Misuse of medical records

The misuse of medical records can take several forms, including unauthorized access, data breaches, fraud, and improper disclosure of patient information.

What constitutes misuse of medical records?

Misuse of medical records occurs when patient information is accessed, shared, or altered without proper authorization. This can take various forms, including unauthorized access, data breaches, medical fraud, and improper disclosure.

Unauthorized access

Recently, Xactus LLC publicly disclosed that a data breach had occurred after discovering that an unauthorized party had gained access to an employee’s email account. A similar attack was also experienced by the Charleston Area Medical Center. Both incidents could result in unauthorized access to sensitive patient information, which can lead to the misuse of medical records. 

Unauthorized access happens when individuals, including healthcare professionals or administrative staff, access patient records without legitimate medical or administrative reasons. Common examples include:

• A nurse or doctor viewing the records of a family member or celebrity out of curiosity.
• Administrative personnel accessing records to gather personal information for non-medical purposes.

Data breaches and cybersecurity threats

Data breaches can expose thousands of patient records, leading to identity theft and financial fraud. The above examples of unauthorized access led to data breaches as they resulted in the exposure of sensitive health information. 

Examples of cybersecurity threats include:

• Hacking incidents: Cybercriminals target healthcare databases to steal patient information.
• Phishing scams: Employees may unknowingly provide access to hackers through fraudulent emails.
• Ransomware attacks: Cybercriminals lock organizations out of their systems and demand ransom for data restoration.

Fraud and medical identity theft

Medical identity theft occurs when someone fraudulently uses another person’s medical information to obtain healthcare services, prescriptions, or insurance claims. This can lead to:

• Financial loss for victims due to fraudulent medical bills.
• Incorrect medical histories that may affect future treatments and insurance coverage.
• Healthcare fraud schemes where unethical providers create fake records to bill insurance companies.

Improper disclosure of patient information

Improper disclosure of medical records can occur intentionally or unintentionally. Examples include:

• Sharing patient information without consent: Discussing medical details with unauthorized individuals.
• Publicly exposing patient details: Conversations in open hospital spaces or social media posts about patient cases.
• Failure to secure digital records: Sending unencrypted emails containing sensitive medical data.

Falsification or alteration of records

Tampering with medical records is another form of misuse that can have severe consequences. Examples include:

• Covering up medical errors by altering records.
• Manipulating data for insurance claims or legal cases.
• Changing research data to meet specific outcomes.

Consequences of medical record misuse

Misuse of medical records can result in serious repercussions for both individuals and healthcare organizations.

Legal consequences

Violations of privacy laws such as HIPAA (Health Insurance Portability and Accountability Act) can lead to heavy fines and lawsuits. Medical professionals found guilty of breaching confidentiality may face license revocation and legal prosecution.

Ethical and professional implications

Breaching patient trust can damage the reputation of healthcare institutions. As a result, healthcare workers may be subjected to disciplinary action or job termination.

Financial and security risks

Patients affected by medical identity theft may suffer financial losses and incorrect medical records.

Healthcare organizations may face lawsuits and penalties, leading to financial instability.

How to prevent misuse of medical records

Preventing medical record misuse requires a combination of strict policies, cybersecurity measures, and awareness.

Implement strong security measures

• Use multi-factor authentication (MFA) for access to medical records.
• Encrypt digital records to prevent unauthorized access.
• Regularly update software and firewalls to protect against cyber threats.

Enforce access control policies

• Restrict access to patient records based on roles and responsibilities.
• Conduct periodic audits to monitor access logs.

Educate healthcare professionals and staff

• Provide training on patient confidentiality and data protection laws.
• Raise awareness about phishing scams and cybersecurity threats.

Read more: How to train healthcare staff on HIPAA compliance

Establish strict data sharing guidelines

• Obtain patient consent before sharing medical records with third parties.
• Use secure communication channels for transmitting patient information.

Encourage patient involvement

• Allow patients to review their medical records for any discrepancies.
• Provide options for patients to report unauthorized access or misuse.

FAQS

How can patients protect their medical records from misuse?

Patients can safeguard their medical records by requesting access logs from their healthcare provider, setting up alerts for unauthorized access, and ensuring their personal information is not shared without consent.

What should I do if I suspect my medical records have been misused?

If you suspect misuse, report it to your healthcare provider, request an audit of access logs, and, if necessary, contact legal authorities or privacy protection agencies.