Medical Records?

Hi All,

When you go to a doctor's office, you sign a release that
says he/she can pull up your medical records (I assume this
means past medical history). Where does this information
come from? Is there a national database that stores this
information or do they get the info from the insurance
provider? If it comes from the insurance provider, how does
the insurance provider have your complete medical history?
If you went to the same provider, I could see them having
all the information but if you changed providers how would
they have previous medical information? Do they get the
medical history from the previous insurance company?

Thanks

On 2004-05-18 16:36:59 -0400, "John" <jharitos@oohay.com> said:

> When you go to a doctor's office, you sign a release that
> says he/she can pull up your medical records (I assume
> this means past medical history). Where does this
> information come from? Is there a national database that
> stores this information or do they get the info from the
> insurance provider?

I wish. No, there isn't.

> If it comes from the insurance provider, how does the
> insurance provider have your complete medical history?

Again, I wish. No, they don't.

> If you went to the same provider, I could see them having
> all the information but if you changed providers how would
> they have previous medical information?

They would request records from your previous physician(s).
This requires that you (the patient) sign a release form
authorizing said release.

> Do they get the medical history from the previous
> insurance company?

Insurance companies do not provide physicians with health
information. If they track it, it's for their own use. Some
insurance companies (usually HMOs) employ companies like
Wellsource to "manage" certain chronic medical conditions,
like diabetes, and will occasionally send physicians
reports. These are typically of little value.

On Tue, 18 May 2004 13:36:59 -0700, "John" <jharitos@oohay.com> wrote:
>
>When you go to a doctor's office, you sign a release that
>says he/she can pull up your medical records (I assume this
>means past medical history). Where does this information
>come from? Is there a national database that stores this
>information or do they get the info from the insurance
>provider? If it comes from the insurance provider, how does
>the insurance provider have your complete medical history?
>If you went to the same provider, I could see them having
>all the information but if you changed providers how would
>they have previous medical information? Do they get the
>medical history from the previous insurance company?

Insurance companies do not maintain medical records. Doctors
do. If you signed a release of information at your doctor's
office, perhaps it was to have your prior doctor send your
new one the records he has about you.

PF

"John" <jharitos@oohay.com> wrote in message
news:Couqc.69532$Fl5.52514@okepread04...
> Hi All,
>
> When you go to a doctor's office, you sign a release that
> says he/she can pull up your medical records (I assume
> this means past medical history). Where does this
> information come from?

From your previous doctors.

The medical privacy laws allow docs to share medical records
for patient care.

Jeff

TPFKAA <tpfkaa@anon.com> wrote in message news:<2004051817533650073%tpfkaa@anoncom>...
> On 2004-05-18 16:36:59 -0400, "John"
> <jharitos@oohay.com> said:
>
> > When you go to a doctor's office, you sign a release
> > that says he/she can pull up your medical records (I
> > assume this means past medical history). Where does this
> > information come from? Is there a national database that
> > stores this information or do they get the info from the
> > insurance provider?
>
> I wish. No, there isn't.

Perhaps not in the US, but there are national databases in
other countries, both administrative and medical, that are
used to track resource use. CMS also has an administrative
database to track utilization in the Medicare Part A and
Part B program. It lacks drug data.

> > If it comes from the insurance provider, how does the
> > insurance provider have your complete medical history?
>
> Again, I wish. No, they don't.

Why do you wish insurers to have a complete medical record?
Personally, I think that my providers and I are entitled to
a complete record - but my insurer and employer are not.
Moreover - there is NO way that I would ever endorse a
governmental agency having my medical record.

> > If you went to the same provider, I could see them
> > having all the information but if you changed providers
> > how would they have previous medical information?
>
> They would request records from your previous
> physician(s). This requires that you (the patient) sign a
> release form authorizing said release.
>
> > Do they get the medical history from the previous
> > insurance company?
>
> Insurance companies do not provide physicians with helth
> information. If they track it, it's for their own use.

That is NOT true. Some insurers routinely feedback
information to providers based on standard UR models. The
first of such models was implemented in the 70's to manage
Medicaid data in Texas and Indiana if I remember correctly.
The models were UR outlier based.

> Some insurance companies (usually HMOs) employ companies
> like Wellsource to "manage" certain chronic medical
> conditions, like diabetes, and will occasionally send
> physicians reports. These are typically of little value.

Except to that physician and his patient.

js

On 2004-05-19 11:49:19 -0400, jonathansmith99@yahoo.com (Jonathan Smith) said:

> Perhaps not in the US, but there are national databases in
> other countries, both administrative and medical, that are
> used to track resource use.

Whatever. This doesn't sound like a clinically useful
database, which is what the OP was asking about.

