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Medical Records Going Digital - 11/26/2007 2:15:57 PM   
pinksugarsub


Posts: 1224
Status: offline 		Hospitals and medical providers are beginning to shift away from paper records and onto electronic ones for such things as lab results, prescriptions administered, etc.
 
Privacy gurus are raising sand about the possibility that a patient's records could be accessed inappropriately, but i have other concerns:  what replaces the care provider's signature, date and time?  What prevents care providers from altering records in the event of an undesirable outcome?  What happens when a care provider's recollection conflicts with the electronic data?
 
http://www.npr.org/templates/story/story.php?storyId=16612715&ft=1&f=1
 
pinksugarsub

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RE: Medical Records Going Digital - 11/26/2007 2:32:45 PM   
sub4hire


Posts: 6775
Joined: 1/1/2004
Status: offline 		What stops your records from being altered now?  It is pretty common practice for records to just disappear if a death is at all sketchy.  At least in the hospitals I have been involved with in the past. 
I've actually seen it happen...and it has happened to me.

I don't see much of a difference with digital versus paper.  Aside from the fact millions upon billions of tree's may get to keep their lives.

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RE: Medical Records Going Digital - 11/26/2007 3:15:33 PM   
CalifChick


Posts: 10717
Joined: 10/28/2007
From: California
Status: offline
quote:

ORIGINAL: pinksugarsub

what replaces the care provider's signature, date and time?  


They sign electronically, and the computer enters the date and time.  Same way as when you do your taxes online.

quote:

ORIGINAL: pinksugarsub

What prevents care providers from altering records in the event of an undesirable outcome?   


1.  The software.
2.  The threat of the risk of losing your license for altering records, exactly the same way as for a paper record.

quote:

ORIGINAL: pinksugarsub

What happens when a care provider's recollection conflicts with the electronic data?


No different from paper records.  The "written" record stands.  If it comes down to a legal issue, and the doctor's recollection conflicts with the digital/printed information, then it is up to the doctor to convince the jury, the judge, whoever, that their memory is correct and the record is incorrect, and why.

Digital records (EMR, or Electronic Medical Records) is certainly nothing new.

Cali

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RE: Medical Records Going Digital - 11/26/2007 3:26:08 PM   
Requiempoet


Posts: 29
Joined: 11/1/2007
From: New York
Status: offline 		Shouldn't they figure out a way to have both a paper document and a digital document...I meanthat's a lot of work but...it's a bit safer.

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RE: Medical Records Going Digital - 11/26/2007 3:38:28 PM   
pahunkboy


Posts: 33061
Joined: 2/26/2006
From: Central Pennsylvania
Status: offline 		records are iffy. drs often wont consider OTHER dr records- only their own. also they cringe at forms- they went to school to practice medicine- not to fill out forms.

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RE: Medical Records Going Digital - 11/26/2007 3:59:08 PM   
farglebargle


Posts: 10715
Joined: 6/15/2005
From: Albany, NY
Status: offline 		The VA's system VistA, is pretty much the solution to all of these problems.

It's 30 years old, and does everything. There are some proprietary component which needed replacement ( digital imaging DICOM licenses are a bitch ) and Medical Digital Imaging is FDA regulated, so there's some effort still required.

AND all the proprietary vendors are shitting kittens, because as far as functionality and accuracy VistA blows them all away.



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RE: Medical Records Going Digital - 11/26/2007 4:55:11 PM   
pinksugarsub


Posts: 1224
Status: offline 		That's one of the few positive comments i've heard about V.A. hospitals.
 
Leave it to farglebargle to end a useless discusssion.
 
pinksugarsub

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RE: Medical Records Going Digital - 11/26/2007 4:58:36 PM   
MidMichCowboy


Posts: 665
Joined: 3/23/2007
Status: offline 		The electronic medical record has to have built in auditing of everyone who touches the record. In some way, a properly designed computer system is harder to change than paper. Notice, I said properly designed.
VistA is not bad but the problem is its based on MUMPS. I don't like MUMPS (a programming environment that is , in my humble opinion, a relic of the 70's). I would like to see the functions of VistA taken and put in a good web based AJAX/relational design that would be open source. I feel this would move us forward.

The problem with paper records: often the people who need them do not have them in Emergencies. If I'm in a car accident on vacation and I have medical conditions that would affect Emergency Care, I'm probably in trouble unless there is someone there to notify the Emergency personnel. Paper can only be in one place at one time.


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RE: Medical Records Going Digital - 11/26/2007 5:04:07 PM   
Greylynn


Posts: 575
Joined: 11/4/2007
Status: offline 		The electronic records will make it easier for your information to be accessable by any provider that treats you no matter where you may be.   Instant access right at their fingertips.  Your doctor can't be found and they can still obtain all the info they may need to save your life.  There won't be any guessing as to what charts say due to crappy handwriting, making the chance of errors less. 

It will also help providers track which patients are drug abusers as they can currently be seeing several doctors and getting scipts written from each one and having them all filled at different pharmacys.   It's my tax dollars paying for all the drug heads on welfare and SSI (meaning most my in-laws - I got the only decent one in the entire freaking family).

My previous doctor didn't handwrite scripts.  She e-mailed them to the pharmacy.  I also like the fact that instead of hunting down films for my xrays that as they are digital they can be accessed with a password and a couple of keystrokes instead of being lost on the way to the doctors office or my having to go pick them up.






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RE: Medical Records Going Digital - 11/26/2007 5:53:28 PM   
TheGorenSociety


Posts: 116
Joined: 2/13/2005
Status: offline 		I could not agree more with Farglebargle  about Vista. I am a PC OEM  among other jobs, I currently do as a reseller.I provide support to several popular medical software programs and they all suck. Having worked on Vista and currently a reseller of the program to  civilian providers, it is extremely difficult to alter anything in a patient file with Vista ,with out it being tracked. It blows away all the other programs, I have ever worked on, or supported including the GE health care platform.   As a vet, I love the fact, I can walk into any VA facility or even the DOD facilities, give them my card and have my entire medical file at the doctor or nurses desktop, no matter where I walk into at. I tried using the civilians system a few times even this last time. I had cancer a while back, each time I got fed up at all of the crap, I went through only to find the doctor A, was not talking to doctor B, because doctor C, had not done his job. The civilians doctors refused to take the biopsy results or the MRI's of the VA, they had to have their own. In the end they lost the ones that cost me a lot of money to get and my MRI's to boot. Almost a year to the day, I went back to the VA, the civilian doctor followed up. I am not saying the VA is the greatest thing since sliced bread, but their care has improved significantly, mainly due to the records automation.  They do a tremendous job with not a lot of money.Vista can be used by any practice or hospital, for that matter. It is built on a enterprise level platform and is very very stable. I try to sell Vista to many clients.It is a hard sell but it is worth it. Edited to add. The VA is currently reviewing  some of the changes you mentioned in your posting Mid Mich Cowboy. Last I heard  they may implement some of them within the next 18 months.

< Message edited by TheGorenSociety -- 11/26/2007 5:59:12 PM >

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