Clinton Advocates Modernizing Medical Records

[Rose Siding]

RALEIGH, N.C. -- Monday night about 800 people heard former President Bill Clinton discuss his ideas for changing health care.

Clinton gave the keynote speech at N.C. State's Emerging Issues forum.

"This is not a problem any state is rich enough to solve alone," Clinton said at the forum, which is focusing on health care issues. "We have to do this together."
...
When it came to answers, the former president said he shares one idea with a former political foe, Newt Gingrich -- modernizing medical records.

"How many times have you been to the ER where you have to give all those facts over again?" Clinton asked. "Go to new doctor have to give all your personal history again? I can't even remember my name much less when I had measles."

http://www.wral.com/news/4174921/detail.html

[The Backlash Cometh]

1. Do you all get the impression

that this country seems obsessed with finding out the mental and physical health of each one of us? I suppose, if they really wanted to keep track of what pollutants and radiation is doing to us, they could always ask for volunteers.

[cthrumatrix]

10. clinton - bush are doing the bidding of the corp/global elite

this two party stuff is BS

[Clark2008]

24. No. I get the impression that hospital staff

are overworked and underpaid.
I'm talking STAFF, not the upper echelon.

[rainbow4321]

61. Yet shrub slashes nursing funding....

He is such a shithead..no other way to describe him. We're losing nurses left and right..younger people don't want to enter the field or get scared off once they get started in a job after reality sinks in, the older ones are getting burnt out or nearing retiring and shrub slashes the funding. Used to be the shortage was cyclic, we'd be short nurses or the field was having to lay nurses off cuz there were too many of us. Not anymore..there is no cycle. It's all downhill from here. I hope he gets to sit on a bedpan til his ass rots off when he gets old and bedbound..he can push that call light all he wants....teach the twins to change the diapers, cuz there ain't gonna be a nurse in sight if this keeps up!


http://www.truthout.org/docs_2005/printer_020705J.shtml

A health department preventative programme aimed at obesity and other chronic diseases is to be cut by 6.5% to $841m, according to the New York Times. Health training schemes will be slashed. One such scheme for nurses, dentists and other health professionals will be reduced by 64% and another to train doctors for children's hospitals will be cut by a third.

[rainbow4321]

62. double post deleted

[jdj]

56. yes. I think the mentall illness stuff has to do with voting rights.

And ultimately centralizing medical records will be used to deny people health insurance and treatment.

Republicans don't make plans for doing things that cost alot of money if they are not going to save exponentially more by doing it.

[flaminbats]

60. but employers need our medical records..

this reduces costs and rewards healthy professionalism.

:tinfoilhat: obedience, justice, and the American way

[elemnopee]

71. It makes sense

Hospitals often require repeat testing to be conducted, because they do not have access to previous records.

Yes we should be aware of big brother, but this has the potential to save couple dollars, make individuals more portable in their healthcare provider, and lessen the bureaucratic burden upon nursing staff.

[mainer]

2. This would cut down on medical errors

while it's true that a centralized medical records database could be abused by those seeking confidentail information, it would really aid medical personnel in knowing a patient's history. I recently had dinner with the person in charge of designing just such a database for the UK national health system, and they're years and years ahead of us. Right now, in the US, we have the archaic system of paper charts, which must be xeroxed and mailed across the country to consulting physicians. if you move, your chart has to physically be transported to your new doctor.

The kaiser permanente system has moved to a computer database for its patients, and it's great! The on-call doctor only has to call up your records, can see what meds you're on, and can type in your new prescription. the computer alerts the md to any drug interactions, thus cutting down on errors and pharmaceutical deaths.

[Conservativesux]

15. Problem is MD's wont enter their screw-ups into the database too.

[Dervill Crow]

18. Screwups

Actually, the electronic record greatly reduces the chance of screwups and documents EVERYTHING and leaves accountability trails each time a record is accessed. Having an accurate list of a patient's medications and allergies immediately available reduces the chance of drug interactions or allergic reactions to a med.

[Conservativesux]

16. And one of the reasons I would never, ever go to Kaiser Permanete'.

You either love or hate KP. I hate em' myself.

