…in the punchbowl


I just love electronic medical records!

Filed under: health, privacy, security — Matt @ 8:57

Electronic medical records definitely speed things up; like, say, exposure of patient health information.

Don’t get me wrong. I think electronic medical information is, in general, a Martha-Stewart-style Good Thing™. When I travel to Colorado Springs and do something boneheaded, it would be mighty useful for the folks in Erica’s ED to have access to my medical records back here outside the District. The problem is limiting the access to those folks, and only for as long as they need it.



  1. Oh, you knew I’d have comments on this’un.
    For starters, ouch – sobering thoughts on medical information and privacy issues. Kinda interesting that, if I wanted to, because I’m a Charge Nurse in the friendly confines of my department, I have access to the whole enchilada from home via remote access to the Citrix server. Being a largely scrupulous individual, I don’t abuse that. But if I felt like it, would you feel comfortable with the security of my home wireless network piping your medical info to me?? (I honestly don’t know the answer to whether that’s safe – I feel like my network is secure and it says it is, but I also realize I’m crazy naive in terms of information security.

    But secondly, another soapbox issue. I don’t think it’s entirely necessary to have complete online access to medical records for any of my patients in an emergency situation. What is important, and sadly not incredibly common, is that folks carry *on their person* a list of pertinent medical history, medications they take, any allergies, and the name of their primary care doctor. And if they’re a cardiac patient, a copy of their most recent EKG is helpful (there’s a company out there that makes plastic wallet cards thereof, and I think that’s a fabulous thing). Beyond that, there isn’t really much we urgently need to take care of anybody – we’re pretty good at putting together the puzzle, and if there’s a time when we wish we knew what was going on in that belly, well, we just scan it. If you had a CT last week in South Carolina, it’d be great if we knew the results – but if you are emergently ill – I mean truly very sick in a yes-you-need-to-be-here kind of a way – you’re getting the full workup anyway because things can change in the course of a day and we need to know what’s going on *now* rather than what’s gone on in the past. That being said, the rest of the medical world has a bit more luxury in terms of tracking down faxed medical records, etc.

    Interesting though…

    Comment by Erica — 2006.07.25 @ 9:48

  2. To be honest, I’m glad they don’t issue you a laptop and let you leave the hospital with the info vis-á-vis the recent issue with Veteran’s Affairs.

    I’m assuming Citrix encrypts traffic between client and server and/or you are connected to the hospital over a Virtual Private Network. Between that and the wireless endpoint encryption, the data on the wire is less of a concern to me than whatever potential keystroke-loggers and other malware might be lurking on your box.

    As to the second issue, I’m not advocating complete online access to all PHI for all situations. For example, in the ED case I could see making information about medications and chronic conditions available; you probably don’t need to know about the broken thumb I had in 8th grade. If I present with a single GSW, you might want to know if this is a repeat performance so any extra lead in the X-rays doesn’t surprise you.

    Your point with respect to the personal information card is a good one. The information you listed will likely be sufficient for ED staff, and concise enough to actually fit in a wallet. But you know — better than I, I bet — there are folks out there who would need a Seinfeld-esque European Carry-All to pack pertinent medical information.

    Comment by Matt — 2006.07.25 @ 11:20

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