Just a quick FYI for those interested in med recs ..... realize that your copy may not be the final & complete copy if all of the encounters are not signed.

RT by @Atul_Gawande


"Putting Doctors and Patients on the Same Page"
https://medium.com/@CommonwealthFund/putting-doctors-and-patients-on-the-same-page-cfed43819a2d#.xvmvyv10f

QuoteWhen doctors share their clinical notes with patients, it can lead both parties to change their behavior

QuoteBut the evidence to date suggests that OpenNotes can spark more open and informed conversations among doctors and patients and — as part of broader efforts to encourage patients to become active participants in their care — may lead to fewer medical errors and better care.

Re: Tweet response for @GilmerHealthLaw

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"Partners computer system brings prescription for frustration"
http://www.bostonglobe.com/business/2016/05/16/partners-healthcare-new-computer-challenges-some-doctors-nurses/1I4QsWGjCJ97xFmUbcDbaJ/story.html

QuoteNow, she says, she's become a captive of the keyboard, spending far more of her time recording every blood pressure reading, every feeding, every diaper change. The demands of the new system are so taxing and time-consuming, Lydon said, that the computer has come between her and her patients.

Quote"They're more about billing and complying with mandates than about what's really useful to the physician to help us take better care of patients," said Dr. Glenn A. Tucker, who chairs the Massachusetts Medical Society's committee on information technology.

Tweeted by @ePatientDave

Individuals' Right under HIPAA to Access their Health Information 45 CFR § 164.524
http://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html#newlyreleasedfaqs

Tweeted by @CMichaelGibson


"As hospitals go digital, human stories get left behind"
https://www.statnews.com/2016/04/06/electronic-medical-records-patients/?utm_content=bufferbd91e&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

QuoteEpic is not well-suited to communicating a patient's complex experience or a physician's interpretation of that experience as it evolves over time, which is to say: Epic is not built to tell a story.

Tweeted by @EricTopol

"Let Patients Read Their Medical Records"
http://well.blogs.nytimes.com/2016/03/31/let-patients-read-their-medical-records/?ref=health&_r=0

QuoteWhen I read a patient's electronic health record, I now assume what's written there is as likely to be wrong or outdated as it is to be accurate. Sometimes these discrepancies are minor and inconsequential; sometimes they can be devastating.

QuoteWe now spend two hours a day reporting quality measures, but what needs to be mandatory in the age of digitalization is the art of story gathering and storytelling.

Tweeted by @mahoneyr

QuoteI think it would be interesting to read a chart full of "no I didn't" and "wasn't like that." @AureliaCotta #hcldr

 

Tweeted by @hmkyale

QuoteKey point: 92% patients want full access to their records! only 18% docs agree. Patients should win. #HIMSS16

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"PATIENTS WANT A HEAVY DOSE OF DIGITAL"
https://www.accenture.com/_acnmedia/PDF-8/Accenture-Patients-Want-A-Heavy-Dose-of-Digital-Infographic-v2.pdf

QuoteMost (92%) patients believe they should have full access to their records, while only 18%
of physicians share this belief. Interestingly, about half (49%) of patients believe they have full access (see Figure 5). The perception gap about EHR access has widened in the past two years, a 42% decline in physicians and a 10% rise in patients.

Patients who reviewed treatment notes improved care and safety


Not a surprise, by any means.    Hopefully this will catch on!

Tweeted by @EricTopol

"The tragedy of the electronic health record"
http://alphaomegaalpha.org/pharos/PDFs/2015-3-Editorial.pdf?http://alphaomegaalpha.org

QuoteTime, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.
—Francis W. Peabody

Quotethe authors described their institution's and physicians' experiences with electronic health record (EHR) systems, discussed the general state of EHRs and how they are used today, related the problems they have experienced with EHRs, and made recommendations for changing how we use them to reestablish the primacy of the doctor-patient relationship

Tweeted by @Atul_Gawande

QuoteMust read for anyone who needs healthcare... ie, everyone. #getmyhealthdata twitter.com/hmkyale/status...

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"Happy Data Independence Day!"
https://getmyhealthdata.org/2015/07/04/happy-data-independence-day/

QuoteThis opening of health data silos will be under the patient's control, and can lay the foundation for a healthcare system that sees patients as partners, and spur unforeseen innovation in technology that helps us manage our health, our healthcare, and healthcare finances.

Tweeted by @ePatientDave

"How to Take Charge of Your Medical Records"
http://www.wsj.com/articles/SB12367224787933994021304581064031716335262

QuoteFor most people, of course, it's all too easy to simply leave their health records in the hands of doctors and hospitals. But that's a big mistake, the advocates argue. First, it gives doctors too much power over information that is vital to patients, and it creates opportunities for errors. Perhaps more important, it keeps patients from using the information themselves for their own benefit.

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Re: Docs helping patients to surf the internet

Quote from: LinksEtc on June 13, 2014, 07:44:14 AM
Tweeted by @SusannahFox

"OpenNotes: Putting Medical Record Transparency to the Test"
http://www.rwjf.org/en/research-publications/find-rwjf-research/2014/02/opennotes--putting-medical-record-transparency-to-the-test.html?cid=xsh_rwjf_tw

Quoteone kind of record has consistently remained off-limits—the doctor's own notes

QuoteThe program—called OpenNotes—has been testing, in three different medical settings, the idea of patients having access to their physician's notes.

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"The promise and peril of OpenNotes"
http://www.kevinmd.com/blog/2014/05/promise-peril-opennotes.html

QuoteDon't give them information in the privacy of their own homes that they aren't equipped to deal with, or anything that might hurt their feelings.

