>  I would like a doctor to have access to my records if I am sick in one
> part of the country while I, along with my PCP, live in another part of the
> country.
>
> Early government estimates show that 212,000 jobs could be created from
> this initiative, but perhaps the biggest obstacle is overcoming HIPAA
> privacy issues.  I am certainly not an expert on this subject, but I would
> love to read what everyone thinks about this topic, both pro and con.


Where to begin?  Well, it's not just "a doctor" that would have the ability
to have access to your medical records, it's anyone who had the password to
the files.   HIPAA is but one concern, it's access control that's the larger
concern.

How many times has your doctor's office changed staff?  If/when you've been
treatd at a hospital or an urgent care clinic, have you ever seen the same
staff twice? What about shifts and days off, naturally there are different
people involved on all of those.

And when you go to a lab to have blood drawn, or give other samples for
testing, is it always the same lab and the same technicians?

What about when your doctor changes practices, or his practice joins another
group, or your insurance changes providers?

And most of the staff in these locations are pretty well technically
trained, I'm sure none of us have event heard "Oh I'm sorry, we can't seem
to find your chart" before... so when these individuals start keying in
information, well, I'm sure it will be done accurately... especially if you
have a real uncommon name like SMITH, S... =)

Now, the BIGGEST concern.  Digital permanence.  Long-term persistent access
to the content stored in digital form if paper records aren't kept.  Most of
the data that comes from medical equipment comes in proprietary formats
linked directly to the manufacturer of the equipmet/device generating the
data.  How long before one of these companies folds or gest bought out or
merges with another and what happens to support for the data generated in
these original formats?  Who pays for converting or migrating it forward to
a format that is still supported?

And what about the media its stored on? Medical professionals aren't data
stewards.  They will likley be commingling data in folders on hard drives
and backing it up in a serial form to tape or DVDs (best case) or will be
streaming it off-site to a third party for backup (worst case) where your
data will be further commingled with the medical records of who knows how
many other people.

Sure thee are benefits, but they aren't outweighed by the risks.  Problem is
the people wanting to build this are the same people that can't store their
own records properly, our friendly Government.  And until they spend the
time necessary to learn about capture and management of data, and long term
digital stewardship of the same, I'm not comfortable with them mandating
it.

Anyone remember what happened following Hurricane Katrina with medical and
mainly prescription records?  I sure do...
http://blogs.computerworld.com/node/994   (unfortunately many of the
embedded links have expired.. a note to many other bloggers here!)  but the
gist of the story is the DHHS told pharmacies to give copies of their tape
records of prescriptions from the various states in the Gulf Coast area to a
central source  for management and availability... but there were no/limited
safeguards in place.  And the intent was the records would be returned "when
things were back to normal in the region", which has yet to take place.
Imagine if you were an AIDS patient, or someone under psychiatric care, or
care for substance abuse and all of thew sudden your prescribed drug
treatment records were essentially public... and the worst part about it was
DHHS said they were not going to enforce the provisions of the HIPAA
regulations during this time.

I have a few posts n my blogspace on Computerworld on EMR/EHR concerns...
http://blogs.computerworld.com/medina  none of them new, in fact some of
them nearly 4 years old, but the problems and concerns are the same... no
one has done ANYTHING to improve on them.

More planning, less rushing into the issue is my word on it.

Larry
-- 
Larry Medina
Danville, CA
RIM Professional since 1972

List archives at http://lists.ufl.edu/archives/recmgmt-l.html
Contact [log in to unmask] for assistance
To unsubscribe from this list, click the below link. If not already present, place UNSUBSCRIBE RECMGMT-L or UNSUB RECMGMT-L in the body of the message.
mailto:[log in to unmask]