How Did Our Medical Notes Become So Useless? • Hacker News Board

Re: How Did Our Medical Notes Become So Useless?

#151

Post by tempestn » Sat, Jan 05, 2019, 3:48 AM UTC

davycro wrote: post #55

dvtrn wrote: post #19

Earlier quoted context omitted.

every time I've done it the response is always defensive, ie "why do you need them" I was asked this once after requesting mine. I flatly said "I don't", and waited. The person on the other end of the line was clearly thrown off by this, probably expecting something they could dish out a canned response to, hoping I'd give up. It was obvious from their voice they were scrambling for what to say to that. A bit of rigm…

I encourage patients to read or listen to me dictate my note about them during our exam. Often they catch something that I had misinterpreted.

That's a great idea! Simple and sounds very effective.

Re: How Did Our Medical Notes Become So Useless?

#152

Post by tempestn » Sat, Jan 05, 2019, 3:52 AM UTC

dvtrn wrote: post #113

tivert wrote: post #70

Earlier quoted context omitted.

> In the US you're legally entitled to your medical records too but every time I've done it the response is always defensive, ie "why do you need them" Whenever I've been asked, I just say "I want them for my files," and I've had no problems. Sometimes questions like that could actually be an attempt to be helpful. For instance to send along only the needed records rather than a fat file full of extraneous info or sa…

Sometimes questions like that could actually be an attempt to be helpful. This is my thinking, annoying as it can be-I understand and can appreciate this position. It's possibly a matter of how that help is intended to be delivered. "Why do you need the files?" versus "Is there something about your last visit you have questions about/do you have a follow up question for your doctor?" etc. I mention this because when…

I agree that it could be handled more delicately, and that doing so would probably be more fruitful (and just more pleasant). I'm not sure it's none of the creditor's business why a payment was late though. It's certainly in their interest that payments be made on time, and to have the ability to estimate the likelihood that future payments will be late. Given an obligation to pay an amount by a given date, it doesn't seem completely unreasonable for an explanation to be requested if the amount isn't paid.

Re: How Did Our Medical Notes Become So Useless?

#153

Post by fencepost » Sat, Jan 05, 2019, 3:58 AM UTC

rhcom2 wrote: post #10

arielweisberg wrote: post #3

Medical notes are largely fiction IME. You should request all your medical records from any doctor you have seen and start demanding they correct them. You will be shocked at the lies they tell about you. You will be even more shocked down the road when you find out how these lies can hurt you.

In the US you're legally entitled to your medical records too but every time I've done it the response is always defensive, ie "why do you need them", "send me the doctors information and I'll fax it to them myself".

This may actually be financial. The rules vary by state, but most states allow practices to charge copying fees (even though they're generally no longer copying paper charts).

I think those are regularly charged if records are being obtained for legal reasons (e.g. drug/equipment manufacturer lawsuits) but are generally not charged if records are being sent to a new provider. Copies for personal use/records are probably on a per-provider basis.

Re: How Did Our Medical Notes Become So Useless?

#154

Post by fao_ » Sat, Jan 05, 2019, 4:23 AM UTC

ambicapter wrote: post #77

katbyte wrote: post #71

Earlier quoted context omitted.

I dissagree. If I have some sensitive medical history and I go in for stitches or some other minor thing with an random doctor I might not want to share all my medical history. It’s my history and I should have the right to control who sees it.

You are not a medical professional and the list of medical procedures or remedies that interact poorly with each other is long and full of unexpected things.

While this is true, knowledge of other treatments can in a number of cases actually harm the patient as well through malpractice.

See: https://journals.tdl.org/jrwg/index.php/jrwg/article/view/97

https://www.dailydot.com/irl/trans-broken-arm-syndrome-healt...

https://www.pinknews.co.uk/2015/07/09/feature-the-dangers-of...

https://www.reuters.com/article/us-britain-lgbt-health/briti...

Sure this is a minority, but it still harms people.

Re: How Did Our Medical Notes Become So Useless?

#155

Post by userbinator » Sat, Jan 05, 2019, 4:31 AM UTC

theseatoms wrote: post #49

nradov wrote: post #31

Earlier quoted context omitted.

