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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

#61

Post by mynameisvlad »

null_flavour wrote: post #37
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…

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.…

None of which a patient, the person who this whole article and comment thread is about, would care about or even understand.

In the age of smartphones and immediate access, it is ancient and hard to work with. It may have benefits, it may be resilient, but none of those are mutually exclusive.

Re: Patients can now access all their health records digitally

#62

Post by mynameisvlad »

aabaker99 wrote: post #53
ceejayoz wrote: post #27

Earlier quoted context omitted.

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.

Their issue wasn’t with the regulation not existing, they knew full well. The problem is that if they refuse, then what? You have no power as an individual to force them to do it.

And as the parent comment said, you have to involve the state and it takes 6 months.

Re: Patients can now access all their health records digitally

#63

Post by srvmshr »

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…

When I was working on MRI data about a decade ago, there was another newer format .NII gaining traction. This was demonstrably easier to work with and the good thing was a lot of views (imagine a time series or fat-water separated information) & could simply be stored in its container format as opposed to Dicom.

I am not sure how well it might work for viewing on patient consoles, but it sure was a step ahead for making data portable.

Edit: NifTI format. I was forgetting the name.

Re: Patients can now access all their health records digitally

#64

Post by [deleted] »

srvmshr wrote: post #63
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…

When I was working on MRI data about a decade ago, there was another newer format .NII gaining traction. This was demonstrably easier to work with and the good thing was a lot of views (imagine a time series or fat-water separated information) & could simply be stored in its container format as opposed to Dicom. I am not sure how well it might work for viewing on patient consoles, but it sure was a step ahead for mak…

[deleted]

Re: Patients can now access all their health records digitally

#65

Post by light_hue_1 »

srvmshr wrote: post #63
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…

When I was working on MRI data about a decade ago, there was another newer format .NII gaining traction. This was demonstrably easier to work with and the good thing was a lot of views (imagine a time series or fat-water separated information) & could simply be stored in its container format as opposed to Dicom. I am not sure how well it might work for viewing on patient consoles, but it sure was a step ahead for mak…

There's no NII format, that's the file extension of a format called NIfTI.

NIfTI is not meant to be a replacement for DICOM. It's meant to be a quick and simple file format only for neuroimaging and only for research. It's missing countless features that are required for clinical use and it stores 3D data. So it's not a good format for xrays, ultrasounds, etc.

Re: Patients can now access all their health records digitally

#66

Post by mikeodds »

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…

The flip side of this is it will let patients catch erroneous note taking which would have a knock on effect for future visits or referrals.

Re: Patients can now access all their health records digitally

#67

Post by rrwo »

mikeodds wrote: post #66
hanklazard wrote: post #44

Earlier quoted context omitted.

“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…

The flip side of this is it will let patients catch erroneous note taking which would have a knock on effect for future visits or referrals.

Yes. I've had this once when moving to a new city and arranging to have my medical records transferred.

My new doctor read the snarky and incorrect internal notes to me.

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