No more medical CDs? We hope.

Many seniors likely have experienced the frustration—and fear—having radiological tests results that needed to be read by multiple doctors. The tests, downloaded to CD, may be transferred through the mails or hand-carried by the patient, but at its best the process can add days, even a week, to diagnostic time. At its worst, when the CD finally arrives, it may be unreadable for various reasons.

Not the pretty kind of cloud. Image courtesy: Getrems.com

Not the pretty kind of cloud. Image courtesy: Getrems.com

Distracted by whatever medical condition required all those tests, you may forget to consider the obvious: Why in these days when people can share photos on their phones are patients still schlepping around CDs?

Fortunately, medical institutions are beginning to catch up. According to a story in Modern Healthcare, there’s now a push for more centralized digital storage of medical images, so that the CD problem could be eliminated. Images and other records are kept “in the cloud,” which essentially means—despite all the hype around the term—a huge bank of computers that’s accessible over the Internet from any digital device. The advantage to you is that the test you took near your home can be read by a specialist thousands of miles away.

While several radiological cloud storage systems are already in place, the kicker is that there isn’t yet one national system. If you stay within one HMO or other medical network, your records may be easily accessed, but if you have to see an outside specialist, you may still be stuck with CDs and the subsequent delays. If you’re considering a new medical group, it’s worth asking if records can be electronically transferred both within—and without—their network. We’re guessing you may see some rolled eyes if you ask, “Will my records be kept in the cloud?”

 

EHRs work with MedLinePlus

Previously, we discussed the AMA’s complaints about Electronic Health Records (EHRs). Now, from the National Library of Medicine (NLM), comes more optimistic news about how they can be useful for patients.

Screen Shot 2014-09-23 at 12.08.09 AMThe NLM’s MedlinePlus Connect links the diagnosis given on an EMR directly to MedlinePlus, instantly giving you details of what your condition is. However, the NLM does caution that in order to get the integrating system up and running you’ll “need to work with the technical representative or staff member who can add links to your EHR system.”

Fortunately, even without an EHR, you can easily use Medline Plus on a desktop computer or mobile device. It’s completely free and has information on a wide range of medical topics, including details on prescription medications and dietary supplements, as well as interactive tutorials and a medical dictionary. All of the information is written in lay language—and that includes, through external links—44 languages in addition to English. If you can understand professional level medical literature, you’ll also want to check out MEDLINE/PubMed, the NLM’s site for biomedical professionals, which offers free summaries of 22 million articles from 5000 biomedical journals, many (but not all) of which link to free full articles.

For those of you who like to know everything before you go under the knife, MedlinePlus also includes videos of surgical procedures. Um, we’ll just stick to picking out get well cards, thanks.

 

AMA on EMRs

In 2009, the American Recovery and Reinvestment Act required that by this year, seventy percent of primary care providers should be using Electronic Medical Records (EMRs). Perhaps unsurprisingly then, the AMA has just issued a press release complaining about them.

ama-logoWhile it may be reassuring to discover that your doctor finds forms just as confusing as you do, the problems with EMRs or EHRs (for “health” records) can affect the care you receive.

Ideally, an EMR (sometimes known as an EHR, for “health” records) should be a complete computer file of all your doctor visits, conditions, complaints, and prescriptions. Everything you tell your primary care doctor should be easily readable by the specialist(s) she sends you to see, avoiding time-wasting repetition and the risk of contra-indicated medications.

The reality is that, alas, EMRs are currently provided by many competing vendors, leaving doctors with many different products to learn that don’t inter-operate as promised. When medical providers should be listening to you, they may instead be distracted by trying to figure out what field to fill in on the electronic form. Worse, many of the promises of mobile health—that you should be able to check your own records on your smart phone, for example—are also on hold while the technology evolves.

The AMA lists the following priorities for fixing the problem:

  • Enhance Physicians’ Ability to Provide High-Quality Patient Care
  • Support Team-Based Care
  • Promote Care Coordination
  • Offer Product Modularity and Configurability (make it customizable for particular specialties and institutions)
  • Reduce Cognitive Workload (in other words, make it less confusing!)
  • Promote Data Liquidity (make it easier for information to “flow” back and forth among providers by using common terms and other standards)
  • Facilitate Digital and Mobile Patient Engagement
  • Expedite User Input into Product Design and Post-Implementation Feedback

The importance of finding the right fix is explained by Steven Steinhubl of the AMA Advisory Committee on EHR Physician Usability: “Given the rapid growth of digital technology in health care, whether for health and wellness, or the management of chronic illness, a comprehensive health information technology strategy must include interoperability between a patient’s mobile technology, telehealth technology, and the electronic health record.”