The Patients Should Have the EMR

[sweaner]

I believe that ideally, the patients themselves should have the EMR. It should be portable, such as on a memory stick. We should have software which enables us to read it and append to it. This would fix what I think is one of the biggest problems in medicine...poor dissemination of information. This costs large amounts of money.

If all docs had their own EMR this would not solve this problem, as they would still not have access to other's data.

Scott

[pprescot]

Most of the parents I deal with can't even keep track of their child's immunization records. Lost, misplaced. A real pain. And we would expect them to do better with their own EMR records? And how do you keep a patient from altering their record?

[Kursk]

Megadittos Rush ... er pprescott. Americans won't even submit to having a national medical identifier, 'cause 'the man' can't be trusted! I'd settle with giving the ER dudes/dudettes/dudinas access on a thumbprinted, 'break the glass' need to my server to snatch my records.

Patients alter records? Neva! They should be allowed to append the record, however. In anticipation I have stopped referring to them as misfigured lecherous piles of pudding in the record, preferring "of his or her physiognomy, suffice it to say that he or she is genetically challenged".

At med exec meeting today we had to deal with HIPAA and denying pysch patients access to their records if the attending thinks it will be damaging to the patient. Only several hours debate last few meetings and 10 pages or so from the laywers, whom I am certain made a tidy sum but donated it to some local orphanage.

[sweaner]

Well, it looks like the implantable chip is on it's way. I feel this type of thing will help with patient care, but privacy issues are certain to come up.

How much money do you think could be saved if we knew. all the details of the patient's past workup and treatment?

Scott

[abower]

If this chip is anything like norplant, then it will be easy to install ( even easier because it will be injected) but difficult to the point of tissue and time loss to remove. You would have to remove it to update it or avoid overcrowding with chips wouldn't you???? :D

[jlively]

The intent of the implanted "chip" is to store nothing more than a unique id and it will never need to be updated with new information. This id could then be used to access some form of database that stores the actual records. Personally I think they are putting the cart before the horse. No need to use an id if there is no data repository to search against. No need to get FDA approval on a device that has virtually zero chance of being accepted by the public.

[Kursk]

The intent of the implanted "chip" is to store nothing more than a unique id and it will never need to be updated with new information. This id could then be used to access some form of database that stores the actual records. Personally I think they are putting the cart before the horse. No need to use an id if there is no data repository to search against. No need to get FDA approval on a device that has virtually zero chance of being accepted by the public.

Exactly!

I can just see my dad railing about the 'mark of the beast!'

[Tim2]

Priceless K!

[Kursk]

http://www.informatics-review.com/

FDA CLEARS VERICHIP™ FOR MEDICAL APPLICATIONS IN THE UNITED STATES
The VeriChip Health Information Microtransponder System consists of an implantable RFID microtransponder, an inserter, a proprietary hand-held scanner, and secure database containing the patient approved healthcare information. About the size of a grain of rice, VeriChip is a subdermal radio frequency microchip. Once inserted under the skin in a brief outpatient procedure, the VeriChip cannot be seen by the human eye. Each VeriChip contains a unique 16-digit verification number that is captured by briefly passing a proprietary scanner over the insertion site. The captured 16 digit number links to the database via encrypted Internet access. The previously stored information is then conveyed via the internet to the registered requesting healthcare provider

[pprescot]

...secure database containing the patient approved healthcare information...

Patient approved??? Uh oh ... And if something really really important gets put into the database but w/o patient approval???

Any bets on how long it takes hackers to get ahold of and reverse engineer the "proprietary" scanner?

I like the idea (with reservations about "patient approved") but prove it's very secure first.

[Kursk]

And what about the transaction costs?
Who will be responsible for data verification/authenticity?
If you treat based on the info and it is inaccurate and leads to a bad outcome are all parties indemnified?

Looks like it's DOA

[Kursk]

I am not thrilled about the idea of the chip for security either. All they need is the chip? Man I don't want them cutting off my arm to get access.

[ozzie]

getting thru aiports ???

sorry sir you will have to remove that arm

setting off scanners in stores..

gettign youself shipped via UPS ..

this is a stupid idea..

I am not a friggin walmart sales object..

It should be swallowed than after maybe 24 hours it will be where it belongs
I can just see the new drug ads
"scan your arm and ask the server if this drug is right for you."

[Kursk]

Yeah, why use a chip anyway - how bout a tatoo'd barcode!

Maybe my dad is on the mark here....

[ozzie]

and for the Jewish folks ???? and as they get older the missing bars are = to normal loss as that age LOL
so when you reach 140 the code is |

[pprescot]

Not to mention the possibility of tracking you where ever you go. Am I paranoid?

[ozzie]

spend much more time with that cat and the only thing you wil be seeing is rehab..lol

[pprescot]

Nope. She likes the Miller. I like iced tea. Fresh. Plain. Cold.

[sweaner]

I understand the problems with this solution, but can we think of a better one? I guess the patient could simply have a password to log onto a database. Anything is better than the system now, which is teh patient's memory. This likely costs billions of dollars due to repeat testing, and is not truely safe...we miss known diagnoses.

Scott

[pprescot]

More info on the VeriChip implant:

- cost to implant $150-200
- Global VeriChip Subscriber Registry service costs $9.95 a month to keep the database up-to-date, which the patient has to do!!!

Gee... I never read that in the press releases!

http://www.eweek.com/article2/0,1759,1676725,00.asp