[WHAT]

37. There would be more consistency of care....

especially for patients in transit or going into the emergency room. It would also alert on new meds of if meds were inadvertently doubled or tripled (many drugs have triple names and I've seen the same drug triple dosed to a patient because different people enter them under different names and the staff itself was too harrassed or new to pick-up on it). Doctors could see previous meds, effects, reactions and med interaction.

I think this would be a good idea and I see many other good reasons for it...notify relatives, flag possable problems...flat affect, verbally abusive etc. are many times indicative of staff/staffing problems, etc.

It does worry me that a person's medical records could be open to abuse but I think something could be figured-out...secure location, password, reason for access given every time.

I think there are more goods than bads on this one.

[RCPJAP]

52. Computers can screw up, too

look at how *accurate* electronic voting is.

[HuckleB]

73. So let's just give up!

Why bother trying to improve anything at all?

[dvaravati]

3. Clinton wants to sell data to drug corporations

I wish he would shut up and go away , like I wish all republicans would.

[KittyWampus]

20. Got A Link For That?

I've heard quite a few people whom I respect advocate for this...

but then your comment carries so much weight.

[napi21]

4. Some of this already is being done.

When I lived in Pgh Pa where they have a hugh hospital system, all your info is availaable on line to all the hospitals, and drs.

There are advantages. It eliminates duplication of tests, helps guard against incompatible medications, and yes, saves time and manpower.

[Democrats_win]

26. Yes: New Hospital in CO is 100% paperless. Why spend tax $$?

Bush just wants to give the rich more of our money to fund something that is already happening. Here is one case where private industry is doing something and now the repubs want the government to step in?!!

Exempla Good Samaritan Medical Center in Lafayette, CO:
http://bcbr.datajoe.com/app/ecom/pub_article_details.php?id=54959

[AngryAmish]

5. Medical records are terrible

Especially handwritten records. Most people can't read the findings of the other people they work with. It is a huge % of medical errors.

[HuckleB]

6. Indeed.

Besides with voice activated software, medical professionals can do computerized notes faster and cheaper (no dictation costs) than ever before. I sure as heck can talk faster than I write, anyway. Besides, my handwriting gets worse every year.

[AngryAmish]

8. How do those things work?

I would be afraid just because of the machine mistaking 2 cc's as "you gotta pee". But if the person can redo it on the spot, that might work.

[Dervill Crow]

19. Voice activated software

The voice activated software I've seen is far from perfect; the reports still require editing unless the dictator has perfect elocution. A macro-driven system for simple clinic notes would be okay, but I am not sure there are any systems that would be more cost effective than dictation and transcription for complex reports.

[Mithras61]

22. How well the voice to text systems work...

depends quite heavily on how much time and effort you put into teaching it (and yourself) to understand.

Speech-to-text applications have made huge strides in the last decade. None are perfect, but some are quite good if you spend the 35 to 40 hours of time needed to train the system to understand you and learning to speak in a fashion that the system can recognize. One of the biggest hurdles for most folks is learning to put a pause between their words so that the system can distinguish between words. Normal spoken speech has a rhythm that a computer can't really detect but a human can, so we can grasp the jumble. Putting a pause between words (even one of just a few milliseconds) allows the computer to distinguish between words and increases the accuracy by a huge ammount.

The other part of it is that mistranscribing can almost always be handled on the fly, but it is unlikely, IMHO, that the doctor would allow himself/herself to handle the problem. This means you couldn't really eliminate the transcriptionist, but it would become more of a proof-reader position... listen to the tape and ensure that what is in the record is what was actually said.

[AngryAmish]

30. The problem I have seen is not in the transcripted reports

It is in the handwritten orders and or progress notes. Most around here are not transcribed. Do you know why there are jokes about doctor's handwriting? Because it is true. Women tend to have better handwriting than men (mine is so bad I gave up in college and printed). Nurses notes (mostly female) tend to be more ledgible than doctors (mostly male for now). Certain hospitals type all these notes (Children's Memorial in Chicago) but they are very much in the minority.

[Dervill Crow]

35. Confidentiality issues

If you're worried about who is accessing your medical records, you can check out this site.

http://www.hhs.gov/ocr/hipaa/privacy.html

[RCPJAP]

54. Oh, the HIPPA law

says that your records are confidential, but are they really?

