April 21, 2016

Disagreeing with Another Writer

I seldom find myself in complete disagreement with other writers, but except for a few points, I find myself disagreeing with most of what Nancy Finn has in her latest blog. Her subtitle “The New Era in Healthcare,” leaves much to be desired as while many physicians and hospitals have moved from hand written records to computer records, these records do not communicate with each other and do not communicate with other record systems across the country.

The good news according to the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, is that more than 75% of all physicians now use some type of electronic record system, up from 18% in 2001.

Over 65% of American doctors also “routinely” send patient prescriptions electronically to the pharmacy and more than half use digital tools for basic clinical tasks, such as receiving alerts, and sending and receiving electronic lab reports to and from their medical record systems.

In a report sent to Congress in 2015, the Department of Health and Human Services stated that hospital adoption of at least a basic electronic record system has markedly increased to 59% of all hospitals.

The sad news is in this new era of digitizing patient records so they can be accessed in real-time by multiple health care providers, patients and caretakers has finally arrived is false. I know this for a fact as in the area where I live, going to the hospital emergency department in my home town does mean that my doctors in the other town cannot access these under any circumstances, even if I authorize this. In order to have my records available to my doctors, I must go the to the local hospital and request in written form the specific records that my primary care doctor needs. After a few days, I can generally pick up the paper copies and maybe a DVD of images to take to my PCP. This is hardly what I would call real-time. These digital records put our health information in one place, but cannot be shared in real-time, searched, or parsed out. So, if I have my doctors in another community, hand written requests must be made by me for the records needed by any of my doctors. This does not mean that wherever I go, the full information is available – only what I request copies of to hand carry with me.

Nancy says, “Our dialogue with our clinicians has changed as well. We are demanding, and getting, our visit notes so that we can check their accuracy and participate fully in our care.” We are still in the dark ages where I live – no copies of our visit notes are available, they are still hidden from us and while we can obtain copies of our lab results, no more is available. Errors cannot be corrected, but we don't know what the errors are unless the doctors thinks to ask us about something. I can participate in my care up to a point and then the doctor takes over and if I disagree – my records are marked as non-compliant.

Apparently, Ms. Finn lives in an ideal world as we still only use office visits only, I do have a secure portal to answer surveys about the visit and office cleanliness, but nothing else, no email, skype, or other advantages of digital communications. If I don't have any questions written out, my questions will not be answered.

There is little or no coordination of care and if I travel, I would need to take copies of certain information as no other information would be available if I was hospitalized or needed to see another doctor.

In this day and age, we can only hope that what Ms. Finn describes was available, but in essence, we are still back in the prior century in having access to our medical records if traveling. If we have caregivers, they are kept in the dark and would not be given access to our medical records, even with a limited power of attorney. Even my own wife can only receive information if she is with me at my doctor appointments. Much of the time she is discouraged from being in the exam room with me.

If you are interested, you may read Nancy Finn's full blog here.

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