Sharing health records helps patients

Published Dec 3, 2016

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Your medical scheme and its administrator and managed-care provider are keen to share the information they hold with you and your doctor, because they believe this will improve the quality of treatment and reduce waste in the healthcare system. If both of those aims are achieved, it will cost less to provide you with health care and, ultimately, lower the contributions you pay.

For some time, doctors have been using tools that enable them to integrate their medical records with the software they use to bill patients. The entry of medical scheme administrators and other entities into the record-sharing arena has resulted in a distinction between:

• Information held by doctors in electronic medical records – or your doctor’s notes – which remain with your doctor and will not be shared, except possibly with other healthcare providers treating you, or the managed-healthcare entity of your medical scheme, if you give your informed consent.

• The information held by the administrator of your medical scheme about your claims for hospitalisation, consultations and medicines, declarations about previous conditions made when you joined the scheme, disease-management programmes and, sometimes, when you grant your consent, the results of medical tests. This information is known as your electronic health record. Sharing this information with your doctor(s), with your consent, can optimise and co-ordinate the care you receive, to ensure you receive the best-quality care at an affordable price.

• The records that are useful for you to keep about the treatment you receive, your test results, and other health indicators. These records are known as patient or personal health records. Granting your consent to share these records can also optimise the care you receive. Personal health records can be used to schedule appointments and monitor your health through measures such as your weight, body mass index and how much you exercise.

You typically consent to the results of tests and scans done by pathologists and radiologists being sent to your doctor, in which case the results would form part of his or her electronic medical record. But such results would be included in an electronic health record or personal health record only if you consented to the administrator of your scheme, or the provider of your personal health record, sharing this information.

If you belong to a disease-management programme – for example, for the management of HIV – you may be asked to consent to the programme to assist in monitoring your CD4 count, so that, if it falls below a certain level, the programme can recommend that a doctor intervenes.

If your doctor does not have access to your electronic health records, your personal health records can be an invaluable way of providing him or her with accurate information.

Both the electronic health record and the personal health record can benefit you if:

• You cannot remember your or your family members’ medical histories.

• You cannot remember when last you suffered from a medical condition.

• You have forgotten what medications you are taking for these conditions and in what dosage.

• You cannot recall allergies or side-effects of medicines you have taken in the past.

• You cannot recall what medication you are taking for any other conditions that may affect the condition for which you are now being treated, or which may negatively interact with any new medicines.

• You haven’t been taking your medication as prescribed. Your doctor will be able to see what claims you have had at a pharmacy and check whether you regularly collect medicine in line with a script.

• You don’t have, or can’t remember, the results of any laboratory tests, such as blood tests, or radiology investigations, and how your condition has developed. Having access to these results can prevent your doctor from sending you for duplicate tests, which saves money.

• You can’t remember when you were admitted to hospital, for what condition and for how long.

• You and your doctor want to understand your medical scheme benefits.

• You want to track your biometric data and link a range of monitoring devices.

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