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Why Secure E-Mail Is Not Healthcare Communications Utopia

I am fortunate to work at an institution that has a fully deployed electronic medical record (EMR) system that incorporates outpatient physician notes and inpatient notes under one umbrella. By and large, patient care is facilitated since both outpatient and inpatient notes appear simultaneously in the patient’s chart, along side telephone messages and clinical results. While there are plenty of kinks to work out, most of us have to admit that there are huge patient care advantages to such a system.

The system also promotes a secure e-mail service for patients to e-mail their physician and a mechanism to have their results forwarded directly to them. With the ability to empower patients directly, many would consider this as the Utopian model for heath care delivery of the future.

And what could be better? Patients get virtually unlimited access to their health care provider, 24-7. Results are whisked to the patient. Speed. Efficiency. “Green.” It’s all good, right?

Maybe. Read more »

*This blog post was originally published at Dr. Wes*

The 2000-Word Patient Email

We assume that technology will improve communication between doctors and patients.

But not always.

Look at the 2,000 word email.

While it isn’t yet the standard means of communication in our clinic (it will be soon) we occasionally take email from patients.  My experience has been that they’re sometimes long and unfocused with tangential information irrelevant to the problem at hand. Read more »

*This blog post was originally published at 33 Charts*

Google Social Search: Track Your Online Persona

Do you remember Personas that visualizes the map of your online presence? Here is a better solution. From one point of view, it’s great to have such a useful tool as Google Social Search. A short video about what it is and how it works.

Social Search taps into a user’s social network profiles and displays relevant links and status updates that members of a user’s own social network have shared at the bottom of the default search results page. According to Google, Social Search will enhance the search experience on Google by providing users with more personally relevant search results.

Read more »

*This blog post was originally published at ScienceRoll*

Prescription Privacy Doesn’t Exist

I wish this was hard to believe:

Like many other people, Ms. Krinsk thought that her prescription information was private. But in fact, prescriptions, and all the information on them — including not only the name and dosage of the drug and the name and address of the doctor, but also the patient’s address and Social Security number — are a commodity bought and sold in a murky marketplace, often without the patients’ knowledge or permission.

But given the money involved, I’m afraid it isn’t.

But with the pharmaceutical industry soon to release $150M dollars of ads promoting health reform as they cozy up to Congressional leaders, the conflicts of interest for patient’s privacy are staggering. Further, the promotion of the electronic medical record, personal health records, and ultimately, cloud computing (where no one will know where health data resides), are firmly part of the health reform landscape.

Now before people think I’m totally against the EMR, let me be candid: I’m not. It does facilitate care and is an incredible means of communication between physicians and laboratories and pharmacies and the like. When used properly, they are miraculous.

But the risks of losing information remain huge. Certainly, the above referenced New York Times article notes that safeguards are supposed to be enacted to prevent this wholesale marketing of your health data.

But suddenly, we learn of a White House snitch line where they will collect e-mails of people who might be spreading “misinformation” about the health reform efforts underway. (Thanks to my previous blog post, I am happy to report I’ve been reported! ;)) But this occurs at a time when privacy issues in health care must be seen as paramount and electronic medical records protected as secure.

Ooops.

So now we have a White House eager to build a snitch line as they cozy up to pharaceutical interests that are already selling personal information from prescription data, all while trying to promote the security of electronic medical records to the masses.

Who are they kidding?

But then, shucks, just think of the marketing possibilities for the government:

And lest people think I’m too partisan (who me?), the Republicans with their travel junkets aren’t any better.

Sheesh!

-Wes

Reference: White House blog with snitch e-mail link at flag@whitehouse.gov .

*This blog post was originally published at Dr. Wes*

Medical Records: One For The Insurance Company And One For Doctors & Patients?

Apparently, there are some legitimate reasons why a patient may lie to their physicians.

A recent article in the Los Angeles Times discusses the phenomenon, which as Dr. Gregory House would aptly summarize as, “Everyone lies.”

In fact, a recent survey suggests that “38% of respondents said they lied about following doctors’ orders and 32% about diet or exercise.”

One interesting reason is that patients are wary disclosing potentially damaging information to health insurance companies. Indeed, when patients apply for individual health insurance, their medical record is pulled up. And since trivial details can cause insurance companies to deny health coverage, patients certainly may have second thoughts about giving an accurate history.

Furthermore, “when processing a claim, the insurance company finds something in a patient’s records that contradicts something the patient said when purchasing the policy, the company can retroactively cancel the policy.”

That’s pretty harsh.

But making medical decisions on inaccurate information has consequences as well, including providing poor patient care.

One suggested option would be to maintain two sets of medical records, one that is shared with the insurance companies, and a private one that is not released to third parties. Some patient advocacy groups even go as far as saying, “If your physician won’t do that, it’s reason enough to leave the physician.”

I currently don’t offer such an option. I wonder how many other practices do.

*This blog post was originally published at KevinMD.com*

Latest Interviews

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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