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.
