Health Service System - City & County of San Francisco

Many options for digital medical records systems and health risk assessments are entering the market. Be aware about when, and with whom, you are sharing private medical data. Ask to read the privacy policy whenever you are in a situation where a digital medical record may be created.

What is a digital medical record?
Most of us are familiar with the rows of folders kept in our physician's office, which document our doctor visits, test results and treatments. Digital medical records track this type of information in a computer database instead of a paper file.

What is a health risk assessment?
A health risk assessment is a tool that creates a digital record of your age, weight, family history and basic test results. Based on this information the tool offers suggestions about how you might improve your health. An HRA can inspire individual behavioral change and raise questions about your health that encourage discussion with your doctor. HRAs are sometimes used as an opportunity for marketing products, like a weight loss system or smoking cessation aid. They also may enable employers to generate health-related statistics about employees.

What are the benefits of a digital record?
Computer-based records can allow physicians to more easily access and share patient information. For example, if a condition requires consultation with more than one doctor a digital record can make it easier for the different physicians to coordinate care. (In that case both doctors must be using a compatible system.) In some cases, patients are also empowered by being given access to their records. Digital medical records can help reduce medical errors and increase cost savings in healthcare administration.

What are the risks of a digital record?
Privacy advocates have raised concerns about inappropriate parties gaining access to an individual's medical history. They point to recent incidents involving non-medical hospital employees reviewing patient records without authorization and the inadvertent posting of a database of personal information on the web by a large insurer. These consumer advocates argue for more stringent patient privacy safeguards.

Do you know when you are generating a digital medical record?
There are many situations in which your data could be collected. For example, during an appointment with your doctor, any time your get basic health screenings, if you seek treatment at a hospital, or if you log on to a Health Risk Assessment and answer questions online.

Do you know why your medical data is being collected?
Is your data being collected by a medical professional so that it can be used to enhance your individual care? Is it being collected so that your information can be analyzed as part of a group? For example, an employer may collect self-reported data from workers in order to find out what percentage are smokers.

Who will have access to your data?
Will your data be accessed by a doctor and medical professionals? Shared with your employer? Are there any sales and marketing entities that will have access to part of your record, such as your phone number or mailing address? And finally, will you be able to view the records yourself, so that you can use them to participate in making decisions about your care?

What legal, technical and procedural safeguards are in place to protect your data?
Healthcare providers, health insurance companies and government agencies that administer healthcare are bound by a federal privacy law (HIPAA) governing medical records. (www.hhs.gov/ocr/hipaa/.) But the most important protection is your ability to question, so that you only allow digital records to be created that adhere to the standards of security that you are comfortable with. Ask about and read the privacy policy.

Does HSS offer employees a health risk assessment?
The healthcare vendors currently contracted by the Healh Service System all offer our members annual wellness exams that include basic health screenings, as well as no-cost, online health risk assessments. Any data that you input into the online tools provided by HSS contracted medical vendors are protected by HIPAA standards. This data is not sold or shared with anyone, including your employer. To learn about the health risk assessment tools available through your health plan, visit:

Blue Shield Wellness Benefit Highlights
Kaiser Wellness Benefit Highlights
PacifiCare Wellness Benefit Highlights
City Plan Benefit Highlights