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Electronic Medical Records, the Story So Far
StupidPeopleTrick writes "After the executive order signed in 2006, states are making strides with privacy breach notification but are struggling with enacting privacy laws and finding funding.
With looming deadlines to move to e-records and e-prescribing, where will the money and the privacy standards come from?"
With looming deadlines to move to e-records and e-prescribing, where will the money and the privacy standards come from?"
The VA hospitals and clinics have an open source package called VistA (Veterans Health Information Systems and Technology Architecture). Veterans can walk into any facility and have their medical records available.
And we already paid for it!
http://www.va.gov/VISTA_MONOGRAPH/
"There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy." Hamlet (I, v, 166-167)
...we are already starting with the "EPD" (Electronic Patient Record) this year.
Every citizen to which it applied got a letter in their home, from the government, asking if they wanted to object. For this they had to reply using the included form and a copy of their ID.
Until now, approximately 500.000 objections have been sent in.
Just last week, the government proposed hard actions against those who violate the "EPD", such as high penalties. Insurance companies are not allowed access to the EPD and doing so would give the patient an immediate right to go to a different insurance company.
Let's be frank - these 500.000 people understand the one and only true thing about EPD : once information is out in the open, you never going to get it back in.
Just a while ago I got my own medical file from my physician - I am in my 30s - which contained 6 pages of text...
That's not a huge load of information, and makes it very easy to copy. Once out, anyone knows my complete medical record from my birth onwards. A penalty against misuse would thus not work, it would simply be used to blame any messengers that stand up and find flaws in the security.
One such flaw was already found last year: most hospitals (yes - publicly accessible hospitals) don't password protect their terminals.
Argument ? In an emergency, they do not want to put up the physician with all those tough things like entering passwords.
I respect the ideas of your new president, but I think he should definitely think again when implementing this - information wants to be free.
Solutions ? Maybe give only the patient the private key to unlock the medical database. It was an argument here, but was quickly thrown away on grounds of "much too difficult" and "what in an emergency" etc. Until that solution is seriously looked upon, or at least until the security of it all is completely looked after, my vote against this would be a big fat "no way".
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I will tell you about the UK experience of computerised medical records.
The government wants everyone's medical records on a database, searchable by who knows who for whatever fishing expedition they want (including giving this private data to drug companies and the EU), no justification of their actions is required. The records are not secure, we already know that because the government lost 26 million taxpayers records in one go, and that's supposed to be a secure system.
So far the scheme has burnt through £16bn (about $24bn), it still mostly does not work, is years behind schedule, and is expected to burn through another £8bn.
If like me you object to your medical records being computerised and being available to any member of the state for their fishing expeditions, your doctor will tell you to get lost.
Like it or not, the state will do whatever it takes, and will not care what laws are already in place (like data protection laws) to stop such schemes.
Take Nobody's Word For It.
<?xml version="1.0"?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.ReleaseTwo.CommitteeBallot03.Aug.2004.xsd" templateId="2.16.840.1.113883.3.27.1776">
<title>Consultation notes</title>
<body>Patient is an incorrigible troll. Recommend medevac to an appropriate jurisdiction and performance of lobotomy. Note: This procedure may or may not result in reduced intelligence or motor skills, as levels between this patient and previously lobotomized patients proved comparable.
</ClinicalDocument>
I hate printers.
My father called the hospital the other day and gave them his name, and they asked "Is your social security number XXX-XX-XXXX?"
Ummm anyone else see a problem with this?