If you use a web based product, read the fine line carefully to find out exactly who owns the records, the vendor or the practice.  If you have your own client/server software and server and store your records locally, then you have the physical records on premise at the practice.  The same holds true for PHR (personal health records) if you store the records on a usb drive, then you have control over who can view, copy and use them, on the web, it's only as good as the vendor's word, and be sure to check out thoroughly who the vendor is and where they receive funding for their products and that you are not agreeing to having your information mined by any outside sources at best.  Use of data mining has already had some affects on both quality and cost of today's healthcare.  BD

"There are certainly large and small vendors that I have seen contracts of that do" that, Tang said. "Some people (vendors) say they have ownership to data. There are contracts that say they will have real-time access to the database, that they will have exclusive access to the data, that they can resell the data. I think it would be unlawful that covered entities abide by that."

PHR vendors are even more problematic, because many are not covered organizations, and if HIPAA applies to them at all, it is only indirectly through "business associate" agreements with the covered groups who hired them."What we're struggling with is how to control the bad apples, because the misuse of health data could hurt the good use of health data," he said.

Robert Gellman, a Washington, D.C.-based lawyer specializing in privacy issues, said he has little use for what he called "commercial, advertising-supported PHRs," calling them "the moral equivalent of a scam." "They get the patient to sign an authorization. That's how they get the data in the first place. Why any patient would agree to do this, I have no idea whatsoever."

Bria said that he has no data on how widespread the practice of data ownership is, but, "Am I shocked by this? No. Do I think it is an issue? Of course it is. I have been approached, as I think everybody has over the years, by pharma and they said they would like to have access to your data and there would be payment because they would like to use that for marketing and research."

Modern Healthcare Online


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