I see now that info is is recorded on computers.
Is the info just recorded just kept on site or entered in a big database?
If I go to a new doctor can they access all past info or do they have request it from past doctor(s)?

you have to sign a release with the old doc and the new ones can request it

quote:

Originally posted by gjgalligan:
If I go to a new doctor can they access all past info or do they have request it from past doctor(s)?

If your new physician is on the same system (Epic or Cerner), then yes, they can access your previous information. Meditech may be the same, although I'm not quite certain on that.

Short answer is yes and no release is required.

The current provider will need to show that he/she had a reason to view previous records, however, should it come into question.

I recently went to see a cardiologist who I had never seen before. During the visit as he was asking me questions he was able to pull up all my prescriptions any doctor had prescribed and also pulled up my most recent annual physical results from my family physician. I was pretty impressed he had instant access to all this information.

Re: “I see now that info is is recorded on computers.”

That isn’t very specific. I have the “MyChart” app on my iPhone, linked to all of my UCSD physicians. If I were to get a different UCSD GP, he/she would certainly have access to my health records. If I changed to a non-UCSD health system, I don’t know if they could access my UCSD medical records.

I’ll just add that MyChart is wonderful. A convenient record of past visits, medical test results, notification of vaccinations due and upcoming appointments. Easy to make new appointments and to pay medical bills. Other features too.

All of the above. Epic is one system (about half the patient records in the US), and pretty widely used, even globally. Your provider(s) must be able to access it, and some providers have their own in-office system, or even paper records. If they have a hospital affiliation, chances are they access some sort of electronic record. It's very convenient, and even safer, because medication lists are updated, treatment and visits are up-to-date, and an ER is likely to have access to this information as well - and patients can access their own records 24/7, and communicate with their healthcare organization. It's legible, and Lord knows many paper records are not. And it can be sent instantly, anywhere in the world with receive capability.

Is it more secure? Yes and no. It's electronic, so there's that. No electronic information is completely secure. None. But neither is paper. And lots of safeguards are in place, and all electronic health records must be HIPAA compliant. Compared to a paper record, an employee can't access it without authorization, and access leaves an electronic trail. You can't just walk out the door with it, at least not easily. It won't be destroyed in a fire or flood. But it's in the hivemind, and it's there forever. On the whole, a good thing, but paper will eventually be a thing of the past, better or worse.

Even if another medical system uses Epic, there is no ability to pull up your previous record unless your new doc is part of the same medical system; I'm pretty sure that's correct.
The medical information systems are supposed to be able to "speak" to each other, but there is no general database of medical records for everyone in the "cloud".
Studies that are done using large medical records databases have to strip off the patient-identifying information to preserve patient confidentiality; at least that's the idea.

It should be illegal to record a patient's medical history on anything but paper.

In the coming decades, some people will rue the day that they allowed their medical history to be put on some Goddamned server. It's wrong. It doesn't help the patient, only the physician and their staff.

Mark my word. There will be consequences, and deep regrets.

quote:

Originally posted by sjtill:
Even if another medical system uses Epic, there is no ability to pull up your previous record unless your new doc is part of the same medical system;

"System" being region in my experience. For example, I am able to access anyone's record in the northwest (basically between here and Seattle). However, I'm not able to access the records of someone in North Dakota or Illinois even if they, too, are on Epic.

quote:

Originally posted by parabellum:
It doesn't help the patient, only the physician and their staff.

I understand your concern and mostly agree with you. However, I disagree with this statement.

It does in fact help the patient.

If I have someone come in for emergency surgery who is unable to communicate their medical history to me, being able to access that information is invaluable and potentially life saving.

Can it be misused? You betcha, and it is every single day. In fact, my own records were accessed by an employee at my facility which was completely unauthorized. She was fired that day. But still, my information is out there.

Personally, I would like to see, as a start, nobody but providers being able to access a medical history. RNs and CNAs have no reason to access that information. It seems to me that it would be easy enough to build that into the software.

quote:

In the coming decades, some people will rue the day that they allowed their medical history to be put on some Goddamned server. It's wrong. It doesn't help the patient, only the physician and their staff.

Mark my word. There will be consequences, and deep regrets.

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Para has a good point. How many data breaches have there been of health care records? Not a day goes by without one. Veterans Administration has had numerous ones.

Eight people at Nortwestern Hospital in Chicago got fired for snooping at Smolletts medical records. I guess they did not realize that the computer logs who looks at the record.

Many of the medical records I view are simply templates composed by an idiot. Admittedly a legible list of the diagnoses, past labs, and current meds are helpful but the rest of the record is often of little use.

my doctor who is a ppo and not hmo has access to my records with all the other doctors that see me and is on the same physician network.

I can log on to my app to see my blood test results.

