Managing Healthcare Data Across Borders Without Losing Medical Privacy

Photo: Unsplash / Myriam Zilles

The pharmacist in Bangkok looked at her screen, then at me, then back at her screen. "I see you filled this prescription in Singapore two weeks ago. You should still have 20 days remaining. Why do you need a refill?"

I hadn't mentioned Singapore. I hadn't shown her my previous prescription bottles. I'd only handed her a paper prescription from a local clinic. But somehow, my medical history had arrived before I did.

That's when I realized: my healthcare data was following me across borders, and I had no idea how.

How Medical Data Crosses Borders (Even When You Don't Want It To)

International health information exchange sounds like a good thing—until you understand how it actually works. There's no global standard, no unified privacy framework, no way to control who sees what. Instead, there's a patchwork of bilateral agreements, commercial data brokers, and pharmacy chains that share data "for your convenience."

I started investigating after the Bangkok incident. What I found was a system designed for efficiency, not privacy.

Insurance networks are the biggest culprits. If you have international health insurance, your provider likely has data-sharing agreements with hospitals and clinics in dozens of countries. When you check in for treatment, the clinic pulls your history automatically. That history includes diagnoses, prescriptions, test results—everything your insurer has on file.

Pharmacy chains share data across borders. If you fill a prescription at a Boots in London and then walk into a Boots in Bangkok, they're part of the same data ecosystem. Your prescription history syncs automatically. Same with other international chains: Watson's, Guardian, even some independent pharmacies that use the same backend systems.

Medical tourism companies are data brokers. Platforms that connect travelers with overseas doctors and hospitals don't just facilitate appointments—they aggregate medical records from multiple sources to "streamline your care." That data often lives on commercial servers with minimal oversight.

E-prescriptions cross borders invisibly. The EU's cross-border e-prescription system allows doctors in one member state to access prescription records from another. It's meant to prevent drug interactions and fraud, but it also means your prescription history is visible to any EU healthcare provider who looks you up.

I confirmed this by requesting my data from my international insurer. The file was 83 pages long. It included every doctor visit, every prescription fill, every lab test from the past seven years—across 14 countries. Some of the entries were from clinics I didn't remember visiting. The insurer had pulled data from local providers automatically, without asking.

What I Actually Carry: A Tiered Medical Data Strategy

After that wake-up call, I rebuilt my medical data approach from scratch. Now I operate on three tiers: minimal data for routine care, controlled data for chronic conditions, and full data for emergencies only.

Tier 1: Routine care (colds, infections, minor injuries). I carry nothing. I pay cash, use a pseudonym when possible, and decline to provide insurance details unless absolutely necessary. The clinic gets what they need to treat me right now—nothing more.

This works in most of Southeast Asia, parts of Latin America, and Eastern Europe, where cash-pay walk-in clinics are common. I've treated ear infections in Vietnam, stitches in Colombia, and food poisoning in Poland this way. No records entered my permanent medical file.

Tier 2: Chronic conditions (allergies, prescriptions, ongoing treatment). I carry a minimal data package: current medications, known allergies, and emergency contact info. This lives in an encrypted note on my phone and on a printed card in my wallet. No diagnosis history, no treatment timeline, no prior prescriptions.

When I need a prescription refill abroad, I show the doctor my current medication list and explain what I need. If they want my full medical history, I decline. Most doctors are fine with this—they just need to know what you're taking now and whether there are any contraindications.

Tier 3: Emergency care (accidents, severe illness, hospitalization). For this, I carry a USB drive with encrypted medical records: full history, imaging, test results, specialist notes. The drive lives in my travel first aid kit, next to my emergency cash. I only hand it over if I'm incapacitated or facing a life-threatening situation.

The encryption is simple: a VeraCrypt container with a strong passphrase. Inside, I keep PDFs of every relevant medical document. If I'm unconscious, the passphrase is with my emergency contact. If I'm conscious, I decide who gets access.

The Privacy Nightmare Hiding in Medical Tourism

Medical tourism is booming: dental work in Hungary, surgery in Thailand, fertility treatment in Mexico. The prices are compelling, but the data practices are horrifying.

I looked into getting a minor procedure done in Malaysia. The booking platform required me to upload: passport scan, full medical history, insurance details, and photos of my face from three angles (for "identity verification"). The privacy policy was a disaster—data retention was indefinite, third-party sharing was allowed for "operational purposes," and the company was based in a jurisdiction with no meaningful data protection laws.

I reached out to the clinic directly, bypassing the platform. They were willing to see me without the data dump, but the platform had already captured my initial inquiry—including my email, phone number, and the procedure I was researching. I started getting targeted ads for recovery services and related treatments within 48 hours.

Here's the rule I follow now: never upload medical records to a third-party platform. If a clinic requires records, I deliver them in person or via encrypted email directly to the provider. If a booking platform demands records upfront, I walk away.

What Travel Insurance Companies Actually Do With Your Data

Your travel insurance provider is not your friend. They're a data broker with a coverage product attached.

