EHR & our healthcare system, match made somewhere?

EHR & our healthcare system, match made somewhere?

Electronic Health Records are a good thing, except when they are not. Being disabled, medical professionals are a major part of my life. Interactions with them, for the most part, can’t be avoided. I consider myself a geek and reasonably wise to electronic communication means. I even have a working knowledge of HIPAA and all that entails. Coming to grips with the utter lack of EHR implementation at the consumer level is difficult to deal with. One of the providers has a reasonably popular medical specific web portal. It’s not very functional, but it exists. Another group is part of the region’s largest system. My mind struggles with the concept of a total lack of confidence in modern medical communications and associated technology. Having a secure HIPAA compliant communication portal, app, or even Whatsapp, which is 100% encrypted, suitable for transferring files that can be imported into the record keeping that all facilities are mandated by law to control. As the nation nudges toward a single payer system, despite current politics, inefficiencies become sore wounds and costly. The lack of portable EHR with a common format for the secure interchange of data will come back and bite the clients who are in no position to weather the outcomes. Nobody, not even TPTB, wins in that environment.

Recently, I had a doctors appointment with my family physician. What is interesting about this event? He carried a tablet with a keyboard dock with him as he discusses with the patient. All of our conversations are transcribed and available for reference. The rest of the office only has the standard technologies; desktop computers, printers, faxes, that sort of thing. I printed out the most recent list of medications, and the staff either scanned or typed the information in their systems; couldn’t tell which, and it didn’t occur to me to ask.

As I was researching this post, there are few events in life that haven’t happened to someone else, this being no exception. As early as five years ago, this entered my view:

Healthcare facilities need to work with providers to make it easy for them to deliver excellent care. This includes having ready, instant, and continuous access to complete patient records – access resulting from compatible EHR systems and dependable computer networks. Standards must be set and enforced that allow compatibility across systems. A start has been made in this direction, but it needs to progress quickly yet carefully (Tong, 2012)

If any of my interactions are any guide, these lessons were not learned nor executed. And that is a shame really. Anything close to a potential utopian solution must have the free and fair interchange of Electronic Health Records while automating as much of the nonclinical minutiae of the American Health Care system; even if it remains a continuation of the Affordable Care Act.

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Health records 101

Most every topic imaginable has a report, think tank, or field study attached to it. That is just the way it is. “Sophisticated” technology will be necessary to make sure that patient records are unique. Many moons ago when I was active in IT, I was always taught to normalize data by creating rules to stop most bad data from entering the system. Errors such as leading a required field blank or a Social Security Number not entered should NEVER happen. The fix is simple, make the fields required, and stop processing until they are filled and properly formatted. In the 2016 version of the web, this can happen with web-based, app-based, or other forms, and it is a no-brainer. Patient name misspellings cannot be eliminated totally, but greatly reduced if a simple crosscheck query of name fields that correspond with SSN numbers or other information that can verify results. The report wants to make it sound or in practice be harder than it really is, but that is why they get “the big bucks”. “Creating policies and procedures for front-end and back-end staff to follow is foundational for the overall data integrity process” (Katie Dvorak, 2016, para. 8).When you hang around any industry long enough, what is old is new again to different generations.


Katie Dvorak. (2016, April 20). Report: Providers must adopt sophisticated tech, stronger policies to prevent duplicate patient records. Retrieved April 21, 2016, from http://www.fiercehealthit.com/story/report-providers-must-adopt-sophisticated-tech-stronger-policies-prevent-du/2016-04-20

Encryption, Encryption, Encryption

After all of the recent issues with Ransomware and other cyber-attacks in the healthcare field, paying attention to the details can be overlooked at your peril. In my home state of Alabama, a laptop was stolen from a vendor to CVS Health. This laptop, for some unexplained reason, had Protected Health Information (PHI) on it. Of course, it was not encrypted, as per CVS network policy, so somebody had a field day with people who used a certain Pharmacy in Shelby County (Birmingham South Suburban). Their so-called private information was not, and now the company has to inform those on it, and presumably make amends for this.The laptop contained information about customers who have had prescriptions filled at the CVS store at 8370 Highway 31 in Calera, the company announced Monday. The laptop was stolen from the vendor and reported to the Indianapolis police department (Kelly Poe, 2016, para. 2).Interesting tidbit here is that it was reported to a police department over 500 miles away from the “scene” of the crime. A later version of the story said it happened at the unnamed vendor’s locale, which is not the CVS in question.

  • This has HIPAA written all over it.
  • Ignorance is not bliss.
  • Compliance is not limited by company size.

Kelly Poe. (2016, April 18). Alabama CVS’ patient information at risk after laptop stolen. AL.com. Shelby County AL. Retrieved from http://www.al.com/business/index.ssf/2016/04/patient_information_at_risk_af.html