Profound changes are under way that threaten the confidentiality of medical records - records that contain not only the potentially embarrassing medical secrets you tell your doctor but details about where you live, what you earn and other personal information that can be used, or misused, for a variety of purposes. With changes in the way these records are stored, maintained and exchanged, a patient's privacy is at risk as never before.
The old paper-based system of recording medical information - in efficient perhaps, but easier to keep private - is for the most part a thing of the past. What's replacing it? Computerized systems in which your secrets are transmitted through cyberspace from your treating physicians to insurers, oversight agencies and others with an interest in the cost of your medical care.
With the growth of HMOs and health networks, these computerized systems often include electronic depositories of patient information, which insurers and others can access from remote locations throughout the country. No one tells you who's looking because no one is required to.
A further complication is the rise of commercial information companies. In 1995, Equifax - the country's largest dispenser of credit reports - announced its intention to enter the computerized medical records industry. Although a joint venture among AT&T, Equifax, and others has been temporarily put on hold, Equifax still intends to tap into this growth industry.
Medical information is fast becoming a commodity. And when your secrets can be bought and sold, you should be concerned about who is looking at your medical records, and why.
Horror stories abound. A New York psychiatrist was asked to leave detailed information about a patient's infidelity and other sensitive matters on an insurance company's answering machine. Tennis star Arthur Ashe's AIDS condition was made public through a leaked report. A convicted child rapist with access to computerized medical records obtained phone numbers that he used to call young girls.
Many think the confidentiality of their medical records is protected by federal law. Not so. Though a proposed federal law - the Medical Records Confidentiality Act of 1995, called the "Bennett Bill" - is being considered by the Senate, the privacy of medical records is now governed only by state law. Many states, however, don't protect the …