The Best Way to Share Health Records? An App in Patients’ Hands

The technical and regulatory pathway to consumer-mediated sharing is clear. From here, patients must demand that providers enable them to authorize who can and cannot access their health information.

This time of year, millions of Americans file taxes. We are required to move sensitive financial data from employers and banks to the Internal Revenue Service. In the old days, we waited for paper W2’s and bank statements to arrive by mail and then spent hours with pencils and stacks of paper. But now tax preparation software enables automatic retrieval and upload of data in seconds and without error. Why is this possible? Because each of us controls our own financial data.

Eric C. Schneider, M.D.Now imagine that we want our sensitive health records transferred to a new doctor. We fill out paper forms, mail or fax them, pay fees, and if we are lucky a stack of printed paper records arrives by fax or mail at our new doctor’s office weeks or months later. Weeks after that they might be scanned into an electronic health record as images but, even then, they can’t be searched easily. At our first visit, we will answer a long list of questions. The answers are in our record, but the office staff and doctor will find it more efficient to re-enter them manually. There will be errors (like the male patient of Eric’s recorded by the system as female).

Why the difference? Much has been written recently about information blocking—the inability or unwillingness of hospitals and doctors to share electronic data from our health records with one another. Lack of technical interoperability and regulations protecting security, privacy, and confidentiality are often blamed. But the reality is that technical barriers are falling. The same technology that enables your smartphone to pull sensitive financial data from your bank to pay your taxes or a taxi driver can be applied to your health care records. More importantly, the regulatory path to health records sharing is now open—the rules are already on the books.

There are three ways your health care records can be shared electronically.  All require your permission. One doctor’s system can query another doctor’s system for specific bits of your record (a digital version of a phone call request). One doctor’s system can push bits of your record to another doctor’s system (a digital version of a fax). Or the doctor’s system can give you your record and you can give it to anyone you wish. The last approach is called “consumer-mediated” sharing. The advantage of consumer-mediated sharing is that you control your data, and you authorize access to it each time...