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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

#51

Post by 9wzYQbTYsAIc »

supertrope wrote: post #47
9wzYQbTYsAIc wrote: post #28

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…

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.

True, part of what I ponder when the thought arises, is how the government would probably need to claim eminent domain over the whole thing, simultaneously build on the already great accessibility features, and then roll it out with a jobs programs in social services to accommodate everyone that needs accommodations.

Re: Patients can now access all their health records digitally

#52

Post by 9wzYQbTYsAIc »

csense wrote: post #48
9wzYQbTYsAIc wrote: post #28

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…

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…

Indeed, a government built open standard would be ideal, especially if the existing login.gov digital services team was involved in rolling out a hypothetical health.gov

Login.gov seems to be on the right track, architecturally speaking.

Re: Patients can now access all their health records digitally

#53

Post by aabaker99 »

ceejayoz wrote: post #27
toomuchtodo wrote: post #13

Earlier 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…

Im not in a position to produce the section reference right now but the regulation discussed in the comments, 45 CFR, requires providers are able to transfer medical records from the old practice to the new practice.

Re: Patients can now access all their health records digitally

#54

Post by 9wzYQbTYsAIc »

nradov wrote: post #24
dogmatism wrote: post #11

*laughs in hospital still on Meditech "Magic" which is essentially a TUI even sitting at the terminal, I can't get the fucking records I need

Have you looked at the Meditech API documentation? https://home.meditech.com/en/d/restapiresources/pages/apidoc...

Hah, at least they have public API documentation unlike others

Re: Patients can now access all their health records digitally

#55

Post by twelve40 »

conqueso wrote: post #50
solardev wrote: post #40

Earlier quoted context omitted.

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

yeah thanks to Mr Cook for example, if you're on a Mac, no dice.

that said, tfa, while encouraging, has no details as to how this all can possibly happen.

Re: Patients can now access all their health records digitally

#56

Post by getcrunk »

conqueso wrote: post #50
solardev wrote: post #40

Earlier quoted context omitted.

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

yea it was easy for me to figure out as well, but I am not the average person. My parent or sibling wouldnt be able to have done it.

Re: Patients can now access all their health records digitally

#57

Post by renewiltord »

twelve40 wrote: post #55
conqueso wrote: post #50

Earlier quoted context omitted.

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

yeah thanks to Mr Cook for example, if you're on a Mac, no dice. that said, tfa, while encouraging, has no details as to how this all can possibly happen.

I just got an external DVD reader and it worked just fine on my M1 mac

Re: Patients can now access all their health records digitally

#58

Post by mwint »

9wzYQbTYsAIc wrote: post #49
bpodgursky wrote: post #35

Earlier quoted context omitted.

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 have been ~2B iPhones made. Doesn’t seem like a big deal. Not even an order of magnitude.

Re: Patients can now access all their health records digitally

#59

Post by 9wzYQbTYsAIc »

mwint wrote: post #58
9wzYQbTYsAIc wrote: post #49

Earlier quoted context omitted.

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 have been ~2B iPhones made. Doesn’t seem like a big deal. Not even an order of magnitude.

I’m not an economist, but I suspect that the supply curve would adjust pretty drastically to even just a doubling of demand, let alone a quadrupling.

edit: there probably isn’t even enough readily available physical material for that many batteries. for example, consider the projected difficulties with supply side for the upcoming increase in demand for electric vehicle battery material

Re: Patients can now access all their health records digitally

#60

Post by sethammons »

hanklazard wrote: post #44
Dig1t wrote: 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…

“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…

"Patient feels nausea when seeing the color yellow; I have proscribed a placebo to gauge the effect." Not something a doc would want the patient to know.
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