can doctors see your patient files

[Poisson]

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This may sound crazy, but I have talked to some doctors before for pre-medical related stuff, and I don't know why, but I feel like they have investigated my medical records, is this even possible for them to do? Specific words in meetings with some doctors have made me think they have some kind of access or noisiness. Its not that I would mind if somebody looked at my medical records, and I know its kind of random for me to say, but I wouldn't just come up with this thought for no reason. I always thought though that in order for a doctor to see medical records, records had to be transferred from the family practitioner to the new doctor. In the case of a university or institution, I would assume any doctor could access the records over some kind of a database. True? Not true?

 

[music2doc]

Depends what you mean. If in the hospital, sure they have access. (I actually "have access" to just about any patient's EMR I want in both major hospital systems for my region and I'm just a tech at one and a research assistant at the other.) However, it would be a major HIPAA violation for them (or me) to go snooping. Most healthcare professionals wouldn't want to take the risk, so I would highly doubt they are looking at your medical records when you shadow them or whatnot. It's probably more likely that something you've said or done or some aspect of your appearance has given it away. If they know your parents, that could also be the source of some of the apparent knowledge.

 

[Gamechanger]

I agree with the above. There is a high possibility that they have access, but a low probabiltiy that they would risk or even bother to look. I mean the risk/reward on this action is stupid skewed towards risk.

That being said, they may have been being overly cautious when discussing certain things because they don't know if you have such conditions. They might just be trying to be sensitive and not offend you.

 

[Ashley1989]

I've thought of this before and I'm worried about it. I have health insurance through my first choice medical school's hospital. I worry sometimes that one of my doctors will be my interviewer when the time comes because I have a medical condition that has required that I see many different doctors throughout my life. These doctors have seen me grow up, and seen me at some of my worst times. One of them who has known me since I was little is a professor at the university as well.. What if I walk into the interview and it's him and he knows all about my medical history? I just shudder at the thought. I don't have anything to hide, but it would still be weird.

 

[Ismet]

I've thought of this before and I'm worried about it. I have health insurance through my first choice medical school's hospital. I worry sometimes that one of my doctors will be my interviewer when the time comes because I have a medical condition that has required that I see many different doctors throughout my life. These doctors have seen me grow up, and seen me at some of my worst times. One of them who has known me since I was little is a professor at the university as well.. What if I walk into the interview and it's him and he knows all about my medical history? I just shudder at the thought. I don't have anything to hide, but it would still be weird.

I believe many schools give their interviewers the names of the people they're interviewing beforehand. It's a conflict of interest to interview someone you know personally. At 2 of my schools, some of the student interviews had to be switched around at the last minute because one of the interviewers personally knew the person they were assigned to interview. Although unlikely, even if he does interview you, it might be to your benefit because he knows you and what you have gone through to get this far.

 

[music2doc]

I've thought of this before and I'm worried about it. I have health insurance through my first choice medical school's hospital. I worry sometimes that one of my doctors will be my interviewer when the time comes because I have a medical condition that has required that I see many different doctors throughout my life. These doctors have seen me grow up, and seen me at some of my worst times. One of them who has known me since I was little is a professor at the university as well.. What if I walk into the interview and it's him and he knows all about my medical history? I just shudder at the thought. I don't have anything to hide, but it would still be weird.

Most schools screen for this. He would likely pass on interviewing you.

 

[235788]

Most schools screen for this. He would likely pass on interviewing you.

I'd imagine it would be more on an honor system... I was interviewed by a physician who worked with one I shadowed. She knew my face, but not my name.


Someone who personally knows you, will likely pass on interviewing you. But they may not refrain from voting....

 

[Poisson]

Depends what you mean. If in the hospital, sure they have access. (I actually "have access" to just about any patient's EMR I want in both major hospital systems for my region and I'm just a tech at one and a research assistant at the other.) However, it would be a major HIPAA violation for them (or me) to go snooping. Most healthcare professionals wouldn't want to take the risk, so I would highly doubt they are looking at your medical records when you shadow them or whatnot. It's probably more likely that something you've said or done or some aspect of your appearance has given it away. If they know your parents, that could also be the source of some of the apparent knowledge.

