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Electronic Medical Records, the Story So Far

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  • by mrmtampa (231295) on Sunday January 18, 2009 @07:08AM (#26504935) Homepage

    The VA hospitals and clinics have an open source package called VistA (Veterans Health Information Systems and Technology Architecture). Veterans can walk into any facility and have their medical records available.

    And we already paid for it!

    http://www.va.gov/VISTA_MONOGRAPH/ [va.gov]

  • Re:What privacy? (Score:4, Informative)

    by Blue Stone (582566) on Sunday January 18, 2009 @09:16AM (#26505493) Homepage Journal

    >If like me you object to your medical records being computerised and being available to any member of the state for their fishing expeditions, your doctor will tell you to get lost.

    You have not told anyone about "the UK experience of computerised medical records", you've informed them of your own (appaling) experience. Make a formal complaint about your doctor and then change him for one who will respect your right to medical confidentiality (something which electronic records rides a coach and horses through).

    I simply gave my doctor a letter, informing him of my wish to opt out, and he accepted it. There's a form letter on www.nhsconfidentiality.org which I will paste here in it's entirety:

    Dear Doctor,

                                                      Exercising right to opt out

    As you are probably aware, the Government is intending to ask you to transfer
    the electronic medical records of your patients onto a national database called
    the "spine". They intend you to do this without first seeking the consent of
    your patients. It is BMA policy that patients should give their individual
    consent prior to their information being transferred on to the national
    database.

    There are substantial concerns about the privacy and confidentiality of
    information transferred onto the national database, not least because promised
    software security safeguards called "sealed envelopes" will not be in place
    and because the patient's instructions with regard to who may access the
    records can be overridden. I do not believe that such a large database, with so
    many staff users, can be regarded as secure.

    I would be grateful if you would ensure that none of my records held by you are
    entered onto the national system. Would you please also file or scan a copy of
    this letter in my records and also record my dissent by entering the "Read
    code" - '93C3. --- Refused consent for upload to national shared electronic
    record.' into my computer record. I am aware of the implications of this
    request and will notify you should I change my mind.

    This request is itself confidential. Please do not divulge my decision, in an
    identifiable manner, to anyone other than to clinicians who are providing care
    to me and who might otherwise place information about me on the national care
    records service.

    Further information for GPs is available online at www.TheBigOptOut.org/for_GPs

    Yours sincerely,

  • by amabbi (570009) on Sunday January 18, 2009 @11:19AM (#26506083)

    (Most medical records today aren't things that patients get--MS is taking the position that patients should be able to see their own records, and even correct their own medical records. (But with digital signatures to keep track of who is updating the record.))

    IANAD (but I will be one in 5 months or so). If that is Microsoft's position, that is the stupidest fucking thing I have ever heard. Worse than Clippy. Worse than Bob. Look, a patient's medical record is supposed to be an OBJECTIVE documentation of a patient's health status and treatment. How, exactly, is a patient qualified to make an objective assessment of their medical problems, diagnostic workups and treatment regimens?

    One thing about electronic records in general--patient accessible ones--is that it should make a difference in accountability. Normally, at many hospitals in the US, if a doctor makes a significant mistake the records disappear. If patients have direct access to their own records, that will become a less common practice.

    Well, that's just complete BS. I don't know where you get your information, but altering a patient's medical record is illegal and, at the very least, will result in a physician's suspension of privileges from a hospital... and most likely, a revocation of their medical license.

    Btw, your patient record is completely accessible. You just have to make a request to the medical records office. No, it's not available on the web, but it's not as if your MR is a secret like your FBI file.

  • by ValentineMSmith (670074) on Sunday January 18, 2009 @03:50PM (#26508611)
    While it is written in M, there is most certainly an integrated billing package (frighteningly enough, in the IB namespace). The VHA most certainly DOES bill 3rd party insurance for recoverable claims.

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