[Dervill Crow]

75. More than they ever have been before.

With a paper chart, who knows who has accessed it or removed things from it? The audit trails on electronic charts document everything. I know personally of someone who lost their job for accessing a record inappropriately, and it was almost immediate. Employers are levied huge fines if their employees fail to follow the HIPAA regulations.

I'm much more worried about confidentiality of my financial records than medical records, but I am not nearly as knowledgeable about that since I work in health care and not banking or insurance or any of those areas and don't know what kind of safeguards are in place and whether they are followed as they should be.

[HuckleB]

38. Dragon Naturally Speaking Rocks!

It only took a couple hours to train it to my voice. It keeps up with me , no matter how fast or slow I talk. It seldom makes an error. Further, one can purchase medical, psychiatric and other dictionaries, so it knows the lingo. There's no way I'd go back to hand writing or to paying someone to transcribe. Both ways are far more inefficient.

[moondust]

64. Dragon Naturally Speaking sucks.

No way it can keep up with a high-speed slurring doctor. No way it will ever understand ESL. What I've seen is pathetic unless one consistently talks like a retarded robot and their speech patterns do not change from day to day, hour to hour, minute to minute. Even then the mistakes it makes that have to be cleaned up are profuse. Not to mention its glaring inability to handle any kind of subtlety of expression (pauses, inflection, etc.)

VR is a shining example of one of those things that looks great on paper and in theory and in sci-fi movies but doesn't work well at all in practice. You can keep it.

[HuckleB]

69. Baloney.

You haven't a clue as to what you're talking about. I've been using it for that past four months, and it keeps up with my speed, which is quite fast. It kept up with me through a cold. It's works incredibly well.

A neurologist recommended it to me. Two pediatricians and a family NP in my office use it, and they're as happy as clams.

Your judgment doesn't mesh with actual experience.

[Dervill Crow]

74. It depends on the user. eom

[peacetalksforall]

7. Clinton is a traitor.

It is one thing for you to carry around your medical history in a form that can be handed to a clinic, doctor, or hospital - it is another thing to have it all in a giant database forever.

It is exactly the first step in another holocaust of so-called undesirables. It is a tool for elimination, blackmail, prejudice, containment, and discrimination.

If you are posting on this forum, you've got to be aware of the atrocities against humans that is being perpetrated by madmen.

It is part and parcel of the Poindexter project.

[OKthatsIT]

9. thank you...definitely not a good sign

Clinton isnt to be trusted

[bushcrab]

59. ding! ding! ding! we have a winner!

simple and to the point. Only the glassy-eyed gullibles should be falling for this one. Anyone who favors any changes proposed by this Administration---especially regarding privacy, after all the lies spewed by these sacks of crap--- are most likely sportin' Kool-Aid mustaches!

[DemNoir]

11. Please don't be alarmed

This is just a routine check of your records. You will be on your way in a few minutes.

[Mel]

12. WTF good is this

if this country can't even make sure that everyone has health insurance?
Who really gives a damn about this if we can't even make sure the over 40 million in this country don't even have access to health care?

[Conservativesux]

14. I couldnt agree more! Until we have National Health Insurance for all..

I say screw em'!

[Rose Siding]

25. It is irrelevant to the larger health care crisis

Will a new record system save the consumer money? Won't the industry increase costs by transitioning and contracting for whatever new data collection/storage methods are used?

Someone will make lots of money, but will premiums be reduced? Will more people be covered?

Looks like ANOTHER invented crisis that will get attention diverted from the ACTUAL crisis?

[Cooley Hurd]

66. Actually, EMR decreases the overhead of a medical practice...

...by automating/streamlining it - dramatically. The costs of an Electronic Medical Records system startup/conversion are quickly offset by the increased productivity.

**Disclaimer: my company specializes in EMR;)**

[lostnfound]

53. Right on. nt

[Conservativesux]

13. Another in a long chain towards a "Gattaca" style discrimination senerio.

I like the fact that medical records are disordered myself.

[sarcasmo]

17. A better way for the Christian Right to track the homosexual.

Thinks about it, when they ask you those sexual questions at the doctors office. The whole idea has my creep o meter way up. I hardly go to the Doctors now and if this were the case big brother can Kiss My ***.

