It was not that long ago that nine out of ten U.S. doctors stored their patients' records in color-coded files and updated them by hand. Now, approximately 85% of nationwide office-based physicians are using electronic health records (EHRs). Similarly, more than 90% of large, medium, small rural and critical access hospitals are currently using EHRs. If you visit a doctor today or are admitted to a hospital, there is a pretty good chance that your doctor will enter your medical record into an EHR, which you can subsequently view and obtain from a dedicated web portal. If you have ever wondered, “Does my health information belong to me or to my doctor?” you are not alone.

There are many people or entities who could claim ownership over a patient’s medical information. Does your physician own it? The medical institution? Some third party? In general, ownership of information belongs to the individual or company who created or authored that information. For example, intellectual property laws protect “original works of authorship.” Medical records represent professional medical opinions of a physician or a medical institution, and therefore may not necessarily be the patient's property. 

Why shouldn't individuals own their medical records? After all, these medical records contain their personal health information and were created for them. Lab work is literally a part of the patient -- why should other people own that?

Every state has different laws (registration required) about who owns medical records. New Hampshire is the only state that explicitly gives patients ownership of their health data, and most states don't have any law delineating the custody of records. However, today most systems provide patients access to information through a web portal. It shows a list of person’s health conditions in easy to understand terms, lists medications she is currently taking and includes lab and imaging study results, as well as recommended health measures.

Under federal and state law, patients have legal privacy, security and accuracy rights related to their health information. However, once that information is captured and documented in written or electronic form (e.g., paper chart or electronic data file), and since the health care provider owns the media in which the information is recorded and stored, the health care provider gains the property right of possession of data. In essence, the health care provider becomes the legal custodian of your health care record and is given specific legal rights and duties relating to possession and protection of that health record.

If you don’t “own” your medical data, then what does all this talk of “patient’s data ownership” really mean? Rather than ownership, it’s the idea of having access and control over your data that you should be focusing on.

For example, the patient has a right to view and get copies of her health information, as well as request changes to the information. Patients also have a right to get their health records in the format they choose -- some patients may want electronic copies of medical records, others might want to obtain them from a web portal and still others may use standard interfaces to access their information in EHRs. This is really important because it allows individuals to retain a copy of their health records in their custody and this has profound implications for how consumers finally become active participants in their health and wellness. Regardless of who owns their medical records, when patients have a copy of their health records that are readily accessible on their phones, for instance, they become more aware and engaged. What's more, engaged patients are healthier patients.

Imagine a time when users will be able to easily review their health data, share it with third parties like hospitals and doctors or sell it to pharmaceutical and research companies that are conducting clinical trials. Access to these records has never been easier -- more than 80% of patients said that their online medical records were easy to understand and useful for monitoring their health.

It is clear that full patient’s access to medical data is just a matter of time and it will have significant implications on everything from patient’s health to the ways we shop and pay for health care. What’s important to remember is that personal health records that are not part of a medical provider’s electronic health record are not considered to be legal records and therefore are not HIPAA covered entities. Meaning, once you obtain a copy of your medical records, that copy is yours. You can do whatever you want with it even though the health care provider remains the legal custodian of your health records and is required to comply with specific regulations relating to possession and protection of your health data. If the health care provider de-identifies or removes your personal information, that data is no longer protected under the Health Insurance Portability and Accountability Act (HIPAA). It can be used for a number of purposes, including aggregation into a specific data set that may be “owned” by the creator of that data set. There is a lot of interest from pharmaceutical and medical research companies in obtaining data that has information about patient’s treatment and outcomes but does not include patient’s personal information. These datasets become valuable commodities and can be bought or sold without your knowledge or consent. In fact, it is a multibillion-dollar market, but you are not getting a dime.

Your physical health records belong to your health care provider, but the information in it belongs to you. Having ownership and control over that information helps you ensure that your personal medical records are correct and complete. It makes you more engaged and healthier! It enables you to understand how your data is being shared. Last but not least, it allows you to treat your health care data as a digital asset that you can donate for research or sell for a monetary benefit. After all, it is your body and your data.

Emergencies

Across the European Union, 112 is the universal emergency phone number.

Never hesitate to call 112 in a life-threatening situation. While accessing emergency services is free of charge, you should be aware that your Sanitas insurance does not cover care in public hospitals, where you would be taken by an ambulance dispatched by 112. Nonetheless, your safety comes first.

Ask to be taken to one of the following Sanitas network hospitals. Be sure to take your Sanitas card with you.

Hospital La Luz
Calle del Maestro Ángel Llorca, 8
P: (+34) 91 453 02 00
Two-minute walking distance from campus.

Hospital Universitario de Madrid
Plaza del Conde del Valle de Suchil, 16
P: (+34) 91 447 66 00
Metro: San Bernardo, Lines 2 and 4

Hospital Universitario Vithas Madrid La Milagrosa
Calle de Modesto Lafuente, 14
P: (+34) 91 447 21 00
Metro: Alonso Cano, Line 7

If you're not in Madrid, call Sanitas at the number on the back of your Sanitas card and ask where you can go.

