Electronic Medical Files

[AGENTLE@aol.com]

  Med-Privacy
  
  I have had some recent individual contacts with members on the aforementioned
  subject, let me make a definite statement on where I stand on wide
  distribution of medical records, especially by computer. 
  
  I am all for high speed data access of medical files in medical cases,
  particularly medical emergencies. If, for instance, I was all the way accross
  the country, say in California, or New Hampshire, and had a cardiac, or spine
  injury, needing emergency treatment, I would HAVE to have immediate reference
  to all my files at my home area, beacuse I have four or five allergies to
  medicines. Two or three are minor, two would kill me on the spot. Having no
  access to that information could be a life or death matter. 
  
  Nothing could beat a national high speed satellite or fast WAN type service
  for that sort of thing. SO, at the risk of offending folks on all sides of
  this issue, let me specifically and vociferously support such a system.
  
  HOWEVER, (or in the words of my late anthropology professor, Lord rest his
  soul, On ze utta handt)...
  
  If this wide coast to coast system has wide access, wide availability, sparse
  monitoring, and little regulation, I have the following suggestions:
  
  I would suppport such a system if, and ONLY if, when and ONLY WHEN, and
  actively, and ONLY actively,
  
  When:
  
  1. Patients are made COMPLETELY aware of all the little secrets of the trade.
  
  2. Made aware of ALL the parties IN DETAIL, such as employers, supervisors,
  Universities, Human Resource Personnel, etc., to whom access will be
  permitted.
  
  3. Made aware (in plain english, with no technobable or legalistic fine print
  for which most folks cannot comprehend) for what purposes the released data
  can be used, (i.e.) for hiring and firing purposes, say by an employer), for
  psychological screening and fishing expeditions by universities), and so
  forth.
  
  4. That patients (consumers) be told, in plain english, in CRYSTAL CLEAR
  clarity, that any and all records can and will be demanded and accessed if a
  particular type of claim arises. And That These same consumers be made aware
  that each and every word they tell their doctors, may be misquoted, and CAN
  POSSIBLY BE USED AGAINST THEM, SHOULD A EMOTIONAL STRESS, WORKERS COMP,
  TRAFFIC INCIDENT, OR DISABILITY CLAIM ARISE, ESPECIALLY AND PARTICULARLY
  PSYCHOLOGICAL AND/OR PSYCHIATRIC SESSION NOTES, WHICH many patients feel, or
  are told are "totally confidential".
  
  If we are talking about open access, I suggest we also talk about open
  frankness about how records are used. 
  
  Saty tuned, I amy have more to say on this, but these are my intitial
  impressions. I feel there is much good, and much evil that can arise when
  widespread high speed access to records is allowed to a wide audience. I was
  made a litigation manager in Dec of 1979, and have seen how a lot of this
  works, and have had a disability hearing on myself, and have had a car
  accident claim, (and had a friend who will never be able to work fulll time
  for the rest of her life because of a traffic accident, who went through an
  extraordinary vicious, malicious, maligning trial herself, so I know the
  inner workings of our system inside out. If someone who has comparable
  hands-on experience (or anyone else) wants to debate my points, or take issue
  with my stances, I welcome their input. 
  
  We can do better, and when we let patients know the behind the scenes "REAL
  DEAL, they can better make an informed consent to ride the 'information
  superhighway'.
  
  Surely there is a way to use the best the technology has to offer, and
  minimize the other side of the coin, and mitigate our systems shortcomings.
  That is why I am on this list, and proactive on this issue.
  
  Alex