With EHR standardization dragging its feet, a new niche is opening up to allow patients to take their medical records into their own hands. PHR(Personal Health Records) providers and sites allow consumers to manage their medical records across different areas such as medical, and dentistry via the internet.
As an example, MyMedicalRecords.com allows patients to upload all their medical data including x-rays, EKG results, tests, and other medical documents and data. They offer services such as calendaring and alerts for doctors appointments, prescription reminders, faxing refills to the pharmacy, and family member access if needed, as well as doctor access.
Intel has also entered the PHR game by scanning medical records and allowing patients and doctors to view the scanned records. Intel Helath Group CTO Doug Busch endorsed the PHR iniative, “With this project, the barriers to adoption [of EMRs] are lower. We are priming the pump to get people accustomed to electronic medical records,”
Intel’s innovations are the tip of the iceberg for the electronic personal health record market. Several of the nation’s largest insurance companies such as Aetna and WellPoint offer Web-based PHRs for their subscribers. WebMD, the online health information resource, powers personal health records for many of these companies as well as its own Web site.
Some of the nation's largest insurance providers are offering web based PHR to their existing subscribers. These companies include Aetna and WellPoint. In addition, WebMD allows users access to their personal health records through the WebMD portal.
In addition, these companies are partnering w/ organizations such as Medic Alert and EMR software providers. These partnerships can facilitate some level of EHR integration. If a patient uses a certain PHR provider's site and that site provides integration for medical records into the doctor's software package, the doctor can import the patient's medical records into their EMR system. Vice versa, the patient may be able to sign up on a site that integrates with their practitioner's software they can import the medical records that the practitioner has to add or update their records.
However, with the lack of any standard integration method coming in the next few years, this will be difficult and most likely mean that doctors will dictate the sites that patients use for PHR. The consensus seems to be that during natural disasters, they are a godsend, as witnessed by the lack of accessible patient information during Hurricane Katrina.
However, there is risk associated with PHR, as described in my EMR Security blog. Furthermore, consumers must be careful when selecting a site to hyold their data. Service agreements must be read carefully, and it is basically a buyer beware situation.
Many vendors are already integrating personal health records with an electronic medical record system. Companies like CapMed and MedKey offer software-based PHRs compliant with HL-7 standards and EMR vendors like NextGen and GE Healthcare. They also include a USB thumbdrive to download and transport health information. Several Web-based applications like TouchNetworks’ HUB allow patients to consolidate and modify their medical documents in one location, permitting access to their physicians and other individuals.
Furthermore, the federal government is chipping in to promote EHR and PHR. Legislation entitled the Federal Employees Electronic Personal Health Records Act, is designed to jumpstart the adoption of this new technology
http://www.healthcareitnews.com/story.cms?id=5487
Thursday, September 07, 2006
Health Records Security
Security of healthcare records continues to be an obstacle in moving from paper to electronic records for doctor and patient adoption. As one of my readers has so kindly pointed out, security of medical records remains a very big concern. Therefore, I have decided to write a blog about some of the major mishaps.
Beginning with the basic security blunders, back in 2002, the VA failed to erase all the medical data on 139 computers before giving them away to educational institutions. The computers contained a wealth of Veteran's data and even government credit card information. Some of these were found at local stores and all but 15 were eventually recovered. Shortly after that the VA tightened their disposal policy and bought an enterprise license for Ontrack Data International Inc.'s DataEraser.
In another major blunder in March of this year, Providence Health System said thieves for the second time in 2006 have stolen laptops containing patient records. In two separate car break-ins, thieves took laptops containing records on a total of 122 hospice and home-care patients in Snohomish County, Wash. Earlier this year, a thief stole computer disks and tapes holding personal records on 365,000 patients across Oregon and Washington.
The most recent high profile privacy compromise was when the personal information of 26.5 million veterans was stolen from a home computer of the a VA employee who was not authorized to remove it from the office. Persoal information included birthdates, social security numbers, and even spousal personal information. According to the VA no medical records were compromised.
In May of this year, Ohio University announced to its students and former students that computers at the health center, containing records of 60,000 people, had been compromised by three seperate hacks. The world privacy forum announced that almost 250,000 to 500,000 consumers have had teir medical privacy compromised.
Beginning with the basic security blunders, back in 2002, the VA failed to erase all the medical data on 139 computers before giving them away to educational institutions. The computers contained a wealth of Veteran's data and even government credit card information. Some of these were found at local stores and all but 15 were eventually recovered. Shortly after that the VA tightened their disposal policy and bought an enterprise license for Ontrack Data International Inc.'s DataEraser.
In another major blunder in March of this year, Providence Health System said thieves for the second time in 2006 have stolen laptops containing patient records. In two separate car break-ins, thieves took laptops containing records on a total of 122 hospice and home-care patients in Snohomish County, Wash. Earlier this year, a thief stole computer disks and tapes holding personal records on 365,000 patients across Oregon and Washington.
The most recent high profile privacy compromise was when the personal information of 26.5 million veterans was stolen from a home computer of the a VA employee who was not authorized to remove it from the office. Persoal information included birthdates, social security numbers, and even spousal personal information. According to the VA no medical records were compromised.
In May of this year, Ohio University announced to its students and former students that computers at the health center, containing records of 60,000 people, had been compromised by three seperate hacks. The world privacy forum announced that almost 250,000 to 500,000 consumers have had teir medical privacy compromised.
