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Medical Records - Online and National

dilaurodilauro ConnecticutPosts: 9,846
edited 06/11/2012 - 8:52 AM in Chronic Pain
I sort of got stumped as to what category to put this thread into. It almost really does not fit into any specific category, but unless I can come up with a better home or someone suggests one, I will keep it here.

Back in 1980, I was working on joint project with IBM and the University of Alabama. The scope was to get medical records online and centralized. My role was just to install/configure the main frames and tie all the pieces together. Well, after about 4 years, that project ceased.
I still look at the downfall is that System Engineers and Programmers were trying to put together a system that the medical industry was going to use. Even at the University side, their IT staff was mostly involved with only little medical input. It just didnt FIT, the technical folks really did not understand what the medical field needed, and they just rammed some menus and procedures down their throats.

Fast forward to 2009+ They has been so much progress in terms of online and centralized medical records. I have been fortunate enough to see this from the medical side as well as the IT side. This time it will work, because the requirements are being generated by the people who will be using the system.

Its still a bit rough, needs some smoothing over, but it will work. The overall benefits to hospital costs are overwhelming. I was totally amazed at just how much could be saved by the way a menu was put together when a doctor would order some medications for a patient. Putting the less expensive medication at the top and putting the expensive medication at the bottom made the difference. Both drugs did the EXACT thing.

Thats just one small part on how this will save money. Then as the data base gets more populated within one hospital it will start to overflow into others so that data can be shared easily. Much of this is done today. Have a MRI in Hartford CT at 11:30 pm and then having a doctor in Paris, France read the image and provide details about the MRI within minutes.

This will work and it should. There are two pieces that need to be addressed (at least at this moment)

1 - Getting doctors, therapists, technicians comfortable with computers, keyboard and mice. Its amazing how many can only touch type with one finger.

2 - The patients view. Since I've been involved with computers for over 35 years, anything in this field is normal to me. But for many it is going to be difficult.
You go in and are seeing a doctor. Before, they would be looking at you, writing down what you said and generally maintain eye contact. Now, there will be many doctors that face sideways to the patient, listening, but then muddling through the keyboard to enter data. There will be this 'sense' of doctor-patient wall put up.

If you think about centralized medical databases, the potential is endless. Just think, lets say if you took a vacation to Italy and came down with appeared to be a heart problem. Within minutes, the doctors in Italy could retrieve all the data and diagnostic tests that that patient had in the States. Based on that, they could determine that instead of a heart problem, it was a
thoracic disc problem that the patient has had for a while.

Now, this example is lame to an extent. I just wanted to post it for what it could be worth.

I can not wait for more and more of this to expand. Remember, lower costs to hospitals at some point will result in changes in insurance which should translate into lower costs to the patient. Thats what we, the patient would love to see

And for the medical field, the ability to have access to medical records, tests, prescriptions, etc for almost any patient will save time, which can translate into helping more and potentially saving more lives.

Ron's disclaimer

I am not associated or affiliated with any hospital (well indirectly, since my wife works at a hospital), nor associated with any physician that is involved with some of these plans, nor any software company that is developing this.
I am just seeing something that I worked on almost 25 years ago, begin to come to life and that is exciting.
Ron DiLauro Spine-Health System Administrator
I am not a medical professional. I comment on personal experiences
You can email me at: rdilauro@veritashealth.com


  • In our area, all of the Records are online and accesible through each hospital only. So St. John may have 5 hospitals in its network and each of the 5 has the same mainframe.

    Same with St.Lukes.

    So When I had my Mri, the Doctor was reading it before I Ever left the building, she was trying to call me with the bad news.
    Another thing is that XRAYS. MRI'S and Ct scans are now saved by the Patient in a Digital File, and they can all be burned on a Disc and copied by the patient. Who can mail out multiple copies where ever they need them.
  • My concern with centralized medical records is the potential for abuse, specifically for data to potentially be used in a manner which may compromise patient care and privacy...
    For a long time there has been already been a data bank called the MIB - Medical Information Bureau, which insurance companies have for a long time used to decide who they would and wouldn't insure, how much premium, riders, denials etc. they would issue. Whenever you see a doctor for something, if insurance is filed, your diagnoses goes into the MIB. One thing I have regretfully already seen is doctors using incorrect medical codes (formerly known as ICD9's) to justify procedures, or "exaggerate" symptoms to allow for upcoding of services in the face of decreasing insurance reimbursements to doctors and hospitals...
    The other issue with centralized records is HIPAA on an even more exaggerated way- and abuse of otherwise private information (say for example, prescriptions) and how many people would have access to all data in the scenario of centralized records. Is it really our business to know Brittany Spears went into a psych. hospital? No. If you were a male with sexual issues due to S1 nerve root impingement from surgery - would you want your neighbors whose daughter is a pharmacy tech to be divulging your private information? No. Think it won't happen even moreso with centralized records?

