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Old 10-08-2008, 02:39 PM
 
Location: NY
1,416 posts, read 4,897,895 times
Reputation: 588

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Both Presidential candidates have stated that as part of their healthcare reform ideas they favor the creation of a 'computerized' or 'online' medical database for patients. Although I've yet to see any studies setting forth exactly how such a database would reduce the cost of medical care and/or insurance to any appreciable degree, both are touting this item as something important. So let's assume for a moment that they are correct in claiming that a centralized medical-records database will ultimately save the general public money in the end (I know... it's a big stretch .... but just for the sake of argument ).

I'm assuming (and again I haven't seen any details on such a plan anywhere) it would resemble the insurance-claims database that many if not most auto and home insurers access, letting them find out the claims history of any prospective customer to see what their loss history is. I'm also assuming that doctors would pay a fee for the use of the 'Patient History Database'. But here's where I have lots of questions:

When someone goes to a doctor or a hospital, would he be given the choice of whether or not the information about his visit or stay or procedures or prescriptions written, be submitted to the Patient History Database? In other words could a patient 'opt out' and say 'No I don't want this very personal information shared with anyone outside of this office, or my insurance company' (if they are insured)?

If someone does allow (or if patients don't have the option to refuse) their records to be put into the database, will he be able to control who has access to the information? Perhaps by giving written permission or a specific access code that Doctor Jones could use, but Doctor Smith could not. Or will it be a case of once the info is in the database, anyone with a subscription to the database will be able to access any patient's records at any time?

As you can see I have serious qualms about this Patient History Database concept. For one thing it smacks too much of Orwell's '1984'. And we all know how many times we hear about credit card records, bank records, stock account records etc being breached; NO large database can ever be completely secure all of the time. So my question for discussion is:

Do you believe that the creation of a Medical History Database would have enough of a positive effect on our current healthcare mess to justify any concerns about individual privacy that may arise?
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Old 10-08-2008, 05:57 PM
 
Location: Fredericksburg, Va
5,119 posts, read 12,713,147 times
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I don't see how that would reduce costs--a doctor will still need that manila file that they attach to your examining room door!
I don't know what the solution is to the rising cost of medical treatment, but I don't think EITHER candidate is on the right track.

You know, a bandaid shouldn't cost $10 at a hospital! If they set the prices more reasonably, more folks could actually PAY for their care! (What a novel idea!!)
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Old 10-08-2008, 06:52 PM
 
13,779 posts, read 23,205,335 times
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Quote:
Originally Posted by cb at sea View Post
I don't see how that would reduce costs--a doctor will still need that manila file that they attach to your examining room door!
I don't know what the solution is to the rising cost of medical treatment, but I don't think EITHER candidate is on the right track.

You know, a bandaid shouldn't cost $10 at a hospital! If they set the prices more reasonably, more folks could actually PAY for their care! (What a novel idea!!)
I cannot imagine how this would reduce costs either...it would help doctors and pharmacists detect doctor "shopping" , patients with memory issues, etc. but reducing costs, I doubt it.

Something else to consider is the complete HIPPAA violation of a huge database. Confidentiality would be difficult to uphold with so many having access.
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Old 10-10-2008, 03:55 PM
 
Location: a nation with hope
13,155 posts, read 16,871,109 times
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There are databases already. Every time you apply for life insurance that information - all of it, especially your health information, the medicines you take, etc. - gets fed into a database that all life insurance companies can access.

HIPPAA doesn't really provide you much protection (IMHO) as you will see if you read it carefully and digest the terms thoughtfully. The medical establishment you are visiting reserves the right to use your information in myriad ways - marketing, teaching, databases, whatever can be construed to fall under the guidelines spelled out, and it's hard to see how all of these uses are of direct value to the patient.
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Old 10-10-2008, 04:05 PM
 
13,779 posts, read 23,205,335 times
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Quote:
Originally Posted by southward bound View Post
There are databases already. Every time you apply for life insurance that information - all of it, especially your health information, the medicines you take, etc. - gets fed into a database that all life insurance companies can access.

HIPPAA doesn't really provide you much protection (IMHO) as you will see if you read it carefully and digest the terms thoughtfully. The medical establishment you are visiting reserves the right to use your information in myriad ways - marketing, teaching, databases, whatever can be construed to fall under the guidelines spelled out, and it's hard to see how all of these uses are of direct value to the patient.
HIPPAA is a PITA, in my opinion. When insurance is applied for, the company takes the applicants word for accuracy but in the fine print they reserve the right to contact other insurers and health care providers.

