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Old 10-15-2008, 03:22 PM
 
Location: NY
1,416 posts, read 4,898,658 times
Reputation: 588

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Quote:
Originally Posted by TristansMommy View Post
I'm talking a swipe card or a chip on a keychain type of thing. .... Of course, because people can loose things there would have to be more than one that the exists, possibly in the possession of your physician. ..... Although we'd have to make sure that it was all on a secure network...
My problem with a system such as this would start with whether it was mandatory. If people want their personal health information stored on an accessible mass database, and it's THEIR CHOICE to do so, then fine. But for patients to be given no choice in the matter of if, or what, such information is put in, and/or to have no control over which healthcare providers can access it afterward ..... I simply don't have that much faith in ANY system working that well.

IMO there is no such thing as a truly secure network.

Also here's another wrinkle: In a mass database, the more people you have inputting information, the greater the probability of screwups. In such a system, there would absolutely need to be some provision for the patient him/herself to access it to make sure that there were no mistakes (like we now have the right to a free copy of our credit reports once a year). In our credit reports, if we see a mistake we are able to have it corrected; but how many people would be able to really see and understand whether something some doctor or PA or medical clerk inserted into their record was a mistake or not? Or whether that prescription really was written for THEM and not for some other patient whose ID number was one digit different (oops, dyslexia strikes again!!)? Suppose Joe Jones' prescription for antidepressants got accidentally coded into John Smith's database instead, and eventually John Smith applied for medical or life insurance, that Rx got picked up, and John either got turned down or had to pay more than he otherwise should have done in premiums? Would John even have caught the mistake if he did have the right to review what's in his database file?

Without massive controls and continual oversight, plus unlimited review access by the patient himself, IMO such a database would cause as many (or more) problems than it would solve. And any such system should definitely be voluntary, not mandatory.
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Old 10-15-2008, 04:04 PM
 
Location: Pennsylvania, USA
5,217 posts, read 4,111,845 times
Reputation: 908
Quote:
Originally Posted by totallyfrazzled View Post
My problem with a system such as this would start with whether it was mandatory. If people want their personal health information stored on an accessible mass database, and it's THEIR CHOICE to do so, then fine. But for patients to be given no choice in the matter of if, or what, such information is put in, and/or to have no control over which healthcare providers can access it afterward ..... I simply don't have that much faith in ANY system working that well.

IMO there is no such thing as a truly secure network.

Also here's another wrinkle: In a mass database, the more people you have inputting information, the greater the probability of screwups. In such a system, there would absolutely need to be some provision for the patient him/herself to access it to make sure that there were no mistakes (like we now have the right to a free copy of our credit reports once a year). In our credit reports, if we see a mistake we are able to have it corrected; but how many people would be able to really see and understand whether something some doctor or PA or medical clerk inserted into their record was a mistake or not? Or whether that prescription really was written for THEM and not for some other patient whose ID number was one digit different (oops, dyslexia strikes again!!)? Suppose Joe Jones' prescription for antidepressants got accidentally coded into John Smith's database instead, and eventually John Smith applied for medical or life insurance, that Rx got picked up, and John either got turned down or had to pay more than he otherwise should have done in premiums? Would John even have caught the mistake if he did have the right to review what's in his database file?

Without massive controls and continual oversight, plus unlimited review access by the patient himself, IMO such a database would cause as many (or more) problems than it would solve. And any such system should definitely be voluntary, not mandatory.

I would say it would haev to be by choice, simply because i believe older generations would be opposed

As for a bunch of people "inputing" information.. how would that be? The doctor would be inputing the information.. no different than how he inputs information into your chart. The inputting of information I was referring to by office staff is the insurance information.. like what labs the patient can use based on their coverage, pharmacy, and where the billing goes etc etc.

As for accuracey.. I believe that inputing the information in a digital chart is far more efficient than handwriting on a chart. Have you ever tried to read a doctors handwriting. What if a doctor mis interprets the handwriting of another doctor, etc that is on a chart?

Also.. why does the digital information have to be on a "database" with ALL your information on this database? YOUR informationis stored on YOUR chip card that the doctor has.. similar to a paper file, only on a digital chip. The NETWORK I was referring to is from that digital clipboard the Dr. can then send the information for the billing directly to the insurance company via that chart.. NOT your entire medical file, but the billing for that day.. which would be sent via paper anyway.
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Old 10-15-2008, 04:09 PM
 
Location: Santa Monica
4,708 posts, read 7,561,052 times
Reputation: 1023
There already exists a very large database that catalogs claims against private health insurance providers. It is run by a company named Medical Information Technology ("Meditech") out of a facility in Westwood, Massachusetts.