> CMS also has an administrative database to track
> utilization in the Medicare Part A and Part B program. It
> lacks drug data.

Also clinically of no value, and (As far as I know) completely
inaccessible to providers.

> Why do you wish insurers to have a complete medical
> record?

I wish *somebody* did.

> Personally, I think that my providers and I are
> entitled to a complete record - but my insurer and
> employer are not.

Well, that's a big reason why we don't have centralized
medical recordkeeping.

> Moreover - there is NO way that I would ever endorse a
> governmental agency having my medical record.

And another reason. However, I believe there are many
advantages to centralized medical information that override
the liberal point of view. I'm not suggesting that complete
records necessarily be maintained in a central repository,
but some basic continuity-type information (e.g., problem
list, medications, allergies, surgical history, etc.) would
certainly be useful.

>> Some insurance companies (usually HMOs) employ companies
>> like Wellsource to "manage" certain chronic medical
>> conditions, like diabetes, and will occasionally send
>> physicians reports. These are typically of little value.
>
> Except to that physician and his patient.

Nah, they're pretty worthless even then.

TPFKAA <tpfkaa@anon.com> wrote in message news:<2004051922443650073%tpfkaa@anoncom>...
> On 2004-05-19 11:49:19 -0400, jonathansmith99@yahoo.com
> (Jonathan Smith) said:
>
> > Perhaps not in the US, but there are national databases
> > in other countries, both administrative and medical,
> > that are used to track resource use.
>
> Whatever. This doesn't sound like a clinically useful
> database, which is what the OP was asking about.

GPDRS - may not "sound" clinically useful, but it is
extremely useful to the NHS.
>
> > CMS also has an administrative database to track
> > utilization in the Medicare Part A and Part B program.
> > It lacks drug data.
>
> Also clinically of no value, and (As far as I know) completely
> inaccessible to providers.

Available to researchers for a fee - has implications for
provider organizations and suppliers. Do you ever read the
medical literature?

> > Why do you wish insurers to have a complete medical
> > record?
>
> I wish *somebody* did.

OK - I think (and the government agrees) that I own the
content of my medical record. I should be responsible for
maintaining it. There is technology available to allow this.

> > Personally, I think that my providers and I are
> > entitled to a complete record - but my insurer and
> > employer are not.
>
> Well, that's a big reason why we don't have centralized
> medical recordkeeping.

No, that is NOT the big reason. The big reason is - NO ONE
wants to pay for it.

> > Moreover - there is NO way that I would ever endorse a
> > governmental agency having my medical record.
>
> And another reason. However, I believe there are many
> advantages to centralized medical information that
> override the liberal point of view. I'm not suggesting
> that complete records necessarily be maintained in a
> central repository, but some basic continuity-type
> information (e.g., problem list, medications, allergies,
> surgical history, etc.) would certainly be useful.

Useful to whom? It is MY medical record and no one elses. If
there is to be a record maintained I will maintain it. Given
the storage capacity of small disks, this is hardly going to
be a technology problem.

> >> Some insurance companies (usually HMOs) employ
> >> companies like Wellsource to "manage" certain chronic
> >> medical conditions, like diabetes, and will
> >> occasionally send physicians reports. These are
> >> typically of little value.
> >
> > Except to that physician and his patient.
>
> Nah, they're pretty worthless even then.

You just don't get it - what is it with you and your
snippets?

http://www.wellpointrx.com/wpw/clini...s.screen#ther-
mg

read it and then tell me specifically what makes the
programs "worthless"?

js

On 2004-05-21 11:05:18 -0400, jonathansmith99@yahoo.com (Jonathan Smith) said:

> GPDRS - may not "sound" clinically useful, but it is
> extremely useful to the NHS.

But the OP wasn't asking about the NHS.

> Available to researchers for a fee - has implications for
> provider organizations and suppliers. Do you ever read the
> medical literature?

But the OP wasn't asking about provider organizations and
suppliers. And yes, I read the medical literature. What that
has to do with the OP's question, I have no idea.

> I think (and the government agrees) that I own the
> content of my medical record. I should be responsible
> for maintaining it. There is technology available to
> allow this.

Any patient is free to maintain a copy of their medical
information on their own. What's stopping you? Many of my
patients want (and receive) copies of their test results.
Some of them keep detailed logs and graphs of their blood
pressure and other parameters. A few of them maintain
summary sheets containing a list of their medicines,
allergies, surgeries, family history, the names of all of
their doctors, etc. Very useful. Unfortunately, I could
probably count those patients on my fingers (and most of
them are engineering/computer types). It seems few people
really want to take the time to do this. Even if they do,
physicians must still maintain records for their own use,
both for the provision of care and for mediolegal reasons.
This usually isn't a problem until you need to see a doctor
who doesn't know you (say, in an ER, when you're
unconscious).

