you might be getting opinions as to what the cause might be.

You're asking why it's bad to withhold relevant medical information from providers when you didn't like what one told you?

Who said anything about withholding information? The pp is talking about the possibility of doctors reaching different conclusions on diagnosis or treatment options based on the same information presented. Happens all the time with nuances. It doesn’t mean finding someone at fault. It means a difference of opinion or approach. That’s the whole reasoning behind “get a second opinion”.

Withholding medical records is withholding information.

It’s not providing it all automatically to every doctor ever seen (and their staff and vendors) for valid reasons discussed in this thread. The patient still provides all relevant information and chooses to share records for the particular situation.

It’s like the patient privacy rights have been trampled on because it’s simply easier that way.

You're changing your story. You previously described not sharing your records with a new doctor when you weren't happy with the diagnosis/treatment of a previous doctor.

PP, you just don't understand. When you don't get the answer you want from one doctor, you have to keep looking until the get it right. Or maybe they get the dose right, but they don't give you the medications or referrals you want -- of course you have to keep looking. How else are you going to get what you want?

If you tell them about other doctors then they are even less likely to take you seriously as a patient, because they will think you have already made up your mind and are just looking to get what you want. Obviously.

I think this is sarcastic but not everyone is some kind of drug seeker. People can have weird medical issues or even routine ones where different drs will have different approaches or thoughts.