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APOCALYPSEFUCK is Tony Manero says

If WebMD is on Windows, likely the PRC Army owns the system already and is selling access to organized crime rings in Eastern Europe.

Sorry, Fuck, but what you mean by that? That the servers may run on Windows and are therefore not secure?

I can agree that Windows in general is a sad excuse for an operating system.

But to get back to the point, it is the insurance companies we should be worried about, not the PRC army and their suspected cyber-warfare.

Insurance companies have historically denied coverage due to pre-existing conditions, whether or not the information was correct. This is supposed to go by the wayside with the recent healthcare reform.

But they can raise premiums astronomically if you have a history of something. I'm sure they'll continue to be creative when it comes to coverage.

Your answer is yes - electronic medical records are designed to be available to all sorts of providers. When you sign a contract allowing them access, you have no choice as to what they will or won't use to determine eligibility. This includes life insurance.

Thanks, ellimeae, I figured you would have knowledge about this topic.

I think PHR would be very useful if you could give the insurance company write-only access to your data. Basically this means granting them permission to deposit their billing information into my repository, but not read what others have deposited.

According to Wikipedia and some other sources I read, the patient can supposedly control who gets access to what, BUT the sticky point is whether an insurance company can DEMAND access as a condition for considering your health insurance APPLICATION. This is what I have not been able to find out. Moreover, can they find out whether I have a PHR account, even if I do not want them to know?

More generally:

With these kinds of systems and the associated regulation, the devil is always in the details, and the problem is that I can't seem to find out what the details are unless I actually try the system and then submit another application to another insurance company. It is both very impractical and also a potential catch-22 (an irreversible choice with possibly bad outcome).

I'll keep looking for blogs and other sources of the practical consequences of PHR. Everyone please keep the information coming if you know of anything informative.

There's always the opportunity for insurance companies to find and "out." It's doubtful that they would insure you if you requested "write only" rather than allowing them to read your file.

Patients can absolutely control who has access to their accounts - but insurers and physicians have the right to deny benefits & treatment if you don't cooperate with them.

An example of an MD is a pain clinic: they have you sign paperwork stating that you will comply with their refill policies. If you go to multiple docs, you are "fired" as a patient. If you visit the ER and receive medications and don't report the scripts that they give, that's also grounds for termination.

PHR is good and bad. If everyone were to use a compatible system that would be awesome - but it's like betamax and VHS. mulitple competing systems that don't speak with each other at the moment. It'll be interesting how it plays out.

APOCALYPSEFUCK is Tony Manero says

I dunno if they're just looking for soft targets across the Internet or it's a cyber diplomatic game of 'LOOK!' like kids play at the dinner table, poking their neighbor and opening their mouths filled with chewed food.

LOL! your a poet and a warrior!!!

elliemae says

PHR is good and bad. If everyone were to use a compatible system that would be awesome - but it's like betamax and VHS. mulitple competing systems that don't speak with each other at the moment. It'll be interesting how it plays out.

Its all in binary stored on the same database files structure regardless of what application you use. For web based there is no differences because their is no apps.

thomas.wong1986 says

Its all in binary stored on the same database files structure regardless of what application you use. For web based there is no differences because their is no apps.

Perhaps so, but all I know is that I can't pull up the MRI of one of my patients without having their program to make it readable.

Hey! So...this is what I study in school therefore I'm just going to answer your questions instead of join the previous Windows debate.

1. who can access PHR and how?

Only you and family members can access it, IF you allow them access. Its going to be like your email, if you give someone the user and password they may login as you and use it. Its your responsibilty and right to keep your information as open or private as you please with your Personal Health Record; which is completely separate from your medical record. With a PHR you and you alone own it. With a medical record the healthcare institution owns it as a business record and you own it as well.

2. can insurance companies access it or demand to see it? (for example
as a condition for accepting an application for insurance). Keep in mind
that insurance companies routinely will ask for a waiver to get
medical history from previous providers when a person applies for
coverage.

Again, no one can access your information unless you allow it. Insurance companies may demand to see your medical records from any institution you have been admitted to, only for billing purposes. When you read the notice of privacy, this is clearly stated with further detail.

3. can insurance companies use medical history originating from PHR to
deny or price coverage? How would you know whether they did?

Again, they cannot use it. Additionally why would they? Not that they think that consumers are not smart, but you don't know every nuance of healthcare. Do you know ICD-9-CM/PCS coding? Can you tell the difference between a HCPCS or CPT code? It would be completely inefficient for them to use your PHR. It may also be inaccurate data. Insurance companies need the assurance of data integrity to be able to reimburse properly.

4. can information from PHR leak into provider medical records and thereby become accessible to
insurance companies (by a doctor entering it, for example)?

They are not linked unless you choose the option of a patient portal.However, in this case there will be information that you may view only and not have the ability to edit. Also, you have a different medical record from every different institution you have ever been to, The point of a PHR is to have an overall data repository for healthcare providers to give you the best possible care.

Overall, you bring up a lot of great questions that all consumers need to know the answer to. I hope that some of this helped!!