Digital Medical Records have the Medical History Wrong for a Patient in the NHS

Posted by PITHOCRATES - April 13th, 2013

Week in Review

The keystone to Obamacare is digitizing medical records.  To make it easier for any health care professional to access a patient’s record no matter where they are.  Even if they’ve never met the patient before.  One set of records kept online for all to see.  No errors from duplicate copies.  No waiting for hardcopies to arrive.  It’s efficiency.  And accuracy.  Allowing great potential for cost cutting by automating the health care system to mass produce the delivery of health care services.

Patients come in and data-entry clerks encode them into the system.  As they move from station to station the next health care provider just has to pull up the work-order on the patient.  Do their part.  And ship the patient off to the next workstation.  Like an auto assembly plant.  Where they have economies of scale.  Keeping costs down.  This is what digitizing medical records will give us.  Well, that, and this (see Grandmother handcuffed and escorted from GP surgery by police after demanding to see medical notes by Amanda Williams posted 4/8/2013 on the Daily Mail).

A grandmother was handcuffed and led away from her doctor’s surgery by police after a row over her demand to see her medical notes.

Mary Kerswell, 67, asked for a copy of her GP records after she was called in for a urine test for a kidney condition she did not have.

When the mother of two was shown a brief summary of her medical history she was shocked to see that as well as being wrongly listed as having chronic kidney disease, it said she was a heavy smoker with Alzheimer’s.

The incorrect summary of her notes also said the healthy pensioner had undergone a hysterectomy and a double hip replacement.

Obviously there was a data input error somewhere along the way.  An error that no one caught because she was just a digital record in the system.  If there was a doctor-patient relationship like there still is in the United States (for awhile at least) her doctor would have caught that error.  Because he would have known the patient.  And because he would have known the patient he would have known the medical history in the digital medical record was wrong.  Because he treats a person.  Not just process a work-order in the system.

This is national health care.  Fewer health care providers taking care of more patients.  Where patients are just anonymous sick people with a work-order attached.  Allowing doctors to handle greater patient loads with ever more limited health care resources.  Common in all countries with an aging population.  Fewer workers paying income taxes to fund the health care of a greater number of people who have left the workforce.  Just like they have in the United States.  So what’s happening in the NHS will no doubt happen in Obamacare.  Because we both have an aging population.

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Can we trust Obamacare when the NHS loses 1.8 Million Confidential Patient Records in a Single Year?

Posted by PITHOCRATES - October 28th, 2012

Week in Review

One of the ways Obamacare is supposed to reduce costs is by digitizing our medical records.  So any of our doctors can pull them up from anywhere.  So that every doctor will always have the most up to date file on us.  The problem is, it just may not be our doctors accessing our records from anywhere.  So some are asking if we should trust the government to protect our confidential information.  For they can look across the Atlantic and see that trusting the government with our confidential information was not a wise thing to do (see NHS lost track of 1.8m patient records in a year with sensitive information found in public bin and for sale on the internet by Jack Doyle posted 10/28/2012 on the Daily Mail).

The NHS lost track of 1.8million confidential patient records in a single year, the Daily Mail can reveal.

In worrying lapses in data security, sensitive paper records have been dumped in public bins and electronic records found for sale on an internet auction site.

The worst cases include details of terminally ill patients being faxed to the wrong number, and patient records being stolen and posted on to the internet.

The total is the equivalent of nearly 5,000 records going missing every day. But the real figure is likely to be much higher because in some incidents it was not known exactly how many records were lost…

The Information Commissioner, Christopher Graham, has levied fines totalling nearly £1million on NHS bodies in the last six months…

Trespassers gained access to the site and copies of records – which dated from the 1950s – were posted on the internet…

The worst breach involved a CD containing 1.6million patient records, including personal details, belonging to Eastern and Coastal Kent PCT. The CD was lost when a filing cabinet went missing during an office move.

The trust was not fined, but signed an undertaking with the ICO not to repeat the error.

The worst breach of patient privacy is punished by a promise not to do that again?  Well, problem solved.  For promises are serious things.  I mean, who has ever broken a promise?

The NHS is taxpayer funded.  So how does that work?  The government fining the government?  Do they reduce the amount of money they spend on health care services?  Does the government then reimburse the NHS Trust?  Or does it simply let more people go without health care?

This is the problem when government provides services.  And the oversight.  The government provides oversight on themselves.  They set the standards.  And they measure if they meet those standards.  Which probably explains why they fix problems with promises.

