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Re: Medical records in the digital age

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On 24/06/2014 17:50, RS Wood wrote:
>  From the «for leprosy, press 1» department:
> Title: Medical records in the digital age
> Author: zafiro17@pipedot.org
> Date: Mon, 23 Jun 2014 17:57:22 -0400
> Link: http://pipedot.org/story/2014-06-23/medical-records-in-the-digital-age
>
> The medical field isn't exactly embracing the digital revolution, although
> it's quick to implement scientific progress in other areas. Trapped in a mess
> of legal, privacy, and insurance regulations and hampered by financial
> disincentives to implement digital record keeping, many medical centers still
> rely on voluminous paper records. But that's changing, and with change comes
> good news and bad.First come the breaches of privacy. In Cincinnati, a woman
> is suing the University of Cincinatti Medical Center[1] after a medical clerk
> posted the woman's medical records (showing name and diagnosis of syphilis)
> to Facebook's page "Team No Hoes." Privacy is also compromised when medical
> records become part of court hearings[2], as many legal cases become part of
> public record and are searchable online. But these risks were part of the
> paper system as well. Recently, a huge number of paper medical records turned
> up in York, UK[3], and Michael Schumacher's paper records seem to have been
> stolen and put up for sale[4]. So what do we need to keep sensitive,
> personal, medical information private? Think quickly, because already some
> doctors can access your medical records via Google Glass[5] as they talk to
> you.
>
> Links:
> [1]: http://www.usatoday.com/story/news/nation/2014/06/06/cincinnati-hospital-sued-facebook/10104065/ (link)
> [2]: http://www.argusleader.com/story/news/2014/06/22/privacy-risk-rises-push-online-medical-records/11229915/ (link)
> [3]: http://www.ydr.com/business/ci_26004767/electronic-medical-records-have-security-advantages-but-systems (link)
> [4]: http://www.stuff.co.nz/auckland/sport/10192413/Michael-Schumachers-medical-records-stolen (link)
> [5]: http://www.psfk.com/2014/06/google-glass-medical-records.html#!2LwgW (link)
>
A subject close to my heart.

We also have issues with:

Accuracy. Records are notoriously inaccurate and that seems to be more 
of an issue when they are all digital and therefore appear the same. At 
least tatty old notes scribbled on yellowing paper suggest a degree of 
out-of-dateness and unreliability. One example of such a mistake, doctor 
put "hyperchlorhydria" instead of "hypochlorhydria" in someone's 
records. With context and thought the mistake is fairly obvious, but as 
a digital record subject to identification by search, that could become 
a critical mistake.

Test results very often do not include reference ranges. As ranges for 
some tests vary by lab and over time, it is vital that the range in 
force at the lab is recorded. All too frequently, it is not.

Incompleteness. You might see a doctor who suggests you need more 
vitamin D but for whatever reason thinks it better for you to buy your 
own (probably almost always a financial reason somewhere in whichever 
system you live under). But your self-supplementing is then never 
recorded. Or notes from a specialist don't reach your main doctor's 
repository.

I buy my own medicine from a web-site without needing a prescription 
because the makes I find acceptable are pretty much unavailable on 
prescription in the UK. Therefore I have little reason to get my doctor 
to prescribe at all. If I didn't, though, my records would suggest that 
I don't take the medicine - a message I very much don't want anyone 
needing to read my records to get. That is a trap many self-purchasers 
fall into.

Words. Yes - simple words which change in meaning over years, between 
countries and, indeed, between two doctors in the one surgery on one 
day! Certainly coded records might be more resilient but they are still 
the minority.

-- 
Rod

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Medical records in the digital age RS Wood  <rsw@therandymon.com> - 2014-06-24 16:50 +0000
  Re: Medical records in the digital age polygonum <rmoudndgers@vrod.co.uk> - 2014-06-24 22:04 +0100
    Re: Medical records in the digital age Paul Sture <nospam@sture.ch> - 2014-06-27 13:42 +0200
  Re: Medical records in the digital age Shadow <Sh@dow.br> - 2014-06-27 09:36 -0300
    Re: Medical records in the digital age Ant <ant@zimage.comANT> - 2014-06-27 08:03 -0700
      Re: Medical records in the digital age Shadow <Sh@dow.br> - 2014-06-27 13:17 -0300
    Re: Medical records in the digital age Will Honea <whonea@whonea.net> - 2014-06-27 23:22 -0600

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