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Thoughts and suggestions?
The provider or facility must act on your request within 60 days, but may extend up to 30 days if they provide a reason to you in writing.
If they have refused to amend your records as per your request, you may submit a formal, written disagreement which must be added to your file.
We are not requesting paper copies. Do not bill us for paper copies. The HITECH Act and its regulations do not allow you to bill for paper copies when an electronic copy has been requested.
If any of the above records are available only as paper copies, and have never been made into an electronic format, please identify the record and provide the cost of copying.
the same openness that at times can increase accountability, collaboration, knowledge sharing, innovation and productivity can also undermine it
She cautions, however, that because OpenNotes appears to be popular and effective in primary care settings does not necessarily mean that it will be equally so in specialty settings—especially those such as psychiatry and oncology, where the balance between openness and patient protection may have to be set differently.
A Canadian physician friend, though, says he uses an electronic record that does not disturb his rapport with patients.
we tend to include extraneous information to justify higher levels and satisfy potential insurance company audits. Canada has only two levels, so doctors’ notes are short and succinct.
Lawyer group auditing EMRs state that the info contained is too unreliable to be admitted as evidence in court: avemarialaw.edu/lr/Content/art…
Regardless of who is at fault, doctors and hospital executives across the country say they are distressed that the expensive electronic health record systems they installed in the hopes of reducing costs and improving the coordination of patient care — a major goal of the Affordable Care Act — simply do not share information with competing systems.
A group of 37 medical societies led by the American Medical Association sent a letter to Health and Human Services last month saying the certification program is headed in the wrong direction, and that today's electronic records systems are cumbersome, decrease efficiency and, most importantly, can present safety problems for patients.
Recording the desires of patients who are on their death beds — or even noting whether a patient has appointed someone to make medical decisions on his or her behalf — has become a huge gap in the nationwide effort to computerize patient care. The few hospitals trying to come up with their own digital approaches are finding it’s not easy.
“When hospitals talk about Hipaa or charge for releasing records what they’re really saying is, ‘I don’t want to do this and I have to find an excuse,’ ” said Dr. David Blumenthal, president of the Commonwealth Fund, who was previously President Obama’s national health information technology coordinator.
“Good” Patients and “Difficult” Patients — Rethinking Our Definitions
[url]http://www.nejm.org/doi/full/10.1056/NEJMp1303057[/url]QuoteAbiding by the unspoken rules of medical etiquette, I had quieted my internal alarms for more than 2 hours.QuoteWhen we call patients and families “good,” or at least spare them the “difficult” label, we are noting and rewarding acquiescence. Too often, this “good” means you agree with me and you don't bother me and you let me be in charge of what happens and when.
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Re: Tweet response for @GilmerHealthLawTweeted by @helenbevanQuoteThe outstanding talk that @allyc375 gave at #confed2015: "From patient voice to patient leadership" youtube.com/watch?v=dnhjgY… #mustwatch
[url]https://m.youtube.com/watch?sns=tw&v=dnhjgYGbEpk[/url]Quote7:33QuoteI'm a label queen
8:57Quote"Maelstrom of mayhem" is my particular favorite
Difficult patients, defined as those who do not assume the patient role expected by the healthcare professional, are encountered in every setting
Labels, such as difficult, hateful, or crazy, tend to follow patients and family members throughout the medical care process and negatively affect the way they are approached and treated (Lin et al., 1991).
By reinforcing and modeling professional behavior and avoidance of labeling, the team leader promotes high quality and safe, patient-centered care.
I am now encountering physicians, being contacted by their patients, arguing that they do not appreciate being called obese in the note. They do not appreciate hearing that they are not compliant when obviously they are not. Since physicians do not want to aggravate more people then they reword or simply refrain from placing particular information in the chart.
Steven Keating’s doctors and medical experts view him as a citizen of the future.
He pushed doctors to conduct an M.R.I., and three weeks later, surgeons in Boston removed a cancerous tumor the size of a tennis ball from his brain.
encountered a medical culture resistant to sharing data, owing to tradition, business practices and legal concerns
But does, say, your podiatrist really need to know about the abortion you had 10 years ago?
Given the option, 49% of the 105 patients who participated decided to withhold at least some information from their doctors. Four patients went so far as to withhold all of it, meaning every time they saw a doctor, they’d start with a clean chart. Every single patient, even those who wanted doctors to see all their data, said they wanted to be asked.
“After requesting Kate’s records, I saw all sorts of things that concerned me, whether it was tired residents making mistakes, factual errors, or written notes that contradicted each other.”
“Most people don’t ask for a copy of their medical record, which is a terrible mistake,” she said.
the CMS recently announced its intention to eliminate this requirement and stick with letting people choose whether they wish to access their medical records or not, and not penalize physicians for letting their patients exercise free will
Contrary to what you may have heard in your Twitter/tradeshow/conference echo chamber, most people have no interest in running around with a miniature ICU strapped to their wrist, and couldn’t care less about the difference between lymphocytes and monocytes.
The new draft says no more “5% rule” – they only have to show that one patient has done it, and they’ll get full federal reimbursement.
I’ve heard of doctors begging their patients to log in to the thing, as a personal favor. Docs I know and like. Yet, back in November, half the providers who’d already succeeded at this measure said that 32% of their patients are doing it! What the heck??
Patient advocates and pro-engagement types dominate the audience at Health Datapalooza in Washington, which kicked off Monday morning. This tweet tells what happens when a vendor executive suggests to this crowd that maybe not enough consumers have requested access to their health data.
The 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?
Once 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).
Three 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.
The 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.
Welcome 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!"
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.
Should 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.
this represents the first poll of physician’s directly and was conducted through the large physician social network known as SERMO.
Tweeted by @kevinmd
"A physician responds to OpenNotes critics"
[url]http://www.kevinmd.com/blog/2014/07/physician-responds-opennotes-critics.html[/url]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"
[url]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[/url]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"
[url]http://www.kevinmd.com/blog/2014/08/progress-notes-poor-tool-doctor-patient-collaboration.html[/url]QuoteDefenders repeatedly invoke “transparency,”QuoteSome of the rhetoric has a defiant, even self-righteous toneQuoteAnd 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
For 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.
Tweeted by @SusannahFox
"OpenNotes: Putting Medical Record Transparency to the Test"
[url]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[/url]Quoteone kind of record has consistently remained off-limits—the doctor’s own notesQuoteThe 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"
[url]http://www.kevinmd.com/blog/2014/05/promise-peril-opennotes.html[/url]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 "
[url]http://www.everypatientsadvocate.com/misdiagnosis.htm[/url]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.
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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.
Must read for anyone who needs healthcare... ie, everyone. #getmyhealthdata twitter.com/hmkyale/status…
This 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.
Time, 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
the 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
Key point: 92% patients want full access to their records! only 18% docs agree. Patients should win. #HIMSS16
Most (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.
I think it would be interesting to read a chart full of "no I didn't" and "wasn't like that." @AureliaCotta #hcldr
When 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.
We 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.
Epic 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.
Now, 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.
“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.
When doctors share their clinical notes with patients, it can lead both parties to change their behavior
But 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.