>> Well, that's a big reason why we don't have centralized
>> medical recordkeeping.
>
> No, that is NOT the big reason. The big reason is - NO ONE
> wants to pay for it.

That's another big reason.

>>> Moreover - there is NO way that I would ever endorse a
>>> governmental agency having my medical record.

You're in ample company.

> Useful to whom?

Everyone involved in your care.

> It is MY medical record and no one elses. If there is to
> be a record maintained I will maintain it. Given the
> storage capacity of small disks, this is hardly going to
> be a technology problem.

This has actually been tried several different ways. To
date, none have really taken off, for a variety of reasons
both practical and economic.

>>>> Some insurance companies (usually HMOs) employ
>>>> companies like Wellsource to "manage" certain chronic
>>>> medical conditions, like diabetes, and will
>>>> occasionally send physicians reports. These are
>>>> typically of little value.
>>>
>>> Except to that physician and his patient.
>>
>> Nah, they're pretty worthless even then.
>
> You just don't get it - what is it with you and your
> snippets?

You mean my opinions? They're no less valid than your own.

> http://www.wellpointrx.com/wpw/clinicalservices.scree-
> n#thermg
>
> read it and then tell me specifically what makes the
> programs "worthless"?

I've yet to receive a report from Wellsource or any similar
entity that added anything to what I was already doing. All
it did was generate extra work in the office to pull the
chart and file the report. Maybe I just take really good
care of my patients.

Griffin <griffin@wells.com> wrote in message news:<2004052118124675249%griffin@wellscom>...
> On 2004-05-21 11:05:18 -0400, jonathansmith99@yahoo.com
> (Jonathan Smith) said:
>
> > GPDRS - may not "sound" clinically useful, but it is
> > extremely useful to the NHS.
>
> But the OP wasn't asking about the NHS.

No? The question was - are there national databases - and
the answer is yes there are.

>
> > Available to researchers for a fee - has implications
> > for provider organizations and suppliers. Do you ever
> > read the medical literature?
>
> But the OP wasn't asking about provider organizations and
> suppliers. And yes, I read the medical literature. What
> that has to do with the OP's question, I have no idea.

Physicians are suppliers.

> > I think (and the government agrees) that I own the
> > content of my medical record. I should be responsible
> > for maintaining it. There is technology available to
> > allow this.
>
> Any patient is free to maintain a copy of their medical
> information on their own. What's stopping you?

Nothing at all other than inconvenience. A bit
contrarian today?

>Many of my patients want (and receive) copies of their test
>results. Some of them keep detailed logs and graphs of
>their blood pressure and other parameters. A few of them
>maintain summary sheets containing a list of their
>medicines, allergies, surgeries, family history, the names
>of all of their doctors, etc.

Goody - so?

> Very useful. Unfortunately, I could probably count those
> patients on my fingers (and most of them are
> engineering/computer types). It seems few people really
> want to take the time to do this. Even if they do,
> physicians must still maintain records for their own use,
> both for the provision of care and for mediolegal reasons.
> This usually isn't a problem until you need to see a
> doctor who doesn't know you (say, in an ER, when you're
> unconscious).

OK - so the solution is to have a complete and accurate
medical record available that can be accessed and updated.
Fine - why does it need to reside in a national database?

> >> Well, that's a big reason why we don't have centralized
> >> medical recordkeeping.
> >
> > No, that is NOT the big reason. The big reason is - NO
> > ONE wants to pay for it.
>
> That's another big reason.

The big reason.

> >>> Moreover - there is NO way that I would ever endorse a
> >>> governmental agency having my medical record.
>
> You're in ample company.

And for good reason.

> > Useful to whom?
>
> Everyone involved in your care.

The only person that matters is me. It needs to be valuable
to me without compromising my confidentiality and my
relationship with my physicians. The issue of patient
confientiality has been addressed by HIPPA for very good
reason. It is important to people to have control over the
access to there private information.

> > It is MY medical record and no one elses. If there is
> > to be a record maintained I will maintain it. Given the
> > storage capacity of small disks, this is hardly going
> > to be a technology problem.
>
> This has actually been tried several different ways. To
> date, none have really taken off, for a variety of reasons
> both practical and economic.

OK - so there's your solution.

