We are fast entering the era of the electronic health record, when it will be possible to call up our medical records on our computers and mobile devices. Medication lists, lab results, appointment schedules—they’ll all be available with clicks of your mouse or taps on the screen of your smartphone or tablet.
But one question that’s far from settled is whether the electronic health record should include the notes that doctors make about them. A doctor’s notes can be straightforward, such as a reminder that an additional test might be needed. But they can also include somewhat speculative observations and hunches about a patient and his or her medical conditions. The Open Notes project is a research program designed to test the consequences of giving patients access to doctors’ notes. Harvard-affiliated Beth Israel Deaconess Medical Center is one of the test sites.
The Open Notes project is far from finished. But results of a survey of the expectations that doctors and patients have for note sharing are being reported in today’s Annals of Internal Medicine.
I don’t think there are any great surprises here. More than half of the primary care physicians Read more »
*This blog post was originally published at Harvard Health Blog*
My last post centered upon the funny-sounding word, ‘parallax.’ I was using it to describe how middle-age athletes see their sport.
But it seems to me that parallax relates to healthcare policy.
First, the definition:
Parallax: an apparent change in the position of an object resulting from a change in position of the observer.
Here goes…(in less than 360 words!)
As America and its government grapple with how much austerity can be tolerated, the cost of healthcare consumption holds center stage.
Everyone knows a portion of the rising costs of healthcare stem from paying doctors a fair wage. (Worry not; I’m not prepping you for a rant about declining reimbursement and higher regulatory costs. This would be too fatiguing. Plus, doctors’ wages lie way beyond the scope of a clinician’s blog.)
Let me tell you a real-life story about a recent situation? It’s meant to illustrate one of the many healthcare policy conundrums. And it shows how one’s views of healthcare policy may depend–on the position of the observer. (ie, parallax) Read more »
*This blog post was originally published at Dr John M*
(Note: After a five month absence from posting comments, I offer this observation, with more to come. There’s much to do.)
The message resonating from the Wall Street protesters is that income inequality doesn’t work. And among the developed nations, theUS is the most unequal. This distinction does not come without cost. The greatest, of course, is the social cost borne by those who are poor. But what the protesters may not fully realize is that another is the high costs of health care. This is because the costs of caring for the poor are much greater. And together with the rising numbers of poor patients, they are crushing the health care system.
This notion may seem shocking, since it is generally believed that low-income patients receive less health care. After all, many have little or no health insurance, and most have poor access to primary care. Isn’t it the wealthy whose access is best and who use the most? The answer is Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
According to some state legislators, the answer is yes. Lawmakers in South Carolina are pushing legislation that would “make it illegal to transport immigrants anywhere, including a hospital” reports the New York Times. Fox News Phoenix reports that in Arizona, a bill has been introduced to “require hospitals, when admitting nonemergency cases, to confirm that a person seeking care is a U.S. citizen or in the country legally. In emergency cases where the patient isn’t here legally, the hospital would be required to call immigration authorities after the treatment is done. Hospitals in non-emergency situations would also be required to contact federal immigration authorities, but they would have more apparent discretion about whether to treat illegal immigrants.”
Such ill-advised efforts by states to criminalize health care for undocumented persons has led the American College of Physicians, the nation’s second largest physician organization, to speak out against “Any law that might require physicians to share confidential information, such as citizenship status to the authorities, that was gained through the patient–physician relationship conflicts with the ethical and professional duties of physicians.” ACP made this statement in a new position paper on immigrants’ access to health care released yesterday at its annual scientific meeting in San Diego, California. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*