To balance privacy issues and accessibility at the point of care, the EMR data
should be
given to the patient, ideally in digital format like HTML or XML. It could then
be carried
in a memory card or PDA or DVD etc. and/or entrusted to a network based agent
of the
patient. That agent would not necessarily have any special medical connections,
it could
just be a trusted keeper of data for a person and would not necessarily have any
capabilities beyond holding and serving data. The data could be encrypted with
a dual key
scheme like PGP to make it unreadable except to designated receivers.
Jim Gray wrote:
>I think it is absurd that I cannot get my lab data from the lab. There are
>categories of medical info like Rx's for major tranquilizers and postive HIV
>test that should be subject to privacy. However, making much of the other
>routine data subject to the extreme privacy rules compromises health care.
>We need a happy medium some how.
>Jim
>
>----- Original Message -----
>From: "Nancy Anthracite" <[EMAIL PROTECTED]>
>To: <hardhats-members@lists.sourceforge.net>
>Sent: Friday, September 02, 2005 10:43 AM
>Subject: Re: [Hardhats-members] Shared lab data/We DO Care
>
>
>> What I am referring to is a proposed requirement by the Department of
>> Health
>> in NYC that the 800 or so clinical labs across the city provide them with
>> the
>> abnormal A1C hemoglobin results and the names of the patients who had them
>> so
>> they could have a database of all of the diabetics in New York City. This
>> was not something where patients would be asked to opt in. They planned
>> an
>> educational campaign for the patients and their doctors using that data.
>> Since diabetes and obesity an "epidemic", they felt this fell under their
>> purview.
>>
>> That is a far different thing from you granting a physician rights to view
>> your lab data. In fact, aren't you a bit outraged that the labs will not
>> give you your data? I surely find that a problem, and the same with x-ray
>> reports. In the occupational setting I work in, often send patients to
>> get
>> x-rays with a note that says to give the patient the results of the x-ray
>> as
>> soon as the radiologist does the wet reading, and that doesn't work half
>> the
>> time or more.
>>
>> I find it curious that the health professionals I have told about this NYC
>> story are all outraged, but those of you who might have your privacy
>> violated
>> were you living there seem like it is no big deal.
>>
>> On Friday 02 September 2005 11:57 am, James Gray wrote:
>> Personally I find the present system of blocking the transfer of lab data
>> a
>> detriment to my medical care. For the past few years I have found that
>> all
>> of my doctors have only part of my lab data (different parts). I cannot
>> just give blanket approval to the lab to share my data with all of my
>> doctors. I have to fill out a copy of a special form for each of my
>> doctors
>> each time I get a test. Why should I have to do that? I know this has
>> nothing to do with an electronic health record, but the issue is the same
>> regardless of whether the records are kept electronically or as paper. I
>> know that my health care has been compromised because the doctors do not
>> have the whole picture. I guess my privacy has not been compromised.
>> Should I be cheering for that?
>>
>> Jim Gray
>>
>> ----- Original Message -----
>> From: "Nancy Anthracite" <[EMAIL PROTECTED]>
>> To: <hardhats-members@lists.sourceforge.net>
>> Sent: Friday, September 02, 2005 4:00 AM
>> Subject: Re: [Hardhats-members] We DO Care
>>
>>>I think you are confusing my concern about having national databases that
>>> store records of patients from all of their physicians, no matter what
>>> system
>>> they are in, and those that are for a system, be it a doctors office, or
>>> in
>>> this case, the VA system. I would not expect Kaiser, for example, not to
>>> have a national system and anyone choosing that insurer is buying into
>>> that,
>>> just like the VA.
>>>
>>> Has anyone heard if the health department in NY City succeeded in
>>> hijacking
>>> the lab results records of its citizens or not? I surely hope not.
>>>
>>> On Thursday 01 September 2005 09:57 pm, Gregory Woodhouse wrote:
>>> I must be missing something. A little while back, I remember you
>>> flatly saying there is no medical justification for replicating
>>> records across facilities. I'm not a doctor, but that was a little
>>> surprising to me. If a veteran is evacuated from Biloxi in the wake
>>> of Katrina, then how is having access to his or her medical record of
>>> no medical value? My assumption was that the concern here was for
>>> privacy (which is no small matter), and that was the reason for my
>>> allusion to privacy concerns in my message.
>>> ===
>>> Gregory Woodhouse
>>> [EMAIL PROTECTED]
>>>
>>> "It is foolish to answer a question that
>>> you do not understand."
>>> --G. Polya ("How to Solve It")
>>>
>>> On Sep 1, 2005, at 2:55 PM, Nancy Anthracite wrote:
>>>> I hope I did not make people think I am supporting one or the
>>>> other. I am in
>>>> favor of both. I feel that if it is a small clinic, it should have
>>>> remote
>>>> backup perhaps with the primary server local. If it is an ASP sort of
>>>> situation, then I think the ASP might provide the primary server
>>>> but there
>>>> should be a local backup available. That describes my comfort
>>>> level, and,
>>>> as a logical extension, it is my opinion that it should be the
>>>> comfort level
>>>> for the VA as well ... not that what I think matters in the least!
>>>
>>> -------------------------------------------------------
>>> SF.Net email is Sponsored by the Better Software Conference & EXPO
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>>> --
>>> Nancy Anthracite
>>>
>>>
>>> -------------------------------------------------------
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>>
>> -------------------------------------------------------
>> SF.Net email is Sponsored by the Better Software Conference & EXPO
>> September 19-22, 2005 * San Francisco, CA * Development Lifecycle
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>> --
>> Nancy Anthracite
>>
>>
>> -------------------------------------------------------
>> SF.Net email is Sponsored by the Better Software Conference & EXPO
>> September 19-22, 2005 * San Francisco, CA * Development Lifecycle
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>> https://lists.sourceforge.net/lists/listinfo/hardhats-members
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>
>
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---------------------------------------
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)
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