MEDITECH - Medical Information Technology, Inc.

Boston Business Journal: Medical Information Technology Inc related content
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Old 10-15-2008, 04:12 PM
 
Location: Pinal County, Arizona
25,107 posts, read 34,361,805 times
Reputation: 4893
A doctor who has 100's of patients would not maintain a "chip" on each patient - the odds of loss are tremendous.

Putting information on a central database, maintained by the doctor, that could given to the patient on, say a thumb drive, might be feasible.

There would have to be a central source that could be backed up - a "chip" would be insufficient -

Doctors will not transcribe onto a database - that is what medical transcriptionists do now - A Doctor might dictate - but will not type -

Same with scripts - many doctors will tell their staff to write the script for the patient - then the doctor will sign it

ANYTIME data is put on a computer of any type though - it is open for hacking.
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Old 10-15-2008, 04:14 PM
 
Location: Pennsylvania, USA
5,217 posts, read 4,111,845 times
Reputation: 908
Quote:
Originally Posted by ParkTwain View Post
There already exists a very large database that catalogs claims against private health insurance providers. It is run by a company named Medical Information Technology ("Meditech") with a facility in Westwood, Massachusetts.

MEDITECH - Medical Information Technology, Inc.

Boston Business Journal: Medical Information Technology Inc related content

I would imagine there would be.. since there are no laws insome states to protect those seeking insurance against discriminaiton based on pre-existing conditions. Your insurance company knows what you have/had or didn't have based on tests, exams or prescriptions.

It's the general public like employers or your neighbor that can't access taht information .. as it could be used to discriminate against you in employment etc.
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Old 10-15-2008, 04:20 PM
 
Location: Pennsylvania, USA
5,217 posts, read 4,111,845 times
Reputation: 908
Quote:
Originally Posted by Greatday View Post
A doctor who has 100's of patients would not maintain a "chip" on each patient - the odds of loss are tremendous.

Putting information on a central database, maintained by the doctor, that could given to the patient on, say a thumb drive, might be feasible.

There would have to be a central source that could be backed up - a "chip" would be insufficient -

Doctors will not transcribe onto a database - that is what medical transcriptionists do now - A Doctor might dictate - but will not type -

Same with scripts - many doctors will tell their staff to write the script for the patient - then the doctor will sign it

ANYTIME data is put on a computer of any type though - it is open for hacking.
GreatDay..

First.. prescriptions can now be entered into a portable handheld device and sent directly to your pharmacy without one ounce of paper changing hands. My son's pediatrician does exactly that. And one of my doctor writes the script on his handheld right there and it goes from whatever room he's in to his printer where he goes and picks it up and hands it to me.

As for maintaining a "chip".. LOL.. um.. do not doctors maintain pages and pages and pages and pages of files on each and every patient.. Ever see those sliding walls and walls of files.

Also.. when a doctor sits with you in a room, they make notations on your chart of their findings.. I've never had not one doctor NOT write down their findings in my check up.. they weren't walking around with a tape recorder tape recording my office visit. NO.. they were writing down things.. and the nurse did too including my blood pressure.n etc etc . I'm saying substitute a paper clipboard at ever door with a walking hand held digital "clipboard" with all the patients digital files loaded for the day and instead of entering information on a sheet of paper they would just enter it right there on teh "digital " paper. And GreatDay.. there are laptops now that you don't actually have to type, you can write right there on the screen that converts to text in digital format.

It's not impossible and will probably happen in the future..it's called modernization.

As for "network".... the Doctors office doesn't have to have your files connected to the internet or accesable to the internet.. just the internal network.


The "chip" by the way, is more of a thing the patient can carry in case of an emergency.. and while your at the doctors office getting your check up, your chip can have the most recent information uploaded onto it for you to have your medical records for you.
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Old 10-15-2008, 04:31 PM
 
13,779 posts, read 23,208,064 times
Reputation: 7378
There is already such a chip...it is sort of like a USB drive and they have a loop like a key chain. They are very expensive and you would have to go ot a doctor that has the software capabilities to read it.
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Old 10-15-2008, 04:37 PM
 
Location: Pinal County, Arizona
25,107 posts, read 34,361,805 times
Reputation: 4893
Quote:
Originally Posted by TristansMommy View Post
First.. prescriptions can now be entered into a portable handheld device and sent directly to your pharmacy without one ounce of paper changing hands.
Great.
May be impractical in many cases

Quote:
Originally Posted by TristansMommy View Post
As for maintaining a "chip".. LOL.. um.. do not doctors maintain pages and pages and pages and pages of files on each and every patient.. Ever see those sliding walls and walls of files.
Sure I have seen the sliding walls. Ever have a hard drive crash? Or, a thumb drive get demagnetized?