[Robert Oak]

21. it's extremely inefficient, he's right...but...

unless the US gets it together with privacy laws and also..

I Hope everyone knows their medical records, including their
social security number is probably being sent offshore...
where there are no real laws to protect you...
only a corp to corp contract!

But, the only defense we have against abuse of medical history
is the ineptitude of the medical system.

But, clearly this ineptitude and the mountains and mountains
of bureaucracy and paperwork doctors have to deal with increases
costs overall.

[Clark2008]

23. URRRGGGHHHH!

This ticks me off... really.

Wesley Clark advocated this in the 2004 primaries and not a peep was reported. Damnit. I know this. I'm sure every Clarkie knows this, but most people don't.

Sorry - not mad at Clinton for promoting a good thing - just angry at the press for not reporting more on Clark's domestic agenda in 2003/2004.

[Auntie Bush]

29. I remember well!

Sad isn't it? :cry:

[cosmicdot]

42. would Acxiom benefit?

the Arkansas company, the world's largest processor of consumer data, where Wes was on the Board of Directors ... might there be lucrative contract awards from such an undertaking?

at least, worth pondering

wonder what marketing data medical records might provide or generate?

other than the Big Brother concerns ... if we centrally databased medical records, we could then downsize medical staffs and, then, off-shore any IT jobs relating to maintenance/customer service ... that seems to be the trend

"Never Heard Of Acxiom? Chances Are It's Heard Of You."
By Richard Behar

~snip~

"...a sheriff in Cincinnati stumbled onto what may have been the biggest security breach of consumer data ever. Searching the home of Daniel Baas, a 24-year-old computer-systems administrator at a data-marketing firm, detectives found dozens of compact discs containing the personal data of millions of Americans. The information, it turned out, had been hacked by Baas over a period of two years from a giant server in Arkansas belonging to a company called Acxiom."

"Never heard of Acxiom? The publicly traded, politically connected Little Rock company is the world's largest processor of consumer data, collecting and massaging more than a billion records a day. Its customers include nine of the country's top ten credit-card issuers, as well as nearly all the major retail banks, insurers, and automakers. It's a business that generates $1 billion in sales annually and, after a few bumpy years, is expected to produce $60 million in profits. Analysts project earnings to grow 15% annually over the next five years."

"For most of its life, Acxiom (the "c" is silent) has kept a low profile—its corporate customers like it that way. But lately it has found itself at the center of a white-hot swirl of anti-terrorism, national security, and consumer-privacy issues. Remember the flap about JetBlue giving passenger records to a government contractor? And the one about John Poindexter's terrorism futures exchange? They all touched Acxiom."

~snip~

http://www.fortune.com/fortune/technology/articles/0,15114,588752,00.html


would reaction be different if such concepts came from Bu$h**-Cheney and the neoconservatives?

one of Acxiom's Board members is Henry Kissinger's working associate,
Thomas F. (Mack) McLarty, III
http://www.acxiom.com/default.aspx?ID=1668&DisplayID=18

one of Acxiom's strategic partners is Accenture ... which assumed the job of Florida's vote database after ChoicePoint; and, which formed a partnership with Halliburton


I just think we should be careful.

~it's a small good ol'boy world~

Accenture | Cheney | Halliburton | Ghost of Enron | SAIC & US Elections
http://www.dailykos.com/story/2005/1/29/85414/3003

[DubyaSux]

27. Actually...

...this is a great idea. The paperwork is too labor intensive and more prone to error.

My wife is an RN that works at home (managed care provider) and our spare bedroom is filled with boxes and boxes of charts. If our house burned down, so would those charts.

But whenever anybody needs something from it, she needs to copy and fax. Almost everyday, she makes a copy of a person's entire chart (which can be very thick) that has to be FedEx'd.

These costs are absurd and it's about time somebody started forcing the issue. As long as we don't demand change, we'll simply continue to pay the higher health-care costs.

Face it - when's the last time you saw health care costs decrease?