    This conversation could get "political" very quickly in terms of rationing of care and medications which I sure was not the intent of the post, but it may not always be the "panacea" that some sources pretend it will be. Do you really think the government is giving doctors incentive to purchase certain medical software systems for the benefit of the patient? Bottom line is if they are footing the bill, they are going to want more control or say in what is done and what time frame. In a perfect world all that personal health information could be accessed only with your permission to improve your quality of care...but that's not how the "big" system will necessarily work or be used. If you have a UserID and password, your "in"...
  • dilaurodilauro ConnecticutPosts: 9,846
    is for this thread to go political.

    This all will be happening in the near future.
    Yes, some of your concerns are very real. Its one thing when all the medical records are in hardcopy, so access is somewhat limited. Once it is online, controlling access needs to be a top priority.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I agree with Optimist. This to me is more of a disaster waiting to happen than a way to streamline and provide better care. In a perfect world I'm sure it would be a fantastic thing, however we do live in imperfect times. For every programmer that develops a new program, there are countless hackers waiting to get their chops into the code to see if they can crack it.
  • We can all debate the potential for abuse. Most anything than can be placed with a high value. Is potentially going to be corrupted by some. In this case information is a big commodity. Information is power and money. Keeping corrupted individuals and groups, be it government, or criminals, is probably the bigger hurdle to overcome.

    I agree with Mouse that she showed an example of how the "system" is flawed. That a person can be a repeat, in a big way, offender. Get a slap on the wrist and continue. But that is an example of how the system has holes and gaps that need to be addressed. Simply blaming it all on the feds and say they all screw everything up is over the top. We can all sight examples of someone who beats the system. The amount of criminals in some respects simply overwhelm the system.

    Make no mistake though. This database will move forward. Along with many other ones being built that track even more information about you. We have to hope HIPAA and other government agencies provide the checks and balances to control abuse. You can't completely stop it.

    Instead of fighting something like this that we really are not going to stop. It would be better to spend our energies on coming up with ideas on how to help insure that safety. Then push back on our politicians and agencies. Don't worry, I'm not looking at the world through rose colored glasses. I still don't trust most politicians further than I can throw them. We need more ideas that help stop them from creating abuse in the first place. That is the daunting task agencies like HIPAA could use help with.
  • With everybody looking for convienience and ways to track the patient and even Drs., I think the real disaster(s) will happen when the system fails, is manipulated, or just plum taken out. More to worry about besides abuse and petty things like that, we are in turbulent times, a period is which there is a lot of uncontrolled changes happening all around us, and I'm not certain things won't start to happen right here at home.
  • We see examples of how people get over on the current systems.... but truthfully, she isn't "getting over" she's simply commiting a crime that most people feel should be treated differently than say... a murderer or rapist, someone that breaks into your house in the middle of the night.

    A current view of how people view "drug" related offenses is to see how the old I think they call them, Rockafeller (sorry, I can't spell that for nothing!)drug laws are viewed.

    People- boomers really, feel that jail for a joint or a pill is excessive. Maybe because at one time or another, they could have been that person ;p
    So... I think some thought needs to be given to how punishment would be metted out. Do you send them to jail? It means they're in with so called hardened criminals, likely to be abused, and they're costing us money. But, lack of jail seems to create folks that just keep on doing that offense. Treatment? Umm... yeah, for folks that WANT to be treated, treatment can help... for those that do it to remain Out of jail or to remain eligible for financial assitance or whatever(welfare druggies) treatment is a major waste of time, money and effort. You cannot begin to imagine how much some of these places charge... and to think that we put people in there that did it to themselves... and will do it again.. and again, boggles the mind.

    Think of how that money could be spent for people that need medical treatment but can't have it because they cannot afford it and do not have insurance... There are an awful lot of people out there that work, pay their bills, pay their taxes... and do not qualify for medicaid either. They just suffer I guess.

    Beyond the scope of the privacy issues there are so many other things that need to be looked at and determined ( Z06 is correct, info IS money and the industry is growing at a time when we're told things are stagnant!!)

    We have to make it clear to those we elect that what they said before the vote had better take place after it or they are gone. This is simply one area where it will affect a certain segment of the population-pain patients- much more than those that take "standardized" meds for HBP, or ER or Diabetes...

    While the change is "a-coming", it's up to us to make sure it doesn't run us over as it goes by.

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