Campus Emergencies

SLU-Madrid's emergency number is (+34) 638 76 37 58. This number is managed by Saint Louis University's Student Life staff.

This phone number is only for health and safety emergencies. Call once you have contacted 112 or you're at one of the hospitals listed above. If no one answers immediately, leave a message. A Student Life staff member will call you back.

If you find yourself in legal trouble or need official documentation replaced (such as a passport or visa), SLU-Madrid Student Life staff may not be able to assist you.

SLU-Madrid's 24-hour counseling emergency number is (+34) 609 26 93 23.

Doctors

Multi Sanitas Health Insurance covers every SLU-Madrid student registered for at least one credit.

Only doctors and hospitals that work with Sanitas will accept Sanitas Health Insurance. You do not need to pay any additional fees to access their services. You will be charged if you choose to go to other hospitals or doctors. There will be no reimbursement.

Pick up your Sanitas card in the Office of Student Life at the beginning of each semester or session. Accidents can happen. Do not wait until you need the card to request it.

SLU-Madrid works with a fully bilingual, U.S.-trained physician. Dr. Borrás's office is easy to reach using public transportation.

Rubén Borrás
(English/Spanish)
Calle Núñez de Balboa, 107 - Office 005
P: (+34) 66 684 79 88
dr.rvborras@gmail.com 
Metro: Avenida de América (Lines 6)

Pharmacies (Farmacias)

Dial 098 or visit Colegio Oficial de Farmacéuticos' website to find out which pharmacy is on call to open after hours and on holidays. Sanitas does not cover prescriptions.

The following pharmacies are open 24 hours a day, seven days a week:

• Pharmacy El Globo, Calle de Atocha, 46
• Pharmacy Goya 12, Calle de Goya, 12
• Pharmacy Goya 89, Calle de Goya, 89
• Pharmacy Mayor 13, Calle Mayor, 13
• Pharmacy Velázquez, Calle de Velázquez, 70

Commonly Visited Physicians

Many specialists require a referral from a general practitioner in order to make an appointment. Therefore, even if you know what type of medical specialist you need to see, we recommend making an appointment with a general practitioner first.

The following is a list of medical health professionals who speak English but do not accept private health insurance.

Aug. 21—Commonwealth Health's physician group can't prevent its former vascular surgeon from working locally for Geisinger, Lackawanna County Judge Michael Barrasse ruled.

Board-certified vascular surgeon Dr. John Kutz began practicing at Geisinger Community Medical Center in Scranton in mid-May, several months after Commonwealth Physician Network (CPN) notified him in late January that his employment contract would not be renewed.

CPN then moved to enforce a noncompete clause prohibiting Kutz from practicing medicine or surgery within 20 miles for two years. It argued in court that Kutz breached the restrictive covenant in his CPN employment agreement.

Barrasse ruled against CPN in an order dated Thursday, denying its request for an injunction and declaratory relief.

Enforcing the noncompete clause would be against the public interest, as access to health care would be compromised given a shortage of board-certified vascular surgeons in the Scranton market, Barrasse ruled.

CPN also lacks a protectable business interest to enforce the noncompete covenant, he said.

The court found no evidence Kutz used confidential information, solicited CPN patients or received any specialized or extensive training from CPN.

"CPN failed to indicate or introduce evidence of whether the practice would be damaged or if its income would decrease," Barrasse wrote. "Rather, CPN clearly demonstrated that its business interests are best promoted without Dr. Kutz in its service."

According to the judge's order, CPN Chief Operating Officer Patricia Kane testified that Kutz's contract was "lopsided" — a high salary for low production. CPN "decided not to proceed with employment after multiple attempts to renegotiate," she testified.

Citing other testimony, Barrasse's ruling notes CPN vascular surgery patients were being absorbed by ancillary services and CPN was not looking for a substitute to replace Kutz in the Scranton market.

"In choosing to terminate Dr. Kutz without cause, hire a replacement located in Wilkes-Barre, and not relocate one of their Wilkes-Barre vascular surgeons to the Scranton catchment area, CPN reduced, the already below average, quantity of vascular surgeons in the Scranton market and effectively abandoned the Scranton catchment area," Barrasse's ruling reads.

Peter Paul Olszewski Jr., the lead attorney representing Kutz, celebrated the ruling as precedent setting for the state.

"The judge ruled that a health care provider cannot enforce a restrictive covenant exclusively for financial gain," he said. "That's precedent setting and that is a tremendous help for all patients ... because it ensures continuity of care."

Forecasting a possible appeal, Commonwealth Health addressed the ruling in a statement Monday.

"We believe the facts in this case support the enforcement of the non-compete," Commonwealth said. "We strongly disagree with the ruling and are evaluating our options for an appeal."

Contact the writer: jhorvath@timesshamrock.com; 570-348-9141; @jhorvathTT on Twitter.

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UAB Vascular Surgery & Endovascular Therapy offers a virtual Sub-Internship program designed for fourth-year medical students interested in vascular and endovascular surgery. The 2022 UAB Vascular Surgery Virtual Sub-Internship will be held from Oct. 2 - 7. 

For more information about the program, please obtain this program. To apply to the program, please contact Sherry Evans at vasadmin@uabmc.edu.