Personal health records are essentially individual patient details, which is usually needed for identification, classification, administrative, and clinical applications (Alder, Maureen, & Beckley, 2004). The field of personal health records has undergone significant evolution overtime from especially with regard to health care environment, state of personal health information technology, and the respective supporting systems, which are basic in supporting health fundamentals. The practice of storing personal health records has predominantly been pursued using the electronic form ever since the inception of the information age, especially using electronic medical records, representing a move away from the traditional paper based systems (Wagner, Rose, & Green, 2009).
The 1970s represented a major shift towards the computerization of personal health records, since this was a time when majority of health institutions were undergoing growth and expansion with regard to the contemporary health care environment (Wagner, Rose, & Green, 2009). This was a critical stage considering the constantly rising consumption of Medicare and Medicaid services by an increasing elder population. During this time, the transition was assisted by the introduction of smaller, compact, and cheaper versions of personal desktop computers (Wagner, Rose, & Green, 2009). This led to an increasing interest in majority of clinical institutions to transform their patient health records into a more efficient and functional system. This growth was limited to large medical establishments who could afford the cost of transforming their personal health records (Wagner, Rose, & Green, 2009).
The 1980s was a period which witnessed the massive production of personal computers leading to their subsequent introduction into less formal medical settings (Wagner, Rose, & Green, 2009).This led to the transition period of personal health records from paper towards electronic patient health records in settings in which there was still a predominant practice of crude paper based systems. This enabled the creation of a patients’ health records databank, which could be accessed from a central point. Consequently, this led to an increasing ease of access of personal health records through elimination of the former bulky paper health records (Wagner, Rose, & Green, 2009). In addition, it led to enhanced storage and location of individual patient records. This model of personal health records was later on enhanced in the late 1980s through the inclusion of an electronic health record, which could allow clinicians conduct better health care assessment of their patients through distribution of data processing, better billing systems, and integrated clinical information (Wagner, Rose, & Green, 2009).
The 1990s period became the period christened as, ‘the era of enhanced health care reform and agenda’ through significant changes regarding the introduction of new platforms of personal health records management (Wagner, Rose, & Green, 2009). The agenda for this significant period was majorly pushed by the changes accompanying key medical systems through political championing of health care reforms. The major focus for this period was the decentralization of personal health records from institutional settings (Wagner, Rose, & Green, 2009). The aim was to enable patients to access health services from virtually any point without the need of having strict institutional attachments. However, this led to a major debate regarding the impending effect on the patient records privacy due to the potential negative impact on the personal health records security (Wagner, Rose, & Green, 2009). This was partly affected by subsequent introduction of online platforms during, which stimulated majority of the resulting arguments concerning personal health records security.
The 2000s period put more emphasis on the aspects of sophistication in the personal health records arena. “Not only did the interest of boosting health profiles become a fundamental question of citizens’ concern, health institutions also became key players in the introduction of sophisticated electronic medical records” (Wagner, Rose, & Green, 2009). This consequently led to patients becoming critical on the manner in which key institutional settings were handling their personal health records. For instance, many patients shifted from institutions that offered less complex systems for personal health records. This was despite increasing costs witnessed with regard to the need to train individuals in working in personal health records in some of the key institutional settings. In the period between 2001 and 2005, there was an increasing debate towards the adoption of electronic health records in key institutional arrangements (Wagner, Rose, & Green, 2009). Presently, many critical clinical settings completely rely upon the use of electronic health records in the management of patient personal health records.
Potential Areas for Health Care Fraud and Abuse
In majority of institutional settings, the role of maintaining patient records is essentially a duty of the medical institution. Nationwide medical institutions are required to comply with stringent security measures in order to guarantee patients protection against any form of infiltration regarding their privacy (Alder, Maureen, & Beckley, 2004). This is especially because in the recent past there has been increasing concerning the manner in which criminals are increasingly having ease of access to critical patient data and subsequently using the data to perform illegal fraud activities through use of impersonation. However, in as much as the role of maintaining medical records is predominantly the duty of the medical institution, the patients themselves also play a significant role in ensuring the privacy of the personal information submitted is subject to safe and limited access (Alder, Maureen, & Beckley, 2004).
Currently, there are numerous standard setting organizations, which provide provisions that are to be followed by practicing medical institutions regarding privacy and integrity of patient data in the provision of medical health care services (Alder, Maureen, & Beckley, 2004). The rules provided by many of them are applicable on an international basis considering the similarities with privacy and integrity issues. For instance, the committee on improving the patient record has provisions for medical institutions, which require them to disclose certain information for evaluation, monitoring, and comparison activities and they further recognize the harms that could potentially be suffered by individuals and institutions (Institute of Medicine et al, 1991). This is mainly an attribute of the proximity with which certain individual information may lick leading to the access of individual records. Furthermore, “The HIPPA privacy standards, 45 CFR Part 160 Subparts A and E of Part 164, prohibit all ‘covered entities from using or disclosing ‘individually identifiable health information’ that is or has been transmitted or maintained electronically, except in certain circumstances” (Cameron & Cleverley, 2007). These requirements are required in order to protect individuals from online exploitation by persons with illegitimate identities. Policies set in place further stipulate specialized requirements providing general provisions for information management. This stipulated conditions are ordinarily not restricted to medical information but cut across to other forms of personal information, which deserves to be preserved under strict privacy. Moreover, provisions for include, “any information transmitted by fax, telephone, computer, electronic handheld device, or any other electronic means is protected by the HIPPA standards…” (Cameron & Cleverley, 2007).
There are several ways in which patient information can be used for fraud and abuse reasons. For instance, unsuspecting patients could give their personal identification numbers to strangers in for official reasons and this information ends up being used in the accomplishment of potential criminal activities. This usually occurs in certain online domains where such information could be requested unknowingly, for instance, when people are looking for information from online medical databases posing to be legitimate. Some of the activities performed by such criminal activities include, individuals demanding reimbursement from insurance bodies in which they are registered or are members (Alder, Maureen, & Beckley, 2004). In fact, numerous insurance bodies have previously fallen prey to these forms of cyber crime activities leading to the loss of millions of dollars to illegitimate processing of insurance claims. Majority of these culprits normally target There are also incidents in which certain health practitioners sell individual information to criminals courtesy of the money token give this sole purpose. Such kind of incidents have occurred in critical clinical and medical environments and subsequently leading to their suspension from offering professional medical services as a result of these kinds of events (Alder, Maureen, & Beckley, 2004).
The influx of information technology has changed the traditional health care environment in terms of access to health care services, billing system, medical staff scheduling, and delivery of specialized services (Alder, Maureen, & Beckley, 2004). This has also led to the decentralization of key medical services since patients are now in a position to access services from virtually any point they deem as being appropriate. Professionals in the health sector are also in a position to activate and monitor medical interventions from virtually any geographical point courtesy of information technology (Alder, Maureen, & Beckley, 2004). Patients in critical care settings are in a position to communicate with their significant others while they are in this critical stage of their health. The transition towards the information age has made health care access to become more efficient especially in areas where the application of traditional billing forms proved to be a fundamental hindrance (Alder, Maureen, & Beckley, 2004).