Medical Records?

John 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.

Quoted message said:

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

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

Quoted message said:

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.

Quoted message said:

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.

John 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? 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" <[email hidden]> wrote in message
news:Couqc.69532$Fl5.52514@okepread04...

Quoted message said:

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 <[email hidden]> wrote in message news:<2004051817533650073%tpfkaa@anoncom>...

Quoted message said:

John 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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

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.

Quoted message said:

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

(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.

Quoted message said:

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 (AFAIK) completely
inaccessible to providers.

Quoted message said:

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

I wish *somebody* did.

Quoted message said:

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.

Quoted message said:

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.

Quoted message said:

Quoted message said:

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 <[email hidden]> wrote in message news:<2004051922443650073%tpfkaa@anoncom>...

Quoted message said:

On 2004-05-19 11:49:19 -0400, [email hidden]

(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.

Quoted message said:

Quoted message said:

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 (AFAIK) completely
inaccessible to providers.

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

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

Quoted message said:

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?

wellpointrx.comclinicalservices.screenOpen ↗
mg

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

js

(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.

Quoted message said:

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.

Quoted message said:

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).

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

Quoted message said:

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

You're in ample company.

Quoted message said:

Useful to whom?

Everyone involved in your care.

Quoted message said:

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.

Quoted message said:

Quoted message said:

Quoted message said:

> 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.

Quoted message said:

wellpointrx.comclinicalservices.screeOpen ↗
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 <[email hidden]> wrote in message news:<2004052118124675249%griffin@wellscom>...

Quoted message said:

On 2004-05-21 11:05:18 -0400, [email hidden]

(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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

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?

Quoted message said:

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?

Quoted message said:

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?

Quoted message said:

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

Quoted message said:

> 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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

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.

Quoted message said:

Quoted message said:

Quoted message said:

>> 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.

Quoted message said:

Quoted message said:

wellpointrx.comclinicalservices.screenOpen ↗
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

(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
[censored]. Feel free to killfile me; I welcome it.

Griffin <[email hidden]> wrote in message news:<2004052211592616807%griffin@wellscom>...

Quoted message said:

On 2004-05-22 09:50:28 -0400, [email hidden]

(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 [censored]. 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
[censored] are concerned.

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

js

(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

John said:

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

Quoted message 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" <[email hidden]> wrote in message
news:2004052722522816807%nospam@herenet...

Quoted message said:

Quoted message 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.

Quoted message said:

The only person that matters is me. It needs to be
valuable to me without compromising my confidentiality and
my relationship with my

Quoted message said:

physicians. The issue of patient confientiality has been
addressed

by

Quoted message said:

HIPPA for very good reason. It is important to
people to have

control

Quoted message said:

over the access to there private information.

Epidemiology would benefit GREATLY from such a huge
collection of information. Indeed, epidemiologists do a
great job of ensuring confidentiality while
maintiaining huge databases. With a centralized
database of medical records, there would be the
potential for patients to benefit from automated
screening for diseases such as cancer.

The challenge of maintaining confidentiality seems to be the
primary obstacle. Whether a database is implemented by a
government agency or a private company, legislation will be
the way for the public to ensure that information is kept in
the right hands.

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