I was the HIPPAA complaint manager in my husbands practice for a while(legally all practices has to have someone in charge of this) and I had a mouse trap on my door and a sign that said "For assistance please push button" and there was an arrow pointing to tht base of the trap

But a government data base would be sketchy, to say the least. Not much better than the Patriot Act fiasco.
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Old 10-10-2008, 04:53 PM
 
Location: NY
1,416 posts, read 4,897,895 times
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Quote:
Originally Posted by southward bound View Post
There are databases already. Every time you apply for life insurance that information - all of it, especially your health information, the medicines you take, etc. - gets fed into a database that all life insurance companies can access.
I didn't know that; but it doesn't surprise me much. I don't have (never had) life insurance but my SO does. He has a whole-life policy that he took out about, hm, 10 years ago I think. So in other words, when he went for the doctor's exam and blood/etc. tests they required at that time, the results got put into the life-insurance database? But that was a one-time thing, correct? He hasn't had to give them any information since then.

I know that nowadays whenever one goes to a doctor, one is given Privacy Forms to sign. I never authorize release of any information to any third party (I have no health insurance so that's not a factor). In other words I don't authorize any sharing of my medical or personal info. I also do NOT EVER give my social security number even though almost all doctor's forms ask for it; I'm fully aware that only certain entities have a right to demand that number and that doctors and hospitals do not fall into that category. Yet I'm sure many people have no clue that they can refuse divulge their SS# and merrily write it in without a second thought. Scary stuff, in this age of identity theft problems!
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Old 10-10-2008, 05:09 PM
 
Location: Moon Over Palmettos
5,975 posts, read 17,139,378 times
Reputation: 4989
Quote:
Originally Posted by southward bound View Post
There are databases already. Every time you apply for life insurance that information - all of it, especially your health information, the medicines you take, etc. - gets fed into a database that all life insurance companies can access.

HIPPAA doesn't really provide you much protection (IMHO) as you will see if you read it carefully and digest the terms thoughtfully. The medical establishment you are visiting reserves the right to use your information in myriad ways - marketing, teaching, databases, whatever can be construed to fall under the guidelines spelled out, and it's hard to see how all of these uses are of direct value to the patient.
I'm not sure this is entirely accurate. It is true that each time you visit a provider, your record is entered into the provider's database. None of that is shared with other providers unless you sign it off. Companies do not share information about its members...that is proprietary as well as competitive information. When insurance company employees perform studies that use member information, each member is assigned a member ID. In fact the member ID is a database index field that more often than not, changes each month, making it difficult, though not impossible, to "follow" treatment episodes for that member. It takes a certain level of security for an insurance company employee to gain access to member name and identifiers such as SSN's. Systems are set-up to hasten and automate claims processing, document diagnoses and treatment plans, and minimize human intervention and the possibility for error which leads to reprocessing. Decreasing processing time saves on personnel, equipment and materials costs. The more claims are auto adjudicated, the less expensive the process is. System enhancements can be set in place to be able to identify fraud, both from the claimant and provider side. Fraud constitutes a large part of medical cost. Insurance company employees are not allowed to save patient information on hard-drives of computers. At one insurance company, an employee whose laptop was stolen from a car broken into was terminated for having patient information in there.
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Old 10-11-2008, 06:17 AM
 
Location: a nation with hope
13,155 posts, read 16,871,109 times
Reputation: 5009
You are correct about the Social Security number. There is a limited list of agencies that can legally ask for that number. However, these days, if you have medical insurance coverage there's really no way you can avoid giving your SS# because that is how the claim is commonly identified when it is submitted. That number follows us everywhere. I suspect that, even if you don't sign off on the HIPPAA, you have no way of ever knowing what they do with your information. And if you sign it, and later change your mind for any reason, you have to notify a specific person, in writing, that you are withdrawing your permission. I personally don't know why someone would have a change of mind except perhaps as a stickler "on principle".)
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Old 10-11-2008, 10:30 AM
 
Location: Somewhere in northern Alabama
16,841 posts, read 51,286,023 times
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I hate the way our government is going. It seems to have been infiltrated with those crabby old teachers that used to say "That will go on your permanent record, young man."

My grandmother was born without a birth certificate or social security number, my mother had a birth certificate but no social security number at birth, and wasn't required to have shots. Contrast that to now. Kids born today are being born into cogs in the machine. The STATE now requires handprints, footprints, social security number, and certificates of live birth, so the others can recognize they have been deemed to be a real person by some authority figure working within the system. Then they have to have a series of shots that prevent them from getting diseases, not so that THEY will be safe, but so that the people they come in contact with will be safe. Parents can get a child "registered" and photographed for a "lost child" database, which can then be circulated on milk cartons, and eventually used by law enforcement to have a photo album of criminal offenders.

Do we really need another database; one that tells the "authorized" world how many hemorrhoids we have had in our lives, or that our eyes crossed as a kid when we farted?

How about we require all congresscritters and elected officials to be spayed or neutered instead?
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Old 10-12-2008, 12:09 AM
 
2,141 posts, read 7,035,617 times
Reputation: 1245
I think it's a con and think the information will be used against people by insurance companies and others who have access to it. Even if the data is protected, anything on a computer is vulnerable. Someone will eventually try to find a loophole to sell the information. Unless we have completely socialized medicine, which we won't. the healthcare industry, like all others, is for profit and someone, one day will find a way to profit from the database.
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