I filed a claim once for a minor emergency room visit in Portugal. The insurer asked for the hospital records, which I provided. What I didn't realize was that they also requested my records from the Portuguese national health system (SNS), which included details from a completely unrelated clinic visit I'd made two years earlier.

The insurer added that old visit to my file without telling me. When I applied for a new policy the next year, my premium was higher because of a "pre-existing condition" that had never been disclosed on my application—because I didn't know they had that data.

I fought it, and eventually got the premium reduced, but the data is still in their system. Once it's in, you can't get it out.

Here's what I do now:

• I read the data-sharing clauses in every travel insurance policy before I buy
• I file claims only when the cost exceeds the deductible by a meaningful margin
• I request a copy of all data the insurer collects after every claim
• I use providers based in jurisdictions with strong privacy laws (EU, Canada, UK)

If I'm paying out of pocket for care, I don't involve insurance at all. The cost of a clinic visit is lower than the long-term privacy risk.

The Countries Where Medical Privacy Doesn't Exist

Some countries have strong medical privacy laws. Others have none.

China: All healthcare data flows through government systems. If you visit a hospital or clinic, your records are accessible to authorities. I avoid non-emergency care in China entirely.

United States: HIPAA provides privacy protections, but there are massive loopholes. Insurance companies, employers, and third-party billing services all have access. If you're traveling to the US and need care, assume your data will be widely shared.

India: Medical privacy laws are weak and enforcement is minimal. Hospitals routinely share patient data with pharmaceutical companies and research firms. I use cash-pay clinics and decline to provide ID unless required by law.

UAE: Healthcare data is tightly controlled by the government. Medical records from Dubai or Abu Dhabi are accessible to immigration and law enforcement. If you have a sensitive medical history, be cautious about what you disclose.

EU (mostly safe): GDPR applies to healthcare data, and enforcement is stronger than most regions. But cross-border data sharing within the EU is common, and your records in one member state may be visible in another.

I keep a list of "safe" and "unsafe" countries for medical care. Safe means strong privacy laws and minimal data sharing. Unsafe means your records will leak, either to government systems or commercial brokers.

How to Get Medical Care Without Creating a Data Trail

It's possible, but it requires planning.

Use cash-pay clinics that don't require ID. These exist in most of Southeast Asia, parts of Africa, and some Latin American countries. You walk in, describe your symptoms, pay cash, and leave. No records, no insurance, no ID check.

Avoid international hospital chains. Bumrungrad in Thailand, Apollo in India, Mediclinic in the UAE—these are excellent facilities, but they're part of global data networks. If you use them, your records will sync with partner hospitals worldwide.

Decline e-prescription systems. If a doctor offers to send your prescription electronically to a pharmacy, say no. Ask for a paper prescription instead. It's slower, but it doesn't create a data trail.

Use a pseudonym when possible. In many countries, clinics don't verify your identity unless you're using insurance. I've used variations of my name or travel aliases for minor care. It's not fraud—I'm paying cash and not making insurance claims.

Encrypt everything you carry. Medical records on your phone, laptop, or USB drive should be encrypted. If your device is lost, stolen, or inspected at a border, your medical history stays private.

What to Do When You Have No Choice

Sometimes you can't avoid the data exchange. You're hospitalized, you need specialist care, or insurance is mandatory.

When that happens, I go into damage control mode:

1. Minimize what you disclose upfront. Provide only the information necessary for immediate treatment. Full medical history can wait until you've confirmed the provider's data practices.

1. Ask about data sharing before treatment. Specifically: who will have access to your records, how long they'll be retained, and whether they'll be shared across borders. Get the answer in writing if possible.

1. Request data deletion after treatment. Under GDPR (if you're in the EU) or local privacy laws, you may be able to request deletion of your records after care is complete. It doesn't always work, but it's worth trying.

1. Document everything. Keep copies of all records, consent forms, and data-sharing disclosures. If there's a breach or misuse, you'll need proof of what was collected and when.

The Records I Actually Keep With Me

Here's what's in my current medical data kit:

• Encrypted USB drive: Full medical history, imaging, specialist notes (VeraCrypt container, 8GB)
• Printed card: Current medications, allergies, emergency contact, blood type (laminated, wallet-sized)
• Phone note (encrypted): Same info as the card, plus doctor contact info for my primary care provider
• Emergency card (separate): Passphrase for the USB drive, held by my emergency contact, only accessible if I'm incapacitated

That's it. No cloud storage, no health apps, no wearable device sync. The data exists in exactly three places, all under my control.

What I Tell People Who Ask

Medical privacy while traveling is not a given—it's something you have to actively protect.

If you're carrying medical records across borders, encrypt them. If you're seeking care abroad, ask about data sharing before treatment. If you have a choice between a data-connected facility and a cash-pay clinic, choose the clinic.

Your medical history is some of the most sensitive data you have. Once it's in a foreign healthcare system, you lose control. Insurers will use it against you. Governments may access it without your knowledge. Data brokers will sell it to whoever pays.

I've rebuilt my approach three times now, each time after discovering a new way my data was leaking. The system is designed to share by default. If you want privacy, you have to opt out at every step.

Your health records are following you. The question is: who else gets to read them?