We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
I have always checked the NO box on the privacy information sheet saying I did not want to share my health and medical records with other doctors and hospitals. Last year while seeing one of my doctors, she began discussing something from another doctor and even another health care system completely. I asked her how she knew about the things she waned to discuss and pointed to the computer and said it says it right here. I explained I had never given permission for my information to be shared with anyone. Didn't seem to make any difference to the medical system that gave all my history to the world and I'm sure the government. Really pissed me off.
I suggest you STUDY (that means read and look up every term and background meaning in the federal register) the actual HIPAA regulation as well as the actual "standard" form in your doctor's office. Typically, what you think you signed up for isn't what you really signed up for.
The intent of HIPAA was never to protect patient information. It was to give the federal government easier access to your information in order to monitor health care usage not only on a global basis (all doctors in the US), but to look at individual doctors who were delivering "too much" care, i.e. they weren't restricting care as the government wished. A thorough and deliberate reading of the actual statutes will bear this out.
What is enacted in 99.9% of doctor's offices is not correct by HIPAA standards. It is TOO STRICT in terms of when and how they release info to spouses and people who you reasonably want to have certain info. The reason for this is that anytime federal regs are invented for an industry (especially medicine), there are "experts" that pop up who (for a hefty fee) will ensure your office is in compliance with the law (so that you avoid $50,000 fines).
It's far easier for them to tell the staff that nobody gets any info than to try to educate a bunch of high school graduates on the nuances of sorting out what is reasonable to disclose and who is a reasonable recipient.
Now, in terms of what the doc can disclose without your consent, it's ok for them to "disclose protected health information, without an individual’s authorization for...Treatment, Payment, and Health Care Operations..." In other words, if the doc thinks he needs to discuss your info with another doctor involved in the case, he doesn't need your written permission.
There are a lot of advantages to EMR but there are unintended consequences too. Mrs. Mudbug's doctor had to sell her practice to a big hospital because of the expense of the EMR systems and the time it took to maintain them. Who would guess that these lefty policies would encourage the big medical businesses? Many of those private doctors are choosing to retire because they can't handle the overhead brought on by Obummercare and don't want to be a cog in a machine any more than they want their patients to be one either.
EMRs are not terrible (though the article shows some of the vulnerabilities of them) or that they are all good, but they are having a profound effect on the medical landscape because of their being forced upon practitioners. They would have become very widespread in the near future anyway so it was senseless to mandate them.
EMRs ARE terrible. They are a disaster. The patient is being fit to the computer. The records are garbage.
The only way they would have become widespread in the future is by making a useful product that helps us do our jobs, doesn't cost an arm and a leg, and is backed by good service. But that's too hard, so the firms got government to order us to use the EHR vendors' product. Now they don't HAVE to be any good, and they never will be.
I don't really care who knows. I suppose there are some cases where you wouldn't want to share but I personally don't care. What I do care about is when the regulations get in the way and cause problems for parents, grandparents, spouses and of course doctors.
EMRs are pretty much mandatory here. Without them doctors can't bill insurance companies, and they can't get their government payments (government pays insurance companies part of the cost they pay to doctors, funded by tax money here).
While technically you have to give them permission to share your data, in reality it's often implicit by agreeing to have a procedure done.
For example if you need to get blood drawn or an X-ray taken, the results are always transmitted electronically to the doctor ordering the exam.
If you get referred to another doctor, the results of the procedures performed by that doctor are emailed to the doctor referring you to be included in their files.
Doctors are starting to lose their licenses for not using EMRs. Nothing the government mandates is for your benefit, especially when you become a "useless eater" requiring more resources than you're worth to the PTB. Soon, if not already, you'll be chipped like your pets...and it can be done without your knowledge.
Don't kid yourself. The government is NOT your friend. Zeke Emanuel certainly gave plenty of warning when he testified before Congress while Obamacare was under consideration. He even intimated that after 65 or so, you cost too much to get any treatment.