The EHR: Let’s talk openly about privacy…

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Do you remember the first time you went shopping and the checkout person asked for your name, postal code, email address… before even getting to your order? I know I was a little hesitant about giving away this personal information, especially not knowing how it would be stored and of course how it was going to be used. Significant changes to privacy legislation here in Canada have made us breathe a little easier – because it essentially outlined that a person must consent or allow companies to hold on to personal data and that companies may only keep this data as long as it’s necessary.

But what does this mean for information about your health that’s stored electronically? What happens to the privacy and confidentiality of your medical data as we move to an electronic health record?

A few years ago the Canadian Medical Association did a study on electronic health records and more specifically, how Canadians felt about sharing their personal health information within the healthcare system. It found that while 6 in 10 Canadians are confident about the benefits of a province wide electronic health record (EHR):

  1. almost 50% are nervous about EHR’s
  2. 72% want the private information shared with their doctor to be kept confidential
  3. 87% believe that the confidentiality of their personal information is the most important issue in setting up an electronic health record

It’s clear there are some critical issues that need to be resolved in the quest to realize the full potential of EHRs. I believe that these types of electronic health records hold great promise in improving healthcare, but I also don’t want to lose control over how my personal information is used.

David Daglish, a Ph.D. candidate at the DeGroote School of Business, McMaster University, is researching consumer opinion regarding electronic personal health records (ePHRs). More specifically, he’s interested in factors of trust, risk, and security. This is important research and I encourage you to participate if you can spare 20-25 minutes.  David’s survey can be found online at www.tinyurl.com/ehealth-study

- Robert

Leave a reply here or share your thoughts on our MedicAlert Facebook page.

My Healthcare Technology Wish List

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I’m amazed about how technology is changing our lives in so many ways.  It’s had a great impact on the way we receive our news, entertainment, even the way we pay for things.  Technology hasn’t yet had a transformative effect on the way in which healthcare is delivered, but it will.  And in the spirit of the New Year, here is my wish list as to what I would like to see happen:

1.   I’d like an electronic ‘window’ into my health information held by my GP. I believe this would allow me to be a better, more informed patient. Linking this data to trusted sources of information on the internet would be even better.

2.  I want to see technology used better to manage my interactions with the healthcare system.  I’d love to schedule my own visits but even better, to use telehealth technology to have a ‘virtual’ visit where I don’t have to physically be in the doctor’s office.

3.  I’d love to see my physician use social media tools to better understand him as a person and perhaps to also get greater insight into the demands and challenges of running his busy family practice. This is new territory with potential pitfalls but the adoption of technology requires much experimentation to get it right.

What are some of your wishes for future healthcare technologies?

Leave a reply here or share your thoughts on our MedicAlert Facebook page.

- Robert

Don’t Ignore the Signs

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Last week while enjoying some time off just before New Years, I watched the first four seasons of Mad Men, a critically acclaimed TV show, which among other themes, dramatizes family life in the 60’s. In one episode the main characters (Don and Betty Draper) are joined by Jean Draper, Betty’s aging father, who comes to live with them.  Jean has dementia, but is undiagnosed.  The effect on the family is severe and immediate… and at times, chilling.  At one point, Jean has his 10 year old granddaughter drive him to the store believing that she is his late wife.

Today I came across a recent survey conducted by the Alzheimer Society of Canada (ASC) on the benefits of getting a diagnosis as soon as possible.  Almost half of those who responded to the survey waited a year, and some much longer, before seeking help.

Earlier diagnosis leads to earlier treatment but it also gives the individual and their family more time to get all the facts and understand the symptoms.  Why is this important?  According to ASC, symptoms of Alzheimer’s disease and other forms of dementia aren’t just signs of “old age”, so being aware of them early on means you and your loved ones can:

• Get the proper care, treatment and support

• Plan for the future & make important medical, financial & legal decisions

Alzheimerletsfaceit.ca is a great resource to help look for and understand early warning signs and much more.

If you have had experience as a caregiver for someone with Alzheimer’s disease or another form of dementia, I’d be happy to hear from you.  Your experiences could be invaluable in encouraging others to seek support earlier.

You may leave a reply below or share your thoughts on our MedicAlert Facebook page.

- Robert

Out with the old, in with the new… errors, that is

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A key selling point of electronic health records is their potential to reduce errors. Moving from paper-based prescriptions to electronic scripts, for instance, should be an easy way to reduce errors from bad handwriting, right?  Not necessarily.

A recent study by the American Medical Informatics Association (AMIA) found that the error rate for electronic prescriptions is 1 in 10, the same rate found in paper prescriptions.  Wait a minute… what?  These results don’t appear to add up, given that many physicians have handwriting that’s difficult to read.

It would appear that while new technology solves old problems, it’s also creating new ones.  Electronic scripts may be easier to read but the script itself could contain new errors because, for example, a physician might feel a false sense of security that the ‘system’ will catch any errors that he/she has made.  Think of it like writing an email and not paying attention to spelling and grammar. We all do it because we assume that the ‘technology’ behind the word processing software will know what we mean to say and catch any missteps – it usually works but not always.  And when it fails it can lead to an embarrassing situation or worse.  To remedy any grave mistakes, the system sends the user alerts – similar to “are you certain you want to prescribe that?”, but not exactly in those words.   Unfortunately, repeated system alerts are usually ignored after a while as ‘alert fatigue’ sets in and this could lead to a situation where a practitioner ignores a critical alert.

The AMIA study reinforces that technology alone rarely solves problems; rather it’s the marriage of technology and new ways of working with that technology that lead to real progress.

If you’ve got any thoughts or questions you’d like to share, please do so by Leaving a Comment here or on the MedicAlert Facebook page.

Funny Thing About My Doctor…

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A funny thing happened last time I visited my family doctor.  The appointment started out just the same as before, but then I realized something was different.  Where was the folder with what seems to me like ‘chicken-scratch’ notes from my doctor?  This folder is always there, wide open on his desk…  And why was my GP now facing a computer instead of me?

As it turned out, my doctor had recently implemented an Electronic Medical Record (EMR) system.  This meant that instead of referring to the trusty file folder with my medical history he now called up this information from a computer station in the examining room.  He proceeded to ask me a series of questions and at the same time carefully typed my responses into his computer.  It was an odd experience because it seemed to violate a basic social convention: that one faces a person and maintains eye contact while having a discussion – especially a one about intimate personal details.

I asked him how his EMR system was working and he said that every patient, without fail, had expressed concern over the presence of the computer in the examining room.  “Where is all that information going?” and “How is that data going to be used?” were two common questions.  It seems like a trivial detail, but how information is recorded seems to have made a difference in the Doctor-Patient relationship.

Some physicians are reorganizing their offices to ensure that their patients have a clear view of the computer screen as the doctor inputs information.  Fundamentally, this makes sense, because it is after all your personal health information that’s being recorded, so why shouldn’t you be able to see it… right?

Do you have an opinion or a question? Share your experience and thoughts with me here and Leave A Reply or feel free to join the conversation on the MedicAlert Facebook page. 

-Robert