Transparency in Healthcare: How Consumers Are Taking Control of Their Medical Information

Getting access to your medical records isn’t always easy. Under HIPAA’s privacy rule, all patients have the right to inspect, review, and receive a copy of their medical records and billing records that are held by health plans and health care providers.

However, state laws and provider regulations can complicate this process. Patients may have to fill out several forms and deal with multiple individuals before they gain access to their records. These procedures are designed to reduce fraud and the improper exchange of sensitive health information, but such barriers can also limit patient access.

Consumers aren’t the only ones looking to take control of their health information. Major tech companies like Apple and Amazon are looking to seize control of the electronic health records market. Learn more about this rising trend and how it could affect patients and providers alike.

Requesting Your Medical Records

Accessing health records can help patients better manage their health and healthcare-related costs, but the process of obtaining this information tends to vary based on the facility in question.

According to the Office of the National Coordinator for Health Information Technology, 81% of individuals surveyed went to a healthcare provider at least once within the past year. Overall, 32% of individuals who went to a doctor in the past 12 months reported experiencing a gap in information exchange. Considering multiple providers may retain the rights to a patient’s health records, collecting all this information can be time-consuming and challenging for some individuals.

Depending on their provider, patients may use online tools and patient login portals to view, manage and download their records, while others may have to contact their provider directly. Smaller doctors’ offices may not have a health information management (HIM) system, so the patient may need to visit the office in person or have their records mailed to their home address.

• Filling Out a Patient Access Request Form

The first step in accessing your health information is to fill out a “Patient Access Request” (or similarly titled) form either online or in person. Personal representatives of a patient or their legal guardian may request these records on the patient’s behalf. If a person has been granted power of attorney for an individual, they have the right to access these records on the patient’s behalf. If a patient is receiving their records in person, they should bring along a photo ID to verify their identity.

• Requesting Specific Information

When filling out the Patient Access Request form, patients should specify which information they’d like to receive. Clinical reports may be hundreds of pages long, so patients should narrow their search as much as possible in order to make sense of this information. Sensitive information such as behavioral or mental health reports, HIV diagnosis and treatment, and substance abuse records may require additional approval processes.

• How Long Does It Take?

HIPAA mandates that providers make these records available to patients within 30 days, but most clinics and facilities can turn them around in just 10 business days. Healthcare facilities can also request a 30-day extension, but the facility must explain the cause of delay to the patient or requestor.

• How Much Does It Cost?

Facilities reserve the right to charge patients for any time, labor, or supplies needed to print off and send these records, but accessing records online can help reduce these costs.

The Rise of Virtual Health Records

As consumers seek access to their medical records, large tech companies are looking to simplify this process. Representatives from companies like Apple, Amazon, and Google recently met with healthcare executives, including those from some of the largest insurance and healthcare facilities in the country, to address this problem.

The group signed onto a new program that would help patients better access their claims records, including lists of everything that gets charged to the patient’s insurance company, including medical tests, procedures, doctor’s visits and medications. Claims records are not the same as clinical records, and they typically don’t include test results and diagnostic information. Yet, increasing access to claims records can help patients better manage the cost of care, especially if the insurance company refuses to pay for a procedure or medication.

The program is being developed by the CARIN Alliance, a coalition of health and tech companies that’s meant to advance “consumer-directed exchange of health information”.

Additionally, major tech companies like Apple and Amazon are creating their own solutions to the medical records problem. Amazon is developing software that would let patients access and search through all their medical records online. Apple is looking to collect consumer health information using health-monitoring apps like Apple Health and devices like the Apple Watch. Google is developing a new piece of technology called “Medical Digital Assist” to help providers dictate notes during patient consultations.

These devices and tools may ease the flow of health information, but they could also lead to privacy concerns. Big tech companies can use this data to track the health of consumers over time. Providers and tech companies alike can use data analytics to detect new trends in the healthcare industry, including patient preferences, medication usage, and the efficacy of different treatment methods. This data can also be used to determine a patient’s overall “risk score”, which could help personalize care in and out of the doctor’s office.

While these projects may end up benefiting providers and patients alike, consumers should use caution when sharing their personal healthcare information with third-party companies. The results of these initiatives remain unclear, but we’ll continue tracking these trends as they go into effect.

Stay tuned to see how healthcare information management continues to evolve.