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How Did Our Medical Notes Become So Useless?

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Re: How Did Our Medical Notes Become So Useless?

#21

Post by [deleted] »

jlamberts wrote: post #8
petermcneeley wrote: post #7

Medicine seems like a technological wasteland. They put "notes" into text boxes and call it "using computers". I wish I had both CS/SE experience and Medical experience so that I could understand what keeps this field in the 1970s. I have suspicions.

In my experience, it's a combination of a couple of things. First off, the field is heavily regulated (in the US anyway) and the penalties for violating regulations like HIPAA are incredibly high. Second, the field is currently dominated by major players such as Epic, so its pretty important to be compatible with them, but they don't really have an incentive to open up their ecosystem since they have such a strangleh…

[deleted]

Re: How Did Our Medical Notes Become So Useless?

#22

Post by isaacdl »

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 is interesting, and I didn't know it! Does it include everything (doctor's notes, etc.), or just whatever your doctor/organization wants to include in your "official" medical record?

I'd like to do this myself, but I want to understand what I'm actually entitled to so I can be prepared if they push back.

Re: How Did Our Medical Notes Become So Useless?

#23

Post by limeblack »

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".

Same experience. Try requesting through a Psychologist or case worker I have had success with that.

Re: How Did Our Medical Notes Become So Useless?

#24

Post by yumraj »

My kids' pediatrician was part of a small office, which merged with a larger office that is affiliated with a large hospital and hence uses EPIC. She used to take hand notes on paper and was quiet efficient when she was with the smaller office. After the move I have seen her struggle with EPIC, and then recently hire a medical transcription service and be followed by a person taking notes so that she can focus on the medical stuff. And, of course I have no idea if the quality of her notes has suffered.

Re: How Did Our Medical Notes Become So Useless?

#25

Post by aschneid »

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".

At Kaiser, you just have to walk into any member services office and request. It doesn't happen right then, but I believe in a few days you get a thumb drive with all of your records on them.

However, the law allows the doctors to redact certain portions in your copy that they feel could be harmful to you.

Re: How Did Our Medical Notes Become So Useless?

#26

Post by ryandrake »

dvtrn wrote: post #19
rhcom2 wrote: post #10

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", "send me the doctors information and I'll fax it to them myself".

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…

Why would they be so hesitant? Surely it’s not that extra work for an office admin to pull something up and hit “print”.

Re: How Did Our Medical Notes Become So Useless?

#27

Post by notabee »

qrbLPHiKpiux wrote: post #17

Doc here - spot on. 25% of my day is typing, reading, deciphering, referencing. I waste so much time not providing care.

I just want to say that I'm happy to see one of y'all on here. If doctors and engineers were to collaborate together directly to fill in each others' domain knowledge gaps instead of buying crap software from companies with poor incentives, some truly amazing things could happen.

Re: How Did Our Medical Notes Become So Useless?

#28

Post by agumonkey »

petermcneeley wrote: post #7

Medicine seems like a technological wasteland. They put "notes" into text boxes and call it "using computers". I wish I had both CS/SE experience and Medical experience so that I could understand what keeps this field in the 1970s. I have suspicions.

A blend of regulation and complex sensitive domain.. the medical field tried a few time going computerized, it failed badly. Half because of project management issue, half because of the field itself .. I think there should be a dedicated CS staff to grow solution cheap and on the fly rather than large upfront monolith that will fail to actually deliver value to patients and employees

Re: How Did Our Medical Notes Become So Useless?

#29

Post by stevekemp »

aschneid wrote: post #25
rhcom2 wrote: post #10

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", "send me the doctors information and I'll fax it to them myself".

At Kaiser, you just have to walk into any member services office and request. It doesn't happen right then, but I believe in a few days you get a thumb drive with all of your records on them. However, the law allows the doctors to redact certain portions in your copy that they feel could be harmful to you.

1-2 years after moving to Finland I had a brain-scan done, and the doctor involved told me I could get a copy of the data if I was interested.

In the past I worked at a medical company, so I was familiar with the joys of DICOM, etc. I paid €20 for a copy of my own brain-scan data on CD-ROM, posted to my house.

Pretty mind-blowing to have access to a scan of my own brain (well blood-vessels at least) on my home PC.

Re: How Did Our Medical Notes Become So Useless?

#30

Post by jermaustin1 »

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…

That's amazing.

I guess, in the US, we only started tracking patients recently. I had to call and have my old records faxed from my old GP in Texas to one in New Jersey, and then again from that GP to my NEWER one in New York. Earliest record was from when I was 7, since neither my mother or I remember who my pediatrician was before then.

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