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Medical records in the digital age

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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

#3816 — Medical records in the digital age

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)

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#3832

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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#3902

On 2014-06-24, polygonum <rmoudndgers@vrod.co.uk> wrote:
>>
> 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.

I've been having a go at someone about undated articles on the web.  As
you say, real paper can suggest some kind of age that a digital document
does not.

> 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.

Back in my college days a doctor prescribed some medicine for me.
The pharmacist told me that the medicine concerned was a) cheaper than the
standard prescription charge and b) was available without a prescription.
I simply ripped up the prescription and paid the normal price.

-- 
You can't look at a glass as half full or half empty if it's overflowing.

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#3894

On Tue, 24 Jun 2014 16:50:13 +0000 (UTC), RS Wood
<rsw@therandymon.com> wrote:


	I'm a retired family doctor, and worked ER too. My ER notes
are quite accurate, as other doctors needed to read them.
	My family doctor notes are heavily coded. So no one would know
that "X" was a slut, "Y" still in the closet, and that "Z" smoked pot.
Bad luck, I suppose, for the young guy who "took over", but I still
believe in my oath. I started stenographing when I heard the patient
histories would be digitalized and put in a central database. It's
illegal in Brazil, but oath trumps law.

	This is a much bigger problem:

http://rt.com/usa/168700-hospitals-spy-patients-purchases-habits/

	[]'s
-- 
Don't be evil - Google 2004
We have a new policy  - Google 2012

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#3897

On 6/27/2014 5:36 AM PT, Shadow typed:
...
> 	This is a much bigger problem:
>
> http://rt.com/usa/168700-hospitals-spy-patients-purchases-habits/

Didn't these patients agree to share private information?
-- 
"I don't know how good ants are at swimmin', but I'd be willing to bet 
that a good fire'd get their attention." --MacGyver in Trumbo's World 
episode
    /\___/\         Ant(Dude) @ http://antfarm.ma.cx (Personal Web Site)
   / /\ /\ \                Ant's Quality Foraged Links: http://aqfl.net
  | |o   o| |
     \ _ /        If crediting, then use Ant nickname and AQFL URL/link.
      ( )         If e-mailing, then axe ANT from its address if needed.
Ant is currently not listening to any songs on this computer.

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#3898

On Fri, 27 Jun 2014 08:03:41 -0700, Ant <ant@zimage.comANT> wrote:

>On 6/27/2014 5:36 AM PT, Shadow typed:
>...
>> 	This is a much bigger problem:
>>
>> http://rt.com/usa/168700-hospitals-spy-patients-purchases-habits/
>
>Didn't these patients agree to share private information?

	Under duress does not count. Share or DIE !!!!!
	[]'s

	"there will be an option for patients to opt-out of the
process and ensure their info remains private."
	After the disclosure. Thoughtful. Avoiding legal issues ?
-- 
Don't be evil - Google 2004
We have a new policy  - Google 2012

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#3911

Shadow wrote:

> I'm a retired family doctor, and worked ER too. My ER notes
> are quite accurate, as other doctors needed to read them.
> My family doctor notes are heavily coded. So no one would know
> that "X" was a slut, "Y" still in the closet, and that "Z" smoked pot.
> Bad luck, I suppose, for the young guy who "took over", but I still
> believe in my oath. I started stenographing when I heard the patient
> histories would be digitalized and put in a central database. It's
> illegal in Brazil, but oath trumps law.
> 

Way back when (ancient times like the mid-1980s) I was dragged in to assist 
a group attempting to digitize the records for residents of a reasonably 
large group of nursing and assisted living homes. My involvement was in the 
areas of communications and database design. The general outline of the 
project was to create a portable, easily transferable record set which 
mirrored the then-prevalent paper records - we were blissfully ignorant of 
the data mining potential, at least in the beginning.  The design phase 
included extensive interviews with the doctors and nursing staffs involved.  
Note that this was well before the bureaucratic echelon had even conceived 
of HIPPA.  Our system was used for a few years but was abandoned as soon as 
the HIPPA regs were circulated - the overhead killed the usefulness. I still 
feel that the concept is of tremendous value but the implementation 
framework imposed by regulations imposed by literally ignorant regulations 
have made whole concept useless.

-- 
Will Honea

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