So it sounds to me like your Provinces have a department that keeps and maintains all its citizens health care information.No, actually. The provinces have ministries/departments or agencies that maintain health
insurance information.
This is still the common confusion. It is health insurance that is
provided by the public/governmental authority, not health care. Health care is provided by doctors (most of them in private practice), other practitioners (e.g. physiotherapists in private practice), and at hospitals (all but the grandfathered ones publicly owned and operated by foundations). The health care is
paid for by the public insurance plan.
So the insurance thingy has records of the codes under which practitioners and hospitals billed the plan, for each service provided. I don't actually think the codes would indicate, for example, whether time spent in a mental health facility was as a voluntary or involuntary patient. It would just be billed at the daily hospital rate, plus any service provided by a doctor that was billed separately.
My OHIP record might not even show that. I go to a community health centre that has doctors on salary, and payment to the centre is on a per capita basis, not a fee-for-service basis.
This might help -- it is talking indirectly about physician fraud in billing the plan, basically (every couple of years some doctor who managed to see 3 patients in every 15-minute slot turns up on the media radar):
http://www.health.gov.on.ca/english/providers/program/ohip/bulletins/4000/bul4413.htmlMinistry of Health and Long-Term Care audit functions include:
Claims Records Review (‘Direct Recovery’)
When the General Manager can determine that claims to the Ontario Health Insurance Plan (“OHIP”) are incorrect based on a review of billing records, the General Manager may initiate a recovery of funds pursuant to the Health Insurance Act. If a physician disputes the General Manager’s decision, he or she may appeal to the TPAP within 15 days of notice of the decision.
Medical Records Review
When a review of the medical records is required, OHIP will notify the physician of the General Manager’s concerns. The physician then has two options: (1) he or she may choose to wait to be audited when the new audit process is available following Justice Cory’s recommendations for change, if any, or, (2) he or she may choose to undergo a ministry audit. If the physician then disputes the ministry’s decision, he or she may appeal the decision to the TPAP within 15 days of notice of the decision.
So there would be authorized access to medical records for the purpose of auditing the doctor (and presumably other providers/billers) only.
This is where the huge cost reductions in administrative expenses come in. Doctors commonly use commercial software for billing the plans (I see $199/year for one such). Plug in the service code, the fee is entered automatically, the bill goes to the plan electronically, the doctor gets paid. No discussions with the insurer, ever. No farting around with a dozen different insurers' requirements. No collecting from the patient.
So -- for any third party to know a person's actual medical history, access to the actual medical records would be needed. The insurance plan's records will just say "15-minute office consultation" or some such thing for most visits, I imagine.
These electronic medical records thingies are different. It's somewhat new so I'm not entirely sure about it.
https://www.ontariomd.ca/portal/server.pt/gateway/PTARGS_0_2_2913_477_0_43/http%3B/www.ontariomd_secure.ca/guides_admin/guideviewer.html?guide=tsp&chap=1&page=1What is a CMS?
A Clinical Management System (CMS) is a software application that combines the clinical and administrative aspects of practice management into an integrated electronic record. The CMS encompasses and manages all aspects of practice management and patient care – from appointment scheduling and billing to clinical encounter notes, medications, test results and a cumulative patient profile.
With a CMS, practice and patient records can be created, stored, accessed and managed electronically. Clinical Management Systems support improved patient care through:
* Integrated clinical and practice management
* Secure, sharable, electronic medical records
* Enhanced diagnostic and prescribing capabilities
* Delivery of preventive care programs
* Interfaces with other healthcare provider services e.g., lab results
* Enhanced accessibility from home or other locations
* Population-based studies, statistical analyses and reports on patient data
Clinical Management Systems reduce:
* Duplication of effort
* Lost or misplaced patient charts
* File storage space requirements
Aha.
http://www.cbc.ca/news/background/healthcare/records.htmlHealth records
Canada lags in electronic medical records
January 28, 2008
They can save lives, and although the up-front cost of implementation is significant, in the long run they can save money, too. Yet among developed countries, Canada is one of the slowest in putting electronic medical records to work.
"I think there's been a failure to recognize just how important it is," said Dr. Brian Day, president of the Canadian Medical Association. "And it's certainly costing a lot of money not to have information."
An electronic medical record is a computerized store of a patient's medical information.
... A simpler way of thinking about an electronic health record is that it's a system that helps ensure anyone who deals with a patient has access to all the information about that patient.
That can be a lifesaver, Day says. He notes that 7.5 per cent of people admitted to hospital experience some kind of adverse effect while undergoing treatment. Many of these — caused by drug interactions, allergies and the like — could be prevented if information about the patient were more readily available, he said.
Canadians can take some comfort from the fact that our pitiful adoption rate of EMRs is matched by one other country in the study: the United States. Canada is "leaps and bounds" ahead of the U.S. in this respect, Alvarez said, although we still fall far behind countries such as the United Kingdom.
Heh.
But again -- this information is available
only to health care providers, and only when they are treating the patient.
I gather your problem is that in this case State Police were pawing through a State list of people who have been involuntarily admitted to mental institutions to vet people for firearm ownership.Actually, I'm not convinced they were -- it isn't clear that the database they have access to consists of any more than identifying info (there would have to be names + birthdates and ID numbers of some sort I imagine) about people who have been involuntarily committed.
It's the fact that there is such a database that includes
people who have no desire to access firearms.
If I had been involuntarily committed to a mental health facility, I would want that information confined to my medical records, to which only health care providers have access. I would NOT want it being entered into ANY other database ANYWHERE to which ANYONE else had access.
The problem I have is that the current system in the US requires that this
medical information be disclosed to a third party - whatever it is that administers the NICS system - without the consent of the patient, and for reasons that have nothing to do with the patient's interests. If I were in the US, and had been involuntarily committed to a facility (or declared to be incompetent), and had no interest in ever accessing a firearm, I would object strenuously to my personal info being disclosed in that way.
It actually makes more sense to me to have public health authorities maintain the database and allow it to be searched for a particular name, when a particular person attempts to acquire a firearm.
This would mean an interim step between vendor and relevant information: vendor seeks authorization from NICS, NICS queries database of ineligible people kept by public health authority. The person attempting to acquire the firearm would be consenting to that disclosure by filling out the NICS form. And people who never filled out a NICS form would not have their personal medical info floating around in a database maintained for reasons having nothing to do with their health care and accessible by people who are not involved in their health care.
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