So is it any wonder that they’ve lost over a million confidential patient records?  No.  Will it be any wonder when Obamacare loses over a million confidential patient records?  Probably not.  Because bureaucrats are bureaucrats.  So digitizing our medical records is probably not a good idea.  For that matter, neither is Obamacare.  Based on the real world example provided by the NHS.

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NHS Doctors compromise Patient Privacy by Accidentally Clicking on ‘cc’ Instead of ‘bcc’ when Emailing

Posted by PITHOCRATES - June 3rd, 2012

Week in Review

One of my favorite Winter Olympics were the 1992 games in Albertville, France.  In part to that montage at the end accompanied by a couple pieces from Carl Orff’s Carmina Burana.  And Charles Kuralt.  Who gave us charming slices of life in the Tarentaise Valley.  Farmers eating a breakfast of cheese and wine after finishing their early chores…before the sun had risen.  And people waiting for freshly baked baguettes in the crisp predawn hours.  Made by bakers the way bakers had baked bread hundreds of years earlier.  Because as Charles said, sometimes the old ways are the better ways.  It turns out that’s true in more ways than one (see Doctors ‘risking email privacy breaches’ by Caroline Parkinson posted 6/1/2012 on BBC News Health).

As the email whizzes off into the ether, dread strikes. It’s gone to the wrong person.

Normally, the worst that can happen is a little embarrassment.

But a medical advice body is warning that while trying to use modern technology to contact patients, doctors are sometimes revealing confidential information…

In one case a practice sent patients an email reminder for a flu vaccination clinic, but mistakenly pasted the email addresses into the “To” rather than the “Bcc” – blind copies – box…

The MDU is issuing advice to doctors about how to send out group emails, and what to do if it goes wrong.

“These are breaches of confidence. It shows those in the email group that other individuals are part of that practice, and part of that particular group.

“And, while you may not be directly releasing clinical information, it can be possible for people to make assumptions, especially in small communities.

“For example, on a flu jab reminder list, you may be on there because you are immunosuppressed, because you have cancer or HIV – or other reasons you don’t want people to know about.”

In the old days there were family doctors.  Who we knew all our lives.  And we paid them for the services they rendered.  In the days before heath insurance became an employee benefit.   And life was good.  Charming.  Folksy.  But now health care has grown into a great bureaucracy.  Where doctors have to spend more of their time being bureaucrats than doctors.  With the advent of employer provided health insurance there were no longer free market forces to determine health care prices.  Because someone else was paying the bill.  Then came the lawyers.  And the malpractice suits.  Changing medicine into a defensive action against frivolous lawsuits.  Further increasing health care costs.  And pulling health care providers further away from practicing medicine.  Instead spending their time managing risk. 

Now Obamacare wants to change this further.  By digitizing medical records.  Turning health care into production line care.  To process more people per hour to reduce costs.  Transforming the doctor-patient relationship to a patient-random government bureaucrat relationship.  Relying on the data in our records more than personal knowledge of a patient like in those folksy old days.  Which can really speed up treatment.  As long as an overworked, underpaid bureaucrat inputs all of the data correctly.  And no hacker breaks into the system to mess with people’s data.  Or steal it.  For it will be one large repository of names, addresses, phone numbers and social security numbers.  As well as intimate medical information.  Which people could use for whole sorts of reasons.  The mind shudders to think what may happen when this information is in the hands of the wrong people.  Especially when health care providers begin emailing each other.  With attachments.  Or their patients.  Like in Britain.  Accidents happen.  Especially when the technology makes it so easy for accidents to happen. 

Doctors are at risk of being in breach of both the Data Protection Act 1998 and the Privacy and Electronic Communications regulations 2003 – and the Information Commissioner would have to be informed.

A spokesman for the Information Commissioner’s office said GP practices, like hospital trusts and local councils had a responsibility to take care of the data they hold.

He added: “Bcc and group emails are a concern. If we find a breach related to Bcc, and particularly if that’s caused damage or distress, we would take enforcement action.”

As if doctors didn’t have enough to worry about in their busy day.  Being both bureaucrat.  And part-time doctor.  Now they have to worry about breaking the law when they accidentally click ‘cc’ instead of ‘bcc’ after a long, sleep-deprived day.

And this is a glimpse into the future of Obamacare.  Where we can only hope it will be as good as the NHS.  For as national health care systems go, it’s one of the best.  But it still doesn’t beat the good old days.  When we had warm familial relationships with our family doctors.  Who knew us better than we knew ourselves.  Who didn’t need digital records or emails.  And not only were we able to pay for our own health care but we liked our health care.

It’s like Charles said.  Sometimes the old ways are the better ways.

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