Thursday, August 31, 2006
VA Hospitals Excerpts
"The centerpiece of that culture is VistA, the VA's much praised electronic medical-records system. Every office visit, prescription, and medical procedure is recorded in its database, allowing doctors and nurses to update themselves on a patient's status with just a few keystrokes. In 1995, patient records at VA hospitals were available at the time of a clinical encounter only 60% of the time. Today they are 100% available. Some 96% of all prescriptions and medical orders, such as lab tests, are now entered electronically. The national comparison is more like 8%. "One out of five tests in a civilian hospital have to be repeated because the paper results are lost," says Veterans Affairs Secretary R. James Nicholson. "That's not happening in our hospitals." VistA is a big reason why the VA has held its costs per patient steady over the past 10 years despite double-digit inflation in health-care prices. "
"At the hospital pharmacy, prescriptions are doled out by robotic devices -- one reason the organization is able to hold co-pays at $8. Each bottle of medicine carries a bar code that is scanned by the computer. If a patient is allergic or takes a conflicting drug, the system will sound an alarm. Similar bar codes are affixed to patient ID bracelets to protect against the wrong patient getting a procedure, a common mixup in hospitals."
Very cutting edge! This makes the co-pay dirt cheap and patients will love it. I don't know what kind of robotics they are using but Microsoft just started a new robotics initiative and have a development kit freely available.
"He meets with an elderly man with severe asthma, takes a quick look at his electronic records, and learns that the patient has not yet had a pneumonia shot. That's a big issue at the VA. The organization has cut hospitalizations by 4,000 patients a year since its pneumonia vaccination rate went from 29% in 1995 to 94% last year."
Excellent I like how they build some prevention into the system.
But to keep patients from developing diabetes in the first place, the VA offers overweight patients the opportunity to join a weight-management program that pairs them with a nutritionist. Few insurers will pay for such prevention in a civilian setting. To Sanderson, preventive care is just one reason he is sure the changes at the VA "have saved thousands of lives over the years."
Awesome! I am very passionate about this stuff. Even patients with adult onset diabetes should be offered the same thing. Being as adult onset diabetes has been proven to be reversible through natural ways, and won't be cured through a magic pill, becuase its typically caused by many years of poor nutrition or obesity . Clinics should offer this kind of service in addition to the diabetes drug.
This is a link to a CNN article abot the VA. Same thing w/ some different interesting stuff.
http://money.cnn.com/magazines/fortune/fortune_archive/2006/05/15/8376846/
"As part of the overhaul, he reengineered the VA's $1-billion-a-year pharmacy, creating a single list of approved medications. To free up pharmacists and to reduce errors, each hospital pharmacy installed systems to automatically refill prescriptions. Today, at the Manhattan VA, the robot-like Optifill system dispenses 1,000 prescriptions a day."
"At the hospital pharmacy, prescriptions are doled out by robotic devices -- one reason the organization is able to hold co-pays at $8. Each bottle of medicine carries a bar code that is scanned by the computer. If a patient is allergic or takes a conflicting drug, the system will sound an alarm. Similar bar codes are affixed to patient ID bracelets to protect against the wrong patient getting a procedure, a common mixup in hospitals."
Very cutting edge! This makes the co-pay dirt cheap and patients will love it. I don't know what kind of robotics they are using but Microsoft just started a new robotics initiative and have a development kit freely available.
"He meets with an elderly man with severe asthma, takes a quick look at his electronic records, and learns that the patient has not yet had a pneumonia shot. That's a big issue at the VA. The organization has cut hospitalizations by 4,000 patients a year since its pneumonia vaccination rate went from 29% in 1995 to 94% last year."
Excellent I like how they build some prevention into the system.
But to keep patients from developing diabetes in the first place, the VA offers overweight patients the opportunity to join a weight-management program that pairs them with a nutritionist. Few insurers will pay for such prevention in a civilian setting. To Sanderson, preventive care is just one reason he is sure the changes at the VA "have saved thousands of lives over the years."
Awesome! I am very passionate about this stuff. Even patients with adult onset diabetes should be offered the same thing. Being as adult onset diabetes has been proven to be reversible through natural ways, and won't be cured through a magic pill, becuase its typically caused by many years of poor nutrition or obesity . Clinics should offer this kind of service in addition to the diabetes drug.
This is a link to a CNN article abot the VA. Same thing w/ some different interesting stuff.
http://money.cnn.com/magazines/fortune/fortune_archive/2006/05/15/8376846/
"As part of the overhaul, he reengineered the VA's $1-billion-a-year pharmacy, creating a single list of approved medications. To free up pharmacists and to reduce errors, each hospital pharmacy installed systems to automatically refill prescriptions. Today, at the Manhattan VA, the robot-like Optifill system dispenses 1,000 prescriptions a day."
When they found out that Vista is an "open source" program that's available for no charge over the Internet, they used a Freedom of Information Act request to get the code from the government and launched Medsphere. For a fee, Medsphere installs a proprietary version of Vista - called OpenVista - and provides round-the-clock customer support.
Kizer is in for a hard slog. He concedes that many hospital executives are reluctant to put their patients' lives in the hands of "a nascent startup with a disruptive technology." And big companies such as General Electric (Research), McKesson (Research), and Cerner (Research) all offer their own computerized clinical systems with electronic health records. So far Medsphere has about six customers, including Midland Memorial Hospital in Texas, that are offering OpenVista at 60 facilities.
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