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elizabethv
elizabethv
6/8/2016 6:19:35 AM
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Platinum
So Confused
I am continually amazed and confused that it is taking so long for healthcare providers to create digital systems to keep track of clients data. This has always seemed like such a basic idea to me. You would think it would help with keeping track of patients allergies, medical history and needs. It should just make sense that doctors would benefit from this as much as patients. That the push is just now starting is beyond confusing to me.

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Ariella
Ariella
6/8/2016 8:59:49 AM
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Author
Re: So Confused
@elizabethv Let me tell you about the downside of that, though. My husband tried to make an appointment on Sunday morning but was told the office couldn't do anything because the computer system was down. The main part of the appointment was having his blood drawn and his blood pressure taken -- neither of which require hookup to a computer. But because the filing system there is a digital one, they didn't want to do anyting at all without access the the computer. 

In a hospital that is even worse. Nurses spend so much time entering the data on the patients into the computer systems that they ignore the patients who attempt to disrupt them by asking for something. I've seen this first-hand at hospitals that are rated among the best. 

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Michelle
Michelle
6/8/2016 2:29:51 PM
User Rank
Platinum
Re: So Confused
@Ariella I've seen a similar shift as digital health records came online. Providers are all very busy entering information into poorly designed systems rather than paying close attention to patient responses. My own medical record with one provider is rife with little inaccuracies that could have been prevented if my answers were recorded correctly. There's nothing live-threatening in all those mistakes, but it doesn't give an accurate picture of me as a patient. 

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Ariella
Ariella
6/8/2016 2:37:19 PM
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Author
Re: So Confused
@Michelle, indeed. Even for doctors who work for the same healthcare network, say LIJ, there is not the kind of record communication you would expect. For example, at my daughter's last checkup, I was surprised to learn that her doctor never got the information about her prescription from the specialist the doctor had referred her to. She still had the old dosage amount on her record, though it was changed nearly a year before. 

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Michelle
Michelle
6/9/2016 10:40:50 PM
User Rank
Platinum
Re: So Confused
@Ariella interoperability and data portability are a serious issue for the healthcare industry. We all expected digital health records to be better than paper -- that expectation only works well in theory. 

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Ariella
Ariella
6/10/2016 8:46:10 AM
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Re: So Confused
< that expectation only works well in theory. > @Michelle so true, I couldn't have put it better. 

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Michelle
Michelle
6/12/2016 5:03:06 PM
User Rank
Platinum
Re: So Confused
@Ariella I hope the future will be better, but I suspect it's going to take a very long time to get there...

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faryl
faryl
6/8/2016 10:47:30 PM
User Rank
Platinum
Re: So Confused
Generally speaking, I like that my health care provider has everything online/digital, because I know everyone I see there has all of my records avaialble, and I especially like being able to see all of my lab results, etc. through my patient account.

That said, a couple of weeks ago I had to go to Urgent Care. They were in "triage" mode with an appx 4 hour wait time because a recent system upgrade took the whole system down - so every one of Sharp's Urgent Care locations were unable to to check patients in, access records, insurance, etc.

 

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elizabethv
elizabethv
6/9/2016 7:40:20 AM
User Rank
Platinum
Re: So Confused
@faryl - I agree, my doctors are all connected with an electronic file system, and I absolutely love it. Particularly that I can receive lab results on my phone in just a few hours. But holy wow! A 4 hour wait at urgent care! I don't even know how I would handle that. I had to wait 2 hours at the urgent care the other day with my two toddlers and I nearly lost my mind. Computers crashing are certainly the bane of all technology.

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Ariella
Ariella
6/9/2016 9:11:02 AM
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Author
Re: So Confused
@faryl my husband recently tried out an urgent care for the flu. He said the doctors were available, but the desk people didn't pay attention to send patients through. The doctor actually came out to look for his next patient. They also were having difficulty with their computer system. No one seemed able to figure it out.

