Need for Nationalized Medical Records

With my last blog and post on Cloud Technology, I thought about the implications in our health records. Could this provide a means to a standardized or "nationalized" health records in the United States?

I know many people have different views on nationalized systems. I happen to be one that does support it due to the facts and data in Europe, South Korea, and various countries in mandating it. I know some will beg to differ, especially those who worry about "Big Brother".

Again, Peter Parker's quote comes back again. Before we talk about why it is bad. We have to understand why Nationalized Medical Records could be good, we need to see its strength. I hope on my next blog, we talk about what is bad about it.

My previous blog, "History of eXRs", hints toward a nationalized patient records. I will be honest that it does but the scope of nationalization varies (by the adopted vendors and health institutions/self-governing, state mandate, and/or national mandate).

Again, why centralized medical records (not nationalistic speaking)?

The Need for Centralized Medical Records
http://www.pinnaclecare.com/about_pinnaclecare/resource_center/white_papers/the_need_for_centralized_medical_records

Note: This is an open-ed and marketing for this group. But it does hit some main points. I will add another article on the same matter of centralized storage.

It starts out with how are patient records are currently documented and saved:

"If you're like most people, you receive your healthcare from more than one doctor—a family medicine specialist, an OB/GYN if you’re a woman, perhaps a dermatologist, an orthopedist, or a cardiologist. That means the records each physician gathers on your health and treatment are scattered across offices all over town, perhaps even all over the region. Of course, you do your best to inform each doctor of all of your conditions, tests, and treatments, but it's hard to remember everything during an appointment and sometimes you may not know what information is germane"

Remember, the biggest concern and growing aspect of most doctors' and dentists' practices are the LIABILITY of taking on patients (when their focus should be in treating the patient).

Without a full picture of the patient, they:
1) can improperly diagnose or duplicate multiple of tests for the patient
2) mistreat and not optimally treat a patient (second paragraph states my concern: "potentially life threatening")
3) collaboratively work with other doctors to provide the best treatment since issue of the patient could hit a different part of health care (Dentistry, it happens a lot like head trauma due to injury that affects jaw, teeth, and neck/backbone)

What comes down to it is:
1) Improved Health Care and Service as well as reducing waste or repetitive diagnosis (cost of healthcare is reduced)
2) Better and Clearer picture of the patient health
3) Easier Transfer and Means of Patient Records Access (This is a big point that I see first hand when a patient relocate, does not like the doctor)

As the article address, Markle Foundation (private foundation) did a study. "The study found over 70% of those questioned believe these records would improve the quality of care they receive."

Also, this clearer picture of yourself (including your family) could show better diagnosis. This is good for you as a patient of immediate care. (The negative I feel is the concern with all this health records and the risks of you being patient.. Meaning pre-existing conditions and family history of say, cancer... Your cost to insurance.. Address on the next blog).

Though the article hits the point of medical records, a nationalized medical records are still away (though the mandate should be by 2014). What is truly important is that your medical records (like your credit report) are accessible via Internet. It is possible to reach the information if you were traveling oversea.

"Because the information is in a compact digital format, it can easily be transferred at any time to any location around the globe if the need arises. There is also a highly secure online site that allows access to a members' complete health record anywhere there’s Internet access."

That is the intention of electronic Patient Records. The biggest concern and issues for centralization are:

1) Standards and guidelines
2) Who dictate the standards and guidelines
3) Security (since this data is so valuable to marketers and hackers)
4) Who holds the data for access?

Centralized, Electronic Storage of Medical Records
http://it.toolbox.com/blogs/adventuresinsecurity/centralized-electronic-storage-of-medical-records-22748

Again, the same arguments of benefits are addresses as well as some of the minor concerns of that benefits (I hit #2 and #3 which is the biggest no from many who oppose this as well as cost).

As Google (a big, cloud data center) will work on a pilot with Cleveland Clinic to provide medical records over the Internet:

"The test program will allow 1,500 to 10,000 patient volunteers at the Cleveland Clinic to store certain records - on prescriptions, allergies and laboratory test results - in a secure Google account. Patients will have passwords, and only they will be able to access the medical records"

With this technology, the speed of obtaining medical records is instantaneous. Added with the right security, the right people will access the right files. That information could be provided to your doctor/dentists. Have you ever dealt with patient records transfer from one office to another (relocation as an example). It could take days to send, verify, and entered (into the system). What if the patient has major surgery and time is an essence? Also, the handling of information could be very diverse (US Mail, UPS, FedEx, email, encrypted email, etc.) Since software do not necessarily work the same way, the data you get might not be usable to your current practitioner (I dealt with a Veterans Hospital eDR sent to a private dental practice via CD. Checking the CD, we could not read anything except file names. Why? Because the Image Format was proprietary and only readable in their software.. There's HIPAA for you.. =P )

With electronic services becoming the norm in dentistry. Paying your bill online, confirm and cancelling appointments, etc., standardization becomes a bigger variable on how the information displayed, accessed, and modified (as well as format for sharing between health organization like your private practitioner to hospital).

As for technology impacting my career?
I hits all angles. I have to be proficient in various governing laws (Like HIPAA, Red Flag, etc.) and state laws and regulations (NY is different from NJ and CT). I can't just be focus on the technology and understands the politic and stakeholders in the industries. Technology is forcing myself to be more of the instigator of technology as well as the ambassador to standardization.

Lastly, this argument is not only Patient Health Care Records. Like this webpage, it talks about the strength and weakness of centralized vs.decentralized filing (in this case, just records.. Who is to say that it could health records if EPA was not written on it).

http://www.epa.gov/records/tools/central.htm