Support the OpenNotes movement. Patients have a legal right to view their records (with some limited exceptions). But it needs to be easy and happen by default rather than as a special request. https://www.opennotes.org/

Forget "view". I want to own my records. It's my personal data that I've enlisted a professional to gather on my behalf.

Once you view, you will own.

(Or so many years of experience with DRM says ;-)

Re: How Did Our Medical Notes Become So Useless?

#156

Post by tdeck » Sat, Jan 05, 2019, 4:36 AM UTC

Here's a fun thing about our system in the US. If you're taken to the emergency room, they'll ask your medical history. And not just once - they'll ask it in the ambulance, radio it ahead to the hospital, then make you wait while they ask you the same questions again and enter them into their system at the hospitsl. Then the next 3 doctors or nurses who come into your room do the same thing, asking you questions you've already answered. Doesn't seem to matter if it's obvious that speaking is painful for some reason (in a case I'm describing a family member had broken ribs).

Re: How Did Our Medical Notes Become So Useless?

#157

Post by Spooky23 » Sat, Jan 05, 2019, 4:39 AM UTC

tdeck wrote: post #156

Here's a fun thing about our system in the US. If you're taken to the emergency room, they'll ask your medical history. And not just once - they'll ask it in the ambulance, radio it ahead to the hospital, then make you wait while they ask you the same questions again and enter them into their system at the hospitsl. Then the next 3 doctors or nurses who come into your room do the same thing, asking you questions you'…

Then the ass in the insurance cart has to do their thing. My wife almost bled out on the table when one of these idiots was literally blocking the medical people. I physically removed him from the area and almost got arrested.

Re: How Did Our Medical Notes Become So Useless?

#158

Post by Spooky23 » Sat, Jan 05, 2019, 4:41 AM UTC

giobox wrote: post #136

goldcd wrote: post #5

In (the UK at least) your medical notes follow you as you sign on with a new GP (General Practitioner - first point of medical contact for anything non-urgent). Now knew this theoretically happened, but was quite bemused to see it happen in practice. I rescued a rat from the silken-jaws of my pseudo-homicidal cat, and the ungrateful rodent bit through half of my finger - I thought it would be sensible to have a check…

I'm not entirely convinced the UK/NHS should ever be used as a good example for handling medical notes, at least by today's standards. As a Brit who left the UK a while ago, I recently had cause to request my "medical records" from my former GP. Of course such data can presumably be requested via the UK's Data Protection Act, but the lack of any kind of standard process or checks really shocked me, given the care the…

Don’t worry, US medical practices will give you a big show about doing anything in the name of HIPPA.

Rest assured, it is a show, and most of your information is fed in real time to a half dozen different entities whom you have never heard of. The people who sell prescription data provide it to the pharma company before your insurer even gets the claim.

Re: How Did Our Medical Notes Become So Useless?

#159

Post by arkades » Sat, Jan 05, 2019, 4:44 AM UTC

tdeck wrote: post #156

Here's a fun thing about our system in the US. If you're taken to the emergency room, they'll ask your medical history. And not just once - they'll ask it in the ambulance, radio it ahead to the hospital, then make you wait while they ask you the same questions again and enter them into their system at the hospitsl. Then the next 3 doctors or nurses who come into your room do the same thing, asking you questions you'…

We do this for a reason. Not only do different people ask specific questions that try to elicit different things, but patients stories evolve with each repetition. People don’t realize how much, but by the third time you’re getting that history, the picture is usually quite different from what the first history depicted.

And since history is 90% of diagnosis, this isn’t some little quirk. It plays a huge role in helping patients. Huge.

Re: How Did Our Medical Notes Become So Useless?

#160

Post by Spooky23 » Sat, Jan 05, 2019, 4:46 AM UTC

ambicapter wrote: post #86

drb91 wrote: post #81

Earlier quoted context omitted.

Your profession should not dictate your rights to your data.

No one is stopping you from accessing your data. The question is to whether you should be able to stop your doctor (or your emergency doctor) from accessing your medical data. Sounds like a bad idea.

The real question that matters most in the ER is “What is your date of birth?”