But as for the data sharing, it just doesn't happen. When my son had surgery, the doctor who told him to go into the hospital never got the hospitalization record. We had to put in a request that only gave paper records to us. I'd guess they're concenred about privacy problems in passing it on to any other hands. And even within the system, like the radiologist report getting to the surgeon within the same hopital, the transfer is not necessarily automatic. Loads of times, we had to take the image in physical form -- even an X-ray itself because of that.

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elizabethv
elizabethv
6/10/2016 8:31:20 AM
User Rank
Platinum
Re: So Confused
@Ariella - I would think your reasonining is spot on. The biggest reason for a hesitation in data sharing is likely HIPAA. I know my doctor had all patients willing to be put on the internal computer system sign a document agreeing to do so. I know everyone wants their privacy protected, and that's certainly understandable. But I also worry it can go too far. If I need to be seen by a different doctor, why wouldn't it make sense that I would want that doctor to have as much information about my past health as is possible?

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Mike Robuck
Mike Robuck
6/10/2016 10:20:07 AM
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Author
Re: So Confused
@elizabethv Service providers need to make sure they comply with HIPPA requirements. Lots of personal healthcare info going back and forth over the Interent. I did have some addiotnal questions on how this works on the backend, but AT&T wasn't ready to talk. 

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elizabethv
elizabethv
6/9/2016 7:36:44 AM
User Rank
Platinum
Re: So Confused
@Ariella - There can be downsides to anything. When I worked fast food, customers used to give us a hard time when we wouldn't take orders when the electric went out and we didn't have registers. Make fun of us because we couldn't do math without the registers. Yet it had nothing to do with needing the registers to do math and everything to do with the fountains, that wouldn't run without electricity, and the actual register drawer that wouldn't open without it. So we were supposed to just sit the money on the counter? Find a random pencil box to collect it in?

Sure, it can be tedious to have to transfer written data to the computer (I actually have to do this very thing in my job daily) and if a nurse is ignoring her patients to do so, that sounds more like a nurse problem. (I happen to know they get specified time for charting, my best friend is a nurse.) And realistically, it can save lives. If a person is allerigic to a specific medication, but unconcious and unable to relay that information - a computerized system would tell doctors not to give it to that patient. Or even if they had previously been addicted to morphine, and overcome that addiction. If a doctor didn't know that, and gave them morphine while they were unconcious, they could potentially start a whole new horrible cycle for that person to deal with. To me, the benefits greatly outweigh the risks.

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Ariella
Ariella
6/9/2016 9:14:59 AM
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Author
Re: So Confused
@elizabethv I agree that it is good if it works as it should. Often, though, it does not. Plus there are additional concerns about the lack of security and the lack of attention. It's not just nurses but doctors, too, who focus so much on the computer that they hardly pay attention to the patient. See the comments on  https://www.healthit.gov/buzz-blog/privacy-and-security-of-ehrs/privacy-security-electronic-health-records/

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batye
batye
6/9/2016 9:38:13 AM
User Rank
Platinum
Re: So Confused
@Ariella in Canada we have almost same set of problems with digital healthcare... plus corraption - http://www.cbc.ca/news/canada/toronto/ehealth-scandal-a-1b-waste-auditor-1.808640

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Ariella
Ariella
6/9/2016 9:50:58 AM
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Author
Re: So Confused
@batye Oh, we get corruption here, too. There are loads of places that pad their bills. As the insurance pays, they figure people won't care, though higher payouts always lead to higher premiums. At my daughter's last checkup, my pediatrician said that she noted a $10K charge for a "procedure" on her mother's office visit. She said there is no way she had a procedure in a regular visit that should cost that much. It's possible that it was due to a clerifcal error in marking down the wrong code, or it is possible it was deliberate. She tried to report the problem, she said, though the insurance company didn't take that much interest.  

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batye
batye
6/9/2016 10:09:19 AM
User Rank
Platinum
Re: So Confused
@Ariella  sad reality many scammers get away with it in Canada at least slap on the wrist... sad sad sad...

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DHagar
DHagar
6/9/2016 2:31:17 PM
User Rank
Platinum
Re: So Confused
@Ariella, regarding healthcare billing errors.  You are correct, the estimates are that 20% or more of bills have an error either in coding, amounts, etc.  We have applied technology and only expedited the errors.  Healthcare needs reforms so that the technology enables it to detect these errors (not just process).

