Monday, January 21, 2013

Patient Access To Electronic Medical Records Strengthened By New HHS Rules

As a physician involved in this mess (and it's a mess), let me chime in and say that you're partially right and partially wrong (TL;DR - it's complicated).

Yes, lots of health care providers (doctors, nurses and ancillary personell) absolutely hate change. There are doctors who are perfectly happy scribbling down a paragraph of acronyms and abbreviations and calling it a day. Then they get mad at the nurse because she can't figure out just what the hell the doc meant.

Those people need to get put in a closet and only used in emergencies (fat chance). Then there are EHR providers that can't program anything harder than "hello world" without six months of testing. It should be fairly easy, for example, to input weights in pounds and convert it on the fly to kg (or stones or troy ounces for that matter). Instead you have input fields that are rigidly structured, and worse, fail in unspecified ways requiring you to re input the data. Those programmers need to be put in a closet an left there.

The problem with patient data is that you don't know the level of understanding that you are shooting for. Do you dump everything out in Doctor Babble? Do you try to make it read at a 5th grade level? Do both? Something else?

PDF is fine for data output that would be static - not so good if the patient wants the new provider to input it into another system. That's a difficult problem to solve. HL7 was supposed to be the standard that offered a solution to that, but, like most standards, it suffers from implementation problems.

And the new gem:

When individuals pay by cash they can instruct their provider not to share information about their treatment with their health plan.

is going to really jam things up. Now you have to sort data on a whole new metric - who can see it. I predict this isn't going to work out well, although I understand the rationale behind it. I also understand how this is going to be abused - your doctor / healthplan doesn't see the fact that you paid for a script for 150 Vicodan. You'd like some more.... Whatcouldpossiblygowrong.

Source: http://rss.slashdot.org/~r/Slashdot/slashdotScience/~3/sBZrEpVKEQ8/story01.htm

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