[deacon2]

28. Data is exactly neutral

It is up to those with access to determine how it is used. On the face of it, this is as reasonable as it gets. But when you factor in the current junta in power, it suddenly takes on Orwellian overtones. I DO wonder what's going through Bubba's mind these days. I think maybe he's been spending too much quality time with 41.

[Dervill Crow]

46. I wonder, too.

what the deal is with 41 and the big dog. I don't see any dark hidden motivations behind the medical records issue, though. HIPAA (the Health Insurance Portability and Accountability Act) has been around since 1996, so this isn't something they just cooked up.

[Bridget Burke]

31. Another account of this speech is CONSIDERABLY different......

RALEIGH, N.C. – Former President Clinton, speaking Monday at a forum on health care access, contrasted his own recent medical care with that received by less-fortunate Americans.

In September, Clinton underwent quadruple bypass surgery after suffering chest pains and shortness of breath.

"I never blinked. I wasn't scared five minutes... because I knew where I was going. I knew who was going to take care of me. And I knew they would get paid."

www.signonsandiego.com/news/nation/20050207-2041-clintonspeech.html

Medical records are not mentioned at all. He may well have discussed them--he's quite capable of mentioning several topics & tying them together--but they were by no means the main subject of the speech.

Why the peculiar emphasis on that aspect of the speech? Of course, the headline of "my" version--"Clinton: More Must Be Done To Improve Health Coverage For All"--would not provide as incendiary a thread title.

[shrike]

41. Very, very different account of the speech

I haven't been real happy with him lately, but this sounds like the Clinton I remember, the one I voted for twice.

[Rose Siding]

44. Can you point out the solutions offered in that piece?

Beyond this very vague offering, I mean...

snip>
Clinton said that all parties, including insurance and pharmaceutical companies, would have to work together to find a solution that would create affordable health care for all.
<end snip

The article I chose was the only one that mentioned any specific component of a "solution"- the only one with any substance, as disappointing as it is.

[shrike]

55. Might be sloppy reporting

Or the reporter might have had a tight space to work with. Just because the reporter didn't report any solutions doesn't mean he didn't give any. Then again, I didn't hear the speech.

[Riding this Donkey]

32. I don't give a rats butt

The terrorists have won the war!
We now have no rights to privacy. Big brother knowing every thing about us is NO GOOD.
I don't care how labor intensive the medical paper work is or how bad the penmanship is, etc. Our right to Dr. patient confidentiality is worth all the potential mess ups! Even if it leads to the death of some.
Our fore fathers fought for our right to privacy and every inch we allow to be taken away is a slap in the face of those that fought for these rights that we should hold dear at ALL costs.
There are many other ways to make our health care safe and those are the ones that should be fought for.
I will not drink the koolaid of giving up one single right because before we know it we will have NONE left.

The Patriot act is another example of terrorism winning. Do you really feel safer, with every right we give up, in the name of protecting ourselves? I do not! In fact, I feel less safe and in more danger from our own government to boot.

Flame on if you must.

[mainer]

33. This is VERY relevant to health care costs and efficiency

Look, I know there's a lot concern here about confidentiality. But where's your concern about the thousands and thousands of hospital drug deaths? The many ER errors due to doctors not knowing a patient's history? The cost overruns from repeating tests that have already been done -- and are in the records that the doctor can't access?

Converting records to electronic storage is going to save money. That's the reason the UK National Health Service is working so hard to get it implemented.

I don't see it happening here in the US until we have a national health plan. But if and when we ever do get a national health plan, this is going to be essential to its efficiency.

[Bridget Burke]

34. And if you check my link at #31....

You'll see that another account of the speech says that affordable health care for all was the major topic of the speech.

But if that version had been posted, we'd have fewer of the "Clinton is a traitor" remarks.

[Riding this Donkey]

36. Health Care for all is a wonderful thing, However

Computerized medical records is just another back door into our confidentiality privilege! Clinton above all should watch out for Big Brother in our lives. He should use his head or else shut the F up!

[Bridget Burke]

39. Did you actually read the article I linked?

Or are you just here to curse at Clinton?

Computerized medical records are already happening. Be concerned about confidentiality, but don't blame the technology.

[Riding this Donkey]

48. I voted Clinton twice, stood by screaming at what those a- holes

did to him. Love Hillary too. But he seems a little to fond of this warmonger POUS for me.