In the meantime - check your bills!

 

 

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Ariella
Ariella
6/9/2016 2:38:28 PM
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Author
Re: So Confused
@DHagar Yes, and the same human error resulting from using technology can cause more serious problems with respect to prescription errors. I once interviewed the CEO of MedAware.  He explained that the computerized systems sometimes have dropdown menus. While that is intended to eliminate the problem of illegible handwriting, it does lead to errors in prescription due to proximity in alphabetical order. 

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DHagar
DHagar
6/9/2016 2:43:24 PM
User Rank
Platinum
Re: So Confused
@Ariella, incredible!  Every additional step you add in processing, without building in intelligence to detect errors, will only compound the problem.  In other words we have "automated" our errors.

I think a "system" design, such as AT&T is designing to connect facilities and patients may lead to a better design than the patchwork applications we are identifying that are not making healthcare better.  Let's hope that leads to better results.

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mpouraryan
mpouraryan
6/9/2016 7:19:06 PM
User Rank
Platinum
Re: So Confused
I am curious to see what your thoughts are @DHagar & @Ariella to this development--and whether in fact the AI evolution we're witness to will in fact render the concerns "mute"--an old friend of mine once noted how Pharmacists are also in trouble as a profession:

http://iosnews.chinadaily.com.cn/newsdata/news//201606/07/400116/article.html

 

Wishing you all a fab and joyous W-end

 

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Ariella
Ariella
6/10/2016 8:50:37 AM
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Author
Re: So Confused
@mpouraryan I've heard about pharmacy being an endangered profession for decades. I'm 100% certain that most of the people I seek working the pharmacy end of CVS are not pharmacists. There are one or two that rotate, but mostly there are cashiers who just check that your order is in and what you have to pay, then have you sign off. Though we still get some prescriptions there, when we can, we get the mail order associated with our insurance because the price can work out to be about 1/3 the cost. So in time that could cut a bit into the pharmacy business of even the major chains like CVS.

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batye
batye
6/13/2016 4:25:53 AM
User Rank
Platinum
Re: So Confused
@Ariella in Canada it the same at my pharmacy... I do hope one day it will improve...  but I think it gonna be soon like coca-cola or ATM machine put your card in get your medicine... 

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Ariella
Ariella
6/14/2016 10:35:26 AM
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Author
Re: So Confused
@batye actually, it would make sense to work it that way for some common prescriptions. It can even be hooked into the computer systems for doctor's prescriptions and for insurance information.

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DHagar
DHagar
6/9/2016 2:28:42 PM
User Rank
Platinum
Re: So Confused
@Ariella, indeed - the patient is now a bystander in many cases.  The health industry has deployed the technology to enrich the science, but has left the improved relationship with the patient behind.  They need to rebalance and make the health care services more intuitive and patient friendly.

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clrmoney
clrmoney
6/8/2016 11:18:34 AM
User Rank
Platinum
AT&T connected to Healthcare
I think this this is great foe At&T to be doing this theis the data services and products they have available to the public. So addind thsi to their repertoire would just increase more revenue for them.

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afwriter
afwriter
6/10/2016 5:48:57 PM
User Rank
Platinum
What a Headache
I know that this is all for the better and healthcare and technology are two industries that go hand in hand, but just reading the comments section on this article gives me anxiety.  I know one IoT area that has already been working for years in the health field is the use of tablets around the hospital.  Instead of having physical Xrays delivered the images can just be sent to a tablet that the doctor is already holding.

 

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elizabethv
elizabethv
6/11/2016 8:29:34 AM
User Rank
Platinum
Re: What a Headache
@afwriter - you're right. Hospitals have been using tablets for awhile. When I was at urgent care with my son earlier this week there was a computer screen in the room that allowed them to pull up his lab results and we discussed them there. There is already a fair amount of use of technology in the healthcare setting. Drawbacks aside, I still support a larger system that would allow doctor to doctor information sharing of medical histories. Like all technology, the kinks will get worked out.

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