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"Trisha's Misdiagnosis Story   "
http://www.everypatientsadvocate.com/misdiagnosis.htm

QuoteI told him I was trying to find another oncologist for a second opinion. There were too many question marks. His reply to me makes me shudder to this day, "What you have is so rare, no one will know anymore about it than I do!"

QuoteRecords in hand, I began to google every word I didn't understand to see if I could learn more.

If I had to pinpoint an exact moment when this patient advocacy mission began, that moment would be it.

------------------------------------------

I guess I'm a fan of transparency.  I can deal with hurt feelings or difficult news, but let me know what is going on.  There may be some sense in letting the doc talk to a patient before giving them the record like in the cancer example.

Tweeted by @danmunro


"New Poll Shows Two-Thirds Of Doctors Reluctant To Share Health Data With Patients"

I was having trouble with this link, but it seems to be working for me now.
http://www.forbes.com/sites/danmunro/2015/06/08/two‒thirds-of-doctors-are-reluctant-to-share-health-data-with-patients/

QuoteShould patients have access to their entire medical record ‒ including MD notes, any audio recordings, etc...?

For many, the response by over 2,300 physicians came as no real surprise.

Quotethis represents the first poll of physician's directly and was conducted through the large physician social network known as SERMO.

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Re: Docs helping patients to surf the internet

Quote
Tweeted by @kevinmd

"A physician responds to OpenNotes critics"
http://www.kevinmd.com/blog/2014/07/physician-responds-opennotes-critics.html

QuoteI can't get away with labeling a patient in my chart as a symptom magnifier or minimizer, having poor insight into their contribution to the problem, describing pain that does not fit with the setting or findings, making poor choices, non-compliant.

QuoteThe point is, the collected information, assessment and plan that the patient and clinician are basing diagnosis and treatment on should be used as a collaborative tool, not as the clinician's private record of why they did what they did (to the patient).

I admire this approach/philosophy.

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Tweeted by @drval

"When Patients Read What Their Doctors Write"

http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write?utm_source=twitter.com&utm_campaign=health&utm_medium=social&utm_term=nprnews

QuoteI sat down next to her and showed her what I was typing. She began pointing out changes.

QuoteAs we talked, her diagnosis — inflammation of the pancreas from alcohol use — became clear, and I wondered why I'd never shown patients their records before.

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"Progress notes are a poor tool for doctor-patient collaboration"
http://www.kevinmd.com/blog/2014/08/progress-notes-poor-tool-doctor-patient-collaboration.html

QuoteDefenders repeatedly invoke "transparency,"

QuoteSome of the rhetoric has a defiant, even self-righteous tone

QuoteAnd there's no clear endpoint: about 60% of the patients surveyed in the OpenNotes study believed they should be able to add comments to a doctor's note

Tweeted by @rzeiger


"Confession of a dishonest physician"
http://ronizeiger.com/confession-of-a-dishonest-physician/

QuoteThe thing is, I have a conflict of interest. I want to be the hero, the one who asked just the right question and guided the patient to the appropriate treatment.

At a minimum, I don't want to sound dumb.

-------------------------



Tweeted by @EricTopol

"How Differently Patients and Doctors View Health Technology, With Dr. Eric Topol"
http://www.cfah.org/blog/2014/how-differently-patients-and-doctors-view-health-technology-with-dr-eric-topol

QuoteWelcome to the digital health chasm, that gap between what consumers want out of digital health and what doctors believe patients can handle at this stage in EHR adoption in doctors' offices and in patients' lives.

I have the video of Jack Nicholson's general in A Few Good Men asserting, "You can't handle the truth!"

&



"Hipaa's Use as Code of Silence Often Misinterprets the Law"
http://www.nytimes.com/2015/07/21/health/hipaas-use-as-code-of-silence-often-misinterprets-the-law.html?_r=1

Quote
By the time Ms. Gray found a nurse willing to listen, hours later, her mother had already been prescribed a drug she was allergic to. Fortunately, the staff hadn't administered it yet.

Each scenario, attorneys say, involves a misinterpretation of the privacy rules created under the Health Insurance Portability and Accountability Act. "It's become an all-purpose excuse for things people don't want to talk about," said Carol Levine, director of the United Hospital Fund's Families and Health Care Project, which has published a Hipaa guide for family caregivers.

---


For Family Caregivers
HIPAA: Questions and Answers for Family Caregivers

http://www.nextstepincare.org/Caregiver_Home/HIPAA/

Tweeted by @JBBC


"RX NARRATIVE: STORY AS MEDICINE #DOTMED14"
http://journeyingbeyondbreastcancer.com/2014/12/08/rx-narrative-story-as-medicine-dotmed14/?utm_content=bufferda040&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

QuoteThe medical chart becomes the official story and the doctor the teller of the patient's story. What happens when the patient narrative doesn't match the physician's version?

--------------------------------



Tweeted by @ConsumerDavid

Will you be able to help your college-age child in a medical emergency?
HIPAA Privacy Rule can get in your way

http://www.consumerreports.org/cro/news/2014/08/will-you-be-able-to-help-your-college-age-child-in-a-health-emergency/index.htm

QuoteOnce a child turns 18, the child is legally a stranger to you," said Jane F. Wolk, a trusts and estates attorney practicing in New York and New Jersey, referring to the legal age in almost all states (in a few it's older).

QuoteThree forms—HIPAA authorization, medical power of attorney, and durabe power of attorney—will help facilitate the involvement of a parent or other trusted adult in a medical emergency.