The "chips" are a potential liability (IMO) to the physician. Entering information on the office database would be more secure and more easily backed up. It would also allow for scanning of documents sent to your physician (test / lab results, personal correspondence) without having to access "the chip".

Quote:
Originally Posted by TristansMommy View Post
Also.. when a doctor sits with you in a room, they make notations on your chart of their findings.. I've never had not one doctor NOT write down their findings in my check up..
My physician actually records her visits with me - her transcriptionist takes the information off and transcribes it

Quote:
Originally Posted by TristansMommy View Post
And GreatDay.. there are laptops now that you don't actually have to type, you can write right there on the screen that converts to text in digital format.
I understand this as I use one. The dang thing screws up the conversion of my writing all the time though!

Quote:
Originally Posted by TristansMommy View Post
As for "network".... the Doctors office doesn't have to have your files connected to the Internet or accessible to the Internet.. just the internal network.
Yes, you are correct - many use an internal network. But, as has been pointed out to you, there are Internet based network servers - that are used by many physicians for the very services we are discussing here.

Quote:
Originally Posted by TristansMommy View Post
The "chip" by the way, is more of a thing the patient can carry in case of an emergency.. and while your at the doctors office getting your check up, your chip can have the most recent information uploaded onto it for you to have your medical records for you.
Great.

BTW, ever have your photographs lost on your digital camera going through Airport screening???
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Old 10-15-2008, 04:53 PM
 
Location: Pennsylvania, USA
5,217 posts, read 4,111,845 times
Reputation: 908
Quote:
Originally Posted by Greatday View Post
Great.
May be impractical in many cases

And in what case is a dr sending your script directly to your pharmacy impractical. By the time I leave the Dr.'s office and get to the pharmacy my script is filled!



Sure I have seen the sliding walls. Ever have a hard drive crash? Or, a thumb drive get demagnetized?

Yes.. and that's why you always back up your hard drive

The "chips" are a potential liability (IMO) to the physician. Entering information on the office database would be more secure and more easily backed up. It would also allow for scanning of documents sent to your physician (test / lab results, personal correspondence) without having to access "the chip".


Office database .. that's what I"m talking about? INternal network is simply referring to all the computers in the office talking with one another accessing each others information and the printers..has nothing to do with the internet.


My physician actually records her visits with me - her transcriptionist takes the information off and transcribes it

Well.. great for your physician. I've been to MANY doctors in my lifetime and not ONE has recorded my visit on a tape recorder..


I understand this as I use one. The dang thing screws up the conversion of my writing all the time though!

Yeah.. and so can recording of transcription.. so perhaps inthis case a transcriptionist can check the accuracy of the entry same as if it were recorded.. and btw.. I agree the technology would need to get better and improve. We are talking hypotheticals here and talking future.. not today and not tommorrow. By the time the entire thing would be implemented across the board I'm sure we'll be far more technologically advanced.

Yes, you are correct - many use an internal network. But, as has been pointed out to you, there are Internet based network servers - that are used by many physicians for the very services we are discussing here.

Yeah..and governments and credit cards all use that too. There is a risk in it all..but of course precautions would have to be taken...



Great.

BTW, ever have your photographs lost on your digital camera going through Airport screening???
No.. never had that happen. But in the future , now knowing that can happen, I will upload all my information onto my laptop and internet photo storage before I go through security. Thanks for the tip!
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Old 10-15-2008, 04:57 PM
 
Location: Pennsylvania, USA
5,217 posts, read 4,111,845 times
Reputation: 908
Quote:
Originally Posted by mrstewart View Post
There is already such a chip...it is sort of like a USB drive and they have a loop like a key chain. They are very expensive and you would have to go ot a doctor that has the software capabilities to read it.

I figured there was one. It wuold be pricey as it's brand new. Given time it will become less expensive .. same as any device.

BTW.. medtronic minimed, who makes my insulin pump now has the technology that send glucose readings to my pump every 5 minutes via subcaneous unit. I have a USB data drive that I plug into my laptop, log into thier website. The USB drive retrieves the data from my pump unit, incuding all the readings from the glucose sensor I wear and all my entries (carbs, etc.) uploads it to the website and breaks it down for me into graphs charts etc to help me monitor my glucose very closely.. trends etc. And my doctor can access it online with my password.. or when I go to the office they can upload the information right from my pump while Im in the office. It's really quite cool!

When the technology gets more frequent and less expenisve I would get one for me and my family. It's nice to have it on you so that all your medical information is there should an accident occurr!
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