As a co-fouder of https://www.medorbit.co (shameless linking my startup I know but in my defense no one here is my possible user) who is trying to make this possible for the African patient this is very motivating.
Patients can now access all their health records digitally
41–50 of 122 posts
Re: Patients can now access all their health records digitally
#42Are doctor's notes part of this? I wonder how many doctor's are going to regret some things they wrote.
Notes have been part of your portable data for a while now.
Doctors who haven't learned to write appropriately (or cryptically) have been foolish for a while.
Re: Patients can now access all their health records digitally
#43Re: Patients can now access all their health records digitally
#44One 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…
“since it means that their personal notes about their patients will be made available directly to the patient, something that was not possible in the past. Doctors often write down their real thoughts about the patient in there and can say some things the patient might not be happy with.”
Just when you thought American healthcare couldn’t get worse, our genius leaders have decided to couple full and immediate patient access to medical notes with frequent patient surveys about their doctor’s visits. Did a patient request unnecessary antibiotics and you refused? Ouch, that’s going to hurt your survey results and possibly impact your future earnings. Oh also, they read through your visit note and saw that you added “obesity” to their problem list since their BMI puts them in that category and you wanted to make sure they were screened appropriately for diabetes and heart disease at their next visit. The patient finds this very offensive and has requested to meet with the practice manager about the situation.
Re: Patients can now access all their health records digitally
#45Earlier quoted context omitted.
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance... > Individuals’ Right under HIPAA to Access their Health Information 45 CFR § 164.524 > Timeliness in Providing Access > In providing access to the individual, a covered entity must provide access to the PHI requested, in whole, or in part (if certain access may be denied as explained below), no later than 30 calendar days from receiving the individual’s…
One of my kids' doctors left their practice, and we followed them to the new. The old practice sent us a letter stating patients were not permitted to do so, and they refused to provide records citing a non-compete. (I had more than one sweary phone call with them over this.) HIPAA has no private right to civil action in these scenarios, so we had to involve the state, and that process took about six months. It's def…
What was it specifically about this doctor that you found it worth to get the state involved? Just curious.
Re: Patients can now access all their health records digitally
#46Earlier quoted context omitted.
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.
Requested but never received, they were sorta like “oh nobody ever asks for those”
Re: Patients can now access all their health records digitally
#47I 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…
That solution assumes everyone has digital skills. The people who most heavily consume medical services are usually older, poorer, disabled, and on the wrong side of the digital divide. Many people lack health literacy or even literacy. How would this scheme even handle forgotten passcodes or device theft?
Vendor lock in and giving a trillion dollar corporation the keys to your health record is a bad idea.
Re: Patients can now access all their health records digitally
#48I 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…
For the "unconscious patient in the emergency room without a working phone" situations, put an RFID tag or a printed QR code in the hospital admission armband, then the doctor / nurse can scan it to enter records from their own device.
Those records go onto the hospital's / practice's server, then when the patient wakes up / next of kin arrives and they find / charge their phone, they enroll by an app that generates a private key on the device, then shows the public key in QR code form. Nurse scans the QR code on their device and signs off on a dialog box that says "Yes I verified the person with this phone has the right to this patient's records," then the server lets the app authenticate and get the records.
The API should be open source so if you want your records, you can hack some JSON, sign an API request with your private key and download it (maybe with jigdo or rsync or something if it's huge X-rays and 3D CAT scans and stuff?). A third party app can put it on your phone for you, but hopefully there will be regulatory stuff that tries to make barriers to consolidation to encourage the system to remain federated.
I.e. regulations should try to make sure your medical history stays within the offices of primary physician / specialist / hospital where you're a patient, and your phone's local storage. But we really don't want some "too big to fail" medical data startup putting ten million people's medical records in one AWS bucket.
Re: Patients can now access all their health records digitally
#49I 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…
Non-emergency intake procedures would be a great point in the workflow to get the authorization handshake out of the way.
In emergency situations, getting medical records isn’t even a guarantee, today.
If all a paramedic had to do was plug in a dead phone and wait 15 minutes to get access to medical records that would otherwise require potentially hours and fax machines, it might be a tic in the acceptability matrix, there.
Using the device to manage your data, with whatver access controls you are allowed, doesn’t necessitate that the data be solely stored on the device.
Using notifications and other operating system functions ought to cover a wide variety of workflow needs. The device would be able to take the place of any signature machines, on-premises, for example.
Finally, as it is today, you can configure iOS and watchOS to display emergency medical information even while locked. Let alone any future enhancements that could really make a dent in the overall healthcare software ecosystem.
edit: how environmentally sustainable it is to make 7+ billion iPhones, is a different topic though
Re: Patients can now access all their health records digitally
#50One 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. A…
It is a big problem. It's unrealistic to expect patients to have access to a DVD ROM drive, let alone the know-how to use any of the software mentioned