> >>>> Some insurance companies (usually HMOs) employ
> >>>> companies like Wellsource to "manage" certain chronic
> >>>> medical conditions, like diabetes, and will
> >>>> occasionally send physicians reports. These are
> >>>> typically of little value.
> >>>
> >>> Except to that physician and his patient.
> >>
> >> Nah, they're pretty worthless even then.
> >
> > You just don't get it - what is it with you and your
> > snippets?
>
> You mean my opinions? They're no less valid than your own.

The lack of depth of thought. Opinions are fine - but
without any rationale or substance they are just snippets of
baseless conjecture. Hardly makes for discourse.

> > http://www.wellpointrx.com/wpw/clini...vices.screen#-
> > thermg
> >
> > read it and then tell me specifically what makes the
> > programs "worthless"?
>
> I've yet to receive a report from Wellsource or any
> similar entity that added anything to what I was already
> doing. All it did was generate extra work in the office to
> pull the chart and file the report. Maybe I just take
> really good care of my patients.

And maybe you are just above being informed of ways to
improve your practice?

js

On 2004-05-22 09:50:28 -0400, jonathansmith99@yahoo.com (Jonathan Smith) said:

> The lack of depth of thought. Opinions are fine - but
> without any rationale or substance they are just snippets
> of baseless conjecture. Hardly makes for discourse.

Which is precisely why I'm going to conclude this
discussion. To date, I have yet to have a conversation with
you that I enjoyed. Frankly, my friend, you seem a bit of an
asshole. Feel free to killfile me; I welcome it.

Griffin <griffin@wells.com> wrote in message news:<2004052211592616807%griffin@wellscom>...
> On 2004-05-22 09:50:28 -0400, jonathansmith99@yahoo.com
> (Jonathan Smith) said:
>
> > The lack of depth of thought. Opinions are fine - but
> > without any rationale or substance they are just
> > snippets of baseless conjecture. Hardly makes for
> > discourse.
>
> Which is precisely why I'm going to conclude this
> discussion. To date, I have yet to have a conversation
> with you that I enjoyed. Frankly, my friend, you seem a
> bit of an asshole. Feel free to killfile me; I welcome it.

You just can't stand it when someone actually stands up top
your pompous ass and does so with data.

Frankly - if I am a bit, you are the whole, as far as
assholes are concerned.

No - I won't killfile you - I'll keep track of your opinions
and show them for what they are.

js

On 2004-05-24 15:20:20 -0400, jonathansmith99@yahoo.com (Jonathan Smith) said:

> I'll keep track of your opinions and show them for what
> they are.

If it makes you feel better, go right ahead. Anything I can
do to help.

When you apply for life insurance or medical insurance,
the respective company does medical research before they
underwrite you. Where does the insurance company get
their information or do they go based on the questionaire
you fill out?

PS: I'm in the US

On Tue, 18 May 2004 13:36:59 -0700, "John"
<jharitos@oohay.com> wrote:

>Hi All,
>
>When you go to a doctor's office, you sign a release that
>says he/she can pull up your medical records (I assume this
>means past medical history). Where does this information
>come from? Is there a national database that stores this
>information or do they get the info from the insurance
>provider? If it comes from the insurance provider, how does
>the insurance provider have your complete medical history?
>If you went to the same provider, I could see them having
>all the information but if you changed providers how would
>they have previous medical information? Do they get the
>medical history from the previous insurance company?
>
>Thanks

On 2004-05-27 22:44:05 -0400, testing@yahoo.com said:

> When you apply for life insurance or medical insurance,
> the respective company does medical research before they
> underwrite you. Where does the insurance company get their
> information or do they go based on the questionaire you
> fill out?

As an F.P., I routinely receive requests from life insurance
companies, long-term care insurance companies, etc.
requesting copies of records. In all cases, the patient has
to have signed a release form.

There is a clearing house of health insurance medical
claims. I doubt it is specific to the actualy diagnosis but
I do know it is regularly used to underwright health
insurance policies.

They pull and "MIB" report, which stands for Medical
Information Bureau. I wonder how what one of these really
says. Having been an insurance agent in the past I never saw
one since it was for underwriters only, but it would be
interesting to see how this fits in with HIPPA and ADA.

--
Patrick H. Mason M.S. OHST, EMT-CT
Certified Safety Engineer
Emergency Medical Technician-ALS

"Griffin" <nospam@here.net> wrote in message
news:2004052722522816807%nospam@herenet...
> On 2004-05-27 22:44:05 -0400, testing@yahoo.com said:
>
> > When you apply for life insurance or medical insurance, the respective
> > company does medical research before they underwrite you. Where does
> > the insurance company get their information or do they go based on the
> > questionaire you fill out?
>
> As an F.P., I routinely receive requests from life insurance companies,
> long-term care insurance companies, etc. requesting copies of records.
> In all cases, the patient has to have signed a release form.