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Patients can now access all their health records digitally

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Re: Patients can now access all their health records digitally

#31
post #25
post #10

One big limitation of this standard is imaging data. X-Ray radiographs, MRI scans, PET scans, etc are not part of the USCDI standard V1 that'll be available to US patients. The current story for getting these scans still sucks and isn't close to being actually available to patients in the US. The best you can get is a set of DVD's containing that stuff, if you are lucky. The problem is that the protocol used by imagi…

I've had routine MRIs for the last couple years and it has been interesting to see how the story to obtain image CDs has changed over the years. Years ago, I could just ask the tech to burn me a CD and it was often ready for me when I left the changing room. Then I had to start asking the reception desk but sometimes wasn't able to pick it up the same day. Most recently, the reception desk said they could no longer h…

The CD I was given has a Windows-only program on it, complete with installer, and that is the only way to view the pictures on the disc. There are no JPG, PNG, GIF, RAW, PDF or any other recognizable files on the disc by itself.

Re: Patients can now access all their health records digitally

#32
post #25

Earlier quoted context omitted.

I've had routine MRIs for the last couple years and it has been interesting to see how the story to obtain image CDs has changed over the years. Years ago, I could just ask the tech to burn me a CD and it was often ready for me when I left the changing room. Then I had to start asking the reception desk but sometimes wasn't able to pick it up the same day. Most recently, the reception desk said they could no longer h…

The CD I was given has a Windows-only program on it, complete with installer, and that is the only way to view the pictures on the disc. There are no JPG, PNG, GIF, RAW, PDF or any other recognizable files on the disc by itself.

That program is probably just a DICOM viewer.

Re: Patients can now access all their health records digitally

#33
post #25

Earlier quoted context omitted.

I've had routine MRIs for the last couple years and it has been interesting to see how the story to obtain image CDs has changed over the years. Years ago, I could just ask the tech to burn me a CD and it was often ready for me when I left the changing room. Then I had to start asking the reception desk but sometimes wasn't able to pick it up the same day. Most recently, the reception desk said they could no longer h…

The CD I was given has a Windows-only program on it, complete with installer, and that is the only way to view the pictures on the disc. There are no JPG, PNG, GIF, RAW, PDF or any other recognizable files on the disc by itself.

If you use linux search for a dicom viewer in the repositories. I've used Weasis without issue so far.

https://nroduit.github.io/en/

Re: Patients can now access all their health records digitally

#34
post #10

One big limitation of this standard is imaging data. X-Ray radiographs, MRI scans, PET scans, etc are not part of the USCDI standard V1 that'll be available to US patients. The current story for getting these scans still sucks and isn't close to being actually available to patients in the US. The best you can get is a set of DVD's containing that stuff, if you are lucky. The problem is that the protocol used by imagi…

Got a dental 3d scan recently and I also couldn’t get that as any sort of digital file

Not available upon request or not offered? Recently had an MRI and they copied the files to a thumb drive I gave them after asking due to not having a CD reader at home for over 5 years. A printed copy was more expensive.

Re: Patients can now access all their health records digitally

#35

I occasionally wonder if it would be the cheaper, sustainable approach to just give everyone an iOS device containing their full medical record in HealthKit and require that all data requests go through your device, where you have full control on who gets access and for how long. A simple back-of-the-envelope calculation results in $1 000 per iOS device x 300 000 000 = $300 000 000 000 (three hundred billion). To put…

This just isn't realistic. No hospital EMR is going to act as a proxy for a thousand customer iOS devices hooked up to the WiFi or whatever.

Just imagine the doctor trying to pull up your chart, and failing because you forgot to charge your phone. Yeah, no.

Or, even better, you get admitted to the ER in critical condition and now nobody can pull up your blood type or even enter your medical records, because you don't have your phone on you.

Not going to happen.

Re: Patients can now access all their health records digitally

#36
post #21

I really love it when I want records from Doc A to be sent to Doc B, then the Doc B offices refuses to get records and insist the patient need to do it, despite signing over all the papers, and then Doc A refuses to send them because they can only give to patient - even though patient is begging to send them. Quadruple the pain if you need records from multiple doctors. This is why now I prefer going to chain hospita…

My experience is that Doc A sends the thumbnail of the image to Doc B. Doc B is happy that Doc A sent an unusable file because he now gets to charge for a new image. Hospitals track MRIs and other images ordered per doctor, and doctors are under pressure to hit their quota.

Not sure where you got the idea that there are "quotas" doctors have to meet for ordering diagnostic tests. I can't speak for other countries but in the US this is not the case.

Re: Patients can now access all their health records digitally

#37
post #10

One big limitation of this standard is imaging data. X-Ray radiographs, MRI scans, PET scans, etc are not part of the USCDI standard V1 that'll be available to US patients. The current story for getting these scans still sucks and isn't close to being actually available to patients in the US. The best you can get is a set of DVD's containing that stuff, if you are lucky. The problem is that the protocol used by imagi…

Having built workstations in imaging that used DICOM extensively, I disagree with the fact that DICOM is ancient and painful to work with. Yes, it is difficult to understand but there are plenty of great toolkits and examples to get started (DCMTK, dcm4che). And it also has open source implementations (dcm4chee).

DICOm has a portable media extension which let's anyone transport studies using USB, keep it in a folder. And it works well when it needs to be fed into a PACS, RIS l

It has stood the test of time when stuff like HL7 went from V2 to V3, CDA and related tailspins till FHIR came about (and let's not talk about ISO13606, OpenEHR).

It's UID space is well defined that's it's used in the aircraft inventory space.

Re: Patients can now access all their health records digitally

#39
post #3

Nothing sets off my fuse than a clinic refusing to send me my data so I can get it to another doctor for another opinion, ESPECIALLY around cost / prognosis (well, they don't "refuse", they just delay for so long). So, so glad to hear this.

> Reminder #5 – How IB actors make EHI available for access, exchange, and use can and will vary based on who the IB actor is, their technological sophistication, and who it is that is seeking to access, exchange or use an IB actor’s EHI. > The information blocking regulations do not require IB actors to adopt or use certain technologies or platforms. IB actors may use “patient portals,” other web interfaces, applica…

[deleted]

Re: Patients can now access all their health records digitally

#40
post #10

One big limitation of this standard is imaging data. X-Ray radiographs, MRI scans, PET scans, etc are not part of the USCDI standard V1 that'll be available to US patients. The current story for getting these scans still sucks and isn't close to being actually available to patients in the US. The best you can get is a set of DVD's containing that stuff, if you are lucky. The problem is that the protocol used by imagi…

Is it really that big a problem? Yeah the DVD is annoying, but once you get it, DICOM is easily viewable, with free and/or open source softare...

https://github.com/bettar/miele-lxiv

https://horosproject.org/about/

https://play.google.com/store/apps/details?id=com.luolai.dro...

https://apps.apple.com/us/app/idv-imaios-dicom-viewer/id1444...

> But we still aren't very close to being able to see X-rays on our phones.

Actually, last time I had such an injury, I copied the files from the DVD to my phone and just showed all the doctors exactly that... x-rays and CAT scans on my phone, all using free apps. Similar viewers exist for Mac and Windows too. It works fine and the image format is a lot more powerful than JPEG, letting you scan between depths (or reconstruct a 3D model from individual slices), etc.

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