I believe that a certain intuition is developed over time by an internal medicine specialist or other doctor, but I also believe that information can help shape the way that person talks. I feel like if a person is high up the command, they can just pop open the computer and look at something (maybe even a tech or RA!). I mean, do they even keep track of who checks what? I don't have a problem with this, but some people may not particularly like it. If lets say Dr. George looks up and sees that Dr. Ireland had an abortion, that may be something Dr. Ireland doesn't want to share. Maybe Dr. Laurie has depression, he may not be thrilled that Dr. George looked up all those details either. I think its totally different to say, lets check on Dr. Shipman about his previous charge, as he is applying to our surgery, then lets check Dr. Shipman's medical records to see if he should work here. I know this stuff most likely doesn't happen, but its an interesting thought. They even insinuated on a documentary that doctors do not like to always get treatment, as they think their buddies are going to know about it.

 

[LizzyM]

I believe that a certain intuition is developed over time by an internal medicine specialist or other doctor, but I also believe that information can help shape the way that person talks. I feel like if a person is high up the command, they can just pop open the computer and look at something (maybe even a tech or RA!). I mean, do they even keep track of who checks what? I don't have a problem with this, but some people may not particularly like it. If lets say Dr. George looks up and sees that Dr. Ireland had an abortion, that may be something Dr. Ireland doesn't want to share. Maybe Dr. Laurie has depression, he may not be thrilled that Dr. George looked up all those details either. I think its totally different to say, lets check on Dr. Shipman about his previous charge, as he is applying to our surgery, then lets check Dr. Shipman's medical records to see if he should work here. I know this stuff most likely doesn't happen, but its an interesting thought. They even insinuated on a documentary that doctors do not like to always get treatment, as they think their buddies are going to know about it.

Most files are electronic and you can not access them without a ID and password. That is like a fingerprint and a time stamp on who accessed a record and when it was accessed.

Files are audited randomly and in special circumstances to find people who are accessing records without authorization. In some instances, people have been fired for accessing records that they had no business viewing.

Most people value their jobs too much to let their curiosity get the best of them.

 

[Poisson]

Most files are electronic and you can not access them without a ID and password. That is like a fingerprint and a time stamp on who accessed a record and when it was accessed.

Files are audited randomly and in special circumstances to find people who are accessing records without authorization. In some instances, people have been fired for accessing records that they had no business viewing.

Most people value their jobs too much to let their curiosity get the best of them.

Thank you for this information, its good there is protection put in place.

 

[bunnity]

When I worked at a major hospital I could pull up a file of anyone who had been to any hospital in the system.

...but I only pulled up the files that I needed (for my own patients). To do otherwise would have been wrong and illegal, and would have gotten me fired.

There was an incident when a very famous person came to our hospital system for treatment after a highly-publicized accident, and about 30 people were fired for trying to get into this person's records without a good reason.

What are you so worried about?

 

[music2doc]

Most files are electronic and you can not access them without a ID and password. That is like a fingerprint and a time stamp on who accessed a record and when it was accessed.

Files are audited randomly and in special circumstances to find people who are accessing records without authorization. In some instances, people have been fired for accessing records that they had no business viewing.

Most people value their jobs too much to let their curiosity get the best of them.

Exactly. So, for instance, where I work, I can see the access record of any patient in our dept. Such a record would look similar to the following:


Smith, John Adam 05/25/1962
AA0004948572 AM0000592759

5/31/12 1524 sjones1 NEW_ACCOUNT ENTER

5/31/12 1524 sjones1 PREREG ENTER

5/31/12 1524 sjones1 ROOM ENTER

5/31/12 1526 kshoc3 TRIAGE_NOTE ENTER

5/31/12 1528 kshoc3 TRIAGE_NOTE EDIT
OLD_VALUE: BP -/-
NEW_VALUE: B 164/96

5/31/12 1546 rshaw TRIAGE NOTE VIEW

5/31/12 1549 rshaw ROOM EDIT
OLD_VALUE: WR
NEW_VALUE: UCH48

5/31/12 1550 rshaw PROVIDER ENTER rshaw

5/31/12 1553 nsmith TRIAGE_NOTE VIEW

5/31/12 1553 nsmith TRIAGE_NOTE PRINT

5/31/12 1554 nsmith PROVIDER ENTER jphilip

5/31/12 1555 jphilip EMR VIEW

5/31/12 1556 jphilip EMR PRINT

5/31/12 1600 mschmid REGISTER ENTER

5/31/12 1615 mschmid REGISTER EDIT

INS OLD VALUE: MEDICARE
INS NEW VALUE: SECURE HORIZONS MEDICARE COMPLETE

5/31/12 1620 jphilip PROVIDER_SUMMARY ENTER

5/31/12 1621 smith PROVIDER_DISCHARGE ENTER

5/31/12 1624 jphilip PROVIDER_DISCHARGE EDIT

5/31/12 1630 rshaw PROVIDER_SUMMARY PRINT

5/31/12 1631 rshaw PROVIDER_DISCHARGE PRINT

....