It's all connected now.

quote:

Originally posted by Doc H.:
It's very convenient, and even safer, because medication lists are updated, treatment and visits are up-to-date, and an ER is likely to have access to this information as well - and patients can access their own records 24/7, and communicate with their healthcare organization.

Not even one clinician or hospital in the US have such complete medical information on me. Foreign entities do however.

quote:

Originally posted by Doc H.:
It's legible, and Lord knows many paper records are not.

Yeah, my pregnancy with identical twins showed up quite legibly on one of my many EHR's. I told that doctor that I found that to be funny, but he should correct the records since the pregnant woman would need that information in her medical records. He didn't. That "software glitch" caused some gender confusion problems during a surgery prep last year.

quote:

Originally posted by Gustofer:
If I have someone come in for emergency surgery who is unable to communicate their medical history to me, being able to access that information is invaluable and potentially life saving.

I do understand why you would need that information, but I think there are better ways of obtaining it.

My relevant and accurate medical information was typed by myself, printed out, and is in my wallet.

iPhones have a Built-in Health App. You could check there too.

quote:

Originally posted by parabellum:
It should be illegal to record a patient's medical history on anything but paper.

In the coming decades, some people will rue the day that they allowed their medical history to be put on some Goddamned server. It's wrong. It doesn't help the patient, only the physician and their staff.

Mark my word. There will be consequences, and deep regrets.

I agree with this. Where I currently work, we still use pens and paper for patient charting. I'm a huge fan of paper charting.

The danger is the health insurance companies will use the knowledge of prior health records to deny service, or increase premiums, so that they can make more money.

The health care provider may be better able to help the patient, but the insurance company only cares about making more money. They don't care a rat's ass whether you wither away and die, you are just a number to them.

quote:

Originally posted by ZSMICHAEL:

quote:

In the coming decades, some people will rue the day that they allowed their medical history to be put on some Goddamned server. It's wrong. It doesn't help the patient, only the physician and their staff.

Mark my word. There will be consequences, and deep regrets.

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Para has a good point. How many data breaches have there been of health care records? Not a day goes by without one. Veterans Administration has had numerous ones.

Para made beyond a point. He created a topic when the massive Marriot data breach was news, informing members that you should just assume that all of your digital information is out there for the taking.

My insurance company was completely compromised by an publicly unidentified foreign entity. They copied everything.

And I recently received a letter from UW Medicine in Seattle that they had been compromised.

You didn't quote Para's contention that EHR's should be illegal. Based upon your prior posts, I think that you could explain this article to us What Providers Need to Know About EHR Mandates in 2018. My basic understanding is that providers will not receive full compensation for Medicare and Medicaid unless they used EHRs. I'm on neither program, I'm just curious. (And of course I invite anyone to explain the current situation as well.)

As others have said, Epic -- a leading vendor for large health systems and integrated delivery networks (insurer and provider in one) -- for example has had a walled-garden within-vendor sharing mechanism in place for a while. Other vendors are now being interconnected through external clinical data collaborations like Commonwell. In addition many providers have their electronic health records (EHRs) tied together using HIE's (Health Information Exchanges).

Many here might recognize the term "Meaningful Use" which incented providers to rush into electronic health records (EHRs) with money from the federal government. Most are beyond the incentive phases of those programs now and are just trying to avoid the penalty phases of those program. The new program term is "Promoting Interoperability" which amongst other requirements is calling for an API interface to be created on the EHRs and presented for patients to tie into their health record with apps.

The argument can be made that EHRs are better for patient safety and improve care. Certainly they avoid replicating services (redoing diagnostic care when switching between providers for instance). But they definitely have downsides including massive costs which have in some cases caused the demise of provider orgs. And of course, the cybersecurity concerns including ransomeware, and data theft.

The danger is more than hacks. The healthcare system has your info, your insurer has your info and your grocery store affinity card tracks your purchases. Let's say all of these entities decide to monetize "their" information. Data analysis shows that each week you purchase 2 dozen eggs and 3 rashers of bacon, your cholesterol continues to increase and your DNA markers show a predisposition to cardiac disease. Guess what steps the insurer might take.
The problem is you need healthcare, you must have insurance and that affinity card is very attractive because of discounts. We all leave digital footprints.

Yeah, I know HIPAA. I am also cynical, there is too much money at stake and lobbyists will find a way.

Obama made EMR a Federal law--that all medical records be in an electronic form. If the doc is not electronic -a $ penalty is applied yearly.

The concept of having your medical record available is good. Allergies , medication usage is readily available. Duplication of resources is reduced--ER visits and CT scans, labs , etc.

Epic is integrating a lot of medical records into its system CARE EVERYWHERE. Epic has snapshots of office visits, different Hospital Epic affiliations.

Recognize one good thing about Electronic records-a patient cannot go to the Emergency Room for pain killers because of this database.