In other words, every single movement is logged. As I understand, there are actually even more in-depth logs that the system keeps for use in internal audits and such. The logs I have access to are generally for basic trouble-shooting at a departmental level. It allows us to quickly figure out from where a mistake might have originated. (This is obviously a simple case example. A real ED visit would have far more activity than this....)

 

[45408]

Most schools screen for this. He would likely pass on interviewing you.

They actually would have a really hard time screening for this, but the interviewer gets the list of names in advance (maybe only very briefly in advance), and anyone worth their salt wouldn't interview someone they already knew fairly well.

I believe that a certain intuition is developed over time by an internal medicine specialist or other doctor, but I also believe that information can help shape the way that person talks. I feel like if a person is high up the command, they can just pop open the computer and look at something (maybe even a tech or RA!). I mean, do they even keep track of who checks what? I don't have a problem with this, but some people may not particularly like it. If lets say Dr. George looks up and sees that Dr. Ireland had an abortion, that may be something Dr. Ireland doesn't want to share. Maybe Dr. Laurie has depression, he may not be thrilled that Dr. George looked up all those details either. I think its totally different to say, lets check on Dr. Shipman about his previous charge, as he is applying to our surgery, then lets check Dr. Shipman's medical records to see if he should work here. I know this stuff most likely doesn't happen, but its an interesting thought. They even insinuated on a documentary that doctors do not like to always get treatment, as they think their buddies are going to know about it.

Absolutely not. Your job would be destroyed for a stunt like this. I'm extremely careful about whose medical record I open up. Although I have opened up the records of several people I work with, because I've operated on them...

 

[music2doc]

They actually would have a really hard time screening for this, but the interviewer gets the list of names in advance (maybe only very briefly in advance), and anyone worth their salt wouldn't interview someone they already knew fairly well.

That's basically what I mean. No, schools cannot entirely "screen" for this, but they can ask their interviewers to identify any candidates from a given day that they already know. At least I know that my state school certainly does this.

Absolutely not. Your job would be destroyed for a stunt like this. I'm extremely careful about whose medical record I open up. Although I have opened up the records of several people I work with, because I've operated on them...

Same here. Occasionally, I've even clicked on or accidentally opened the wrong patient record. I immediately closed it and moved on. No one has every questioned me for that. Mistakes are made, but the hospital can even see how long you've been looking at a given record, so a 2-3 second period before closing the record (i.e., after opening the wrong one) will be interpreted very differently from a 30-60 second period browsing the pt's record. They can also see where you went within the record, etc. It's all quite well monitored with most modern EMR systems.

 

[wholeheartedly]

It is tracked and it would be wrong for someone to access information if they aren't involved in your medical care. Like LizzyM said, this is audited and people will get fired if caught accessing information they have no business accessing.

That said, auditing won't always catch people and its effectiveness really depends on the system. It seems the reasons people get caught are 1) high profile patient's record is closely monitored (like all access is tracked and looked at) 2.) someone gets concerned about inappropriate access and then an investigation is conducted or 3) someone shows high usage for access lots of records and comes under scrutiny.

In reality people do access stuff they shouldn't access or employees share stuff with other people that are not involved in the patients care in violation of the rules. People get fired various places for doing this stuff not infrequently but other people still come along and do it too despite getting extensive training on the rules and consequences. I don't understand why people would be stupid enough to take that kind of risk, but they do.

As for who has access, it really depends. In one place I've been all records had to be transferred (mailed, faxed) from the local clinic to the local hospital. Another place, all of the different health systems in the region had some agreement to share medical records through a secure electronic system. You had the choice to not sign a release to do that, but the way the form was set up, almost everyone signed.

So no one should have looked you up like that, but it is possible it's happened. I believe you can request information about who has accessed your records. You'll probably see names you won't recognize as different allied health people might have accessed it for appropriate reasons, but if you see one of the people you think inappropriately accessed it then you might have a problem.