I love computers and think they are great for many things such as the only news we can get these days. But I draw the line when my personal info is put in them and my right to privacy is taken away.


The medical professions and others can just do things the old fashioned way and allow me to keep my right to privacy.

So sorry. Flame away.

[lancdem]

43. That affordable health care focus

was the headline I saw on yahoo, not the one on modernizing records.

[Bridget Burke]

70. But this version of the speech was picked for posting!

Wonder why?

[Rose Siding]

45. Do you have sources for that information?

How much could a system like that save? The repubs always blame costs on malpractice settlements, but I understand that those aren't really the burden that they make them out to be.

Don't the vast numbers of uninsured children hike costs more than mistakes over penmenship? Why isn't it the health care provider's responsibility to WRITE clearly?.

Maybe later- maybe after everyone can go to a doctor instead of ending up in emergency or waiting until conditions become more serious -maybe then we could find some way to make it easier for the professionals to record their own orders.

Does Clinton really think that people have HAD IT, just HAD IT with trying to remember when they had measels?

[BigBearJohn]

40. 1984 twenty years late

[Gin]

47. Beat 'em at their own game....believe in your own good health...

the body can heal itself. First we have to believe in that concept and ourselves. No drugs needed. No high payments.

But..the medical community will never let that happen.

The societal belief that we will inevitably fall apart and need drugs and doctors to keep us alive is nothing more than propaganda.

(IMHO)

[leesa]

49. How about some GD health care WORKERS instead??

We are so strapped for staff, it's ridiculous.

[davis_islander]

50. I'm all for it...

As long as you can "opt out" if you so desire.

[WestMichRad]

51. Oh, Great!

Can't wait until the day when we can all get on the Internets and anyone can download my medical history. :eyes:

[Princess Turandot]

57. Sounds like a comment intended as a sop to the business ..

community, which I'm assuming may have been part of the attendees at the conference. Electronic medical records are not a panacea for the woes of the US healthcare system,clinical or financial, by any stretch of the imagination. It's too bad that he added a semi-stalking horse to his speech.

A lot of hospitals already computerize demographic and ancillary testing information, so if you go to an ER you have been to before as people tend to do when they are at home, the MDs can access it if they choose. And you know, a clerk probably does need to ask you whether your address and insurance is still the same. Someone should ask abt known allergies: people do develop new ones. I also suspect that when you are a high-profile individual like Clinton, you will still be asked a ton of questions,no matter how much your records are computerized. Personally, I'm pretty thrilled these days if I go to a new MD and s/he spends more than a few minutes taking a history from me directly. I think it's more meaningful than reading a sheet of paper. (I do keep a copy of my medical history on my computer, as well as current medications I may be taking, bring them in and hand them to the new MD, to save myself from filling out a lot of forms.)

[Kimber Scott]

58. The VA modernized their records - all on computer - it's great.

You can go from department to department and you don't have to explain anything. Go to the lab, they know what you need. Go to the gynecologist, they know what meds you're taking. No need to fill out paperwork, over and over again. I like it.

[rainbow4321]

63. There are sooo many more important issues....

so why chimp is acting like THIS is..who knows...let me guess, he has donor$ in the medical software company or hardware friends that would be benefit?
One of the largest chains-- HCA hospitals--- are already computerized, using the Emar system...meds, nurses notes/careplans, history/physicals/consultations/lab results..and so on. Is there room for improvement, sure, just like there is for any system. But to hear chimphead talk, one would think we are still drawing pictures on cave walls.
Try getting hospitals to use better staffing grids so we are not short staffed all the time, so nurses are not having to stay and extra hour or two at the end of their shift charting...but, oh yeah, that would mean pissing people off like AHA and Frist's hospital/company, wouldn't it, chimp? Can't have them sharing any of the billions they make every year on people whoare actually keeping the place running. Much better to give it to the execs, right?

[moondust]

65. Oh yeah, it'll be just great.

Your electronic record will be flashed by satellite to India for some processing. (Conveniently) lacking adequate privacy laws, companies there will "mine" records, build databases, and discretely provide relevant information "for a price" to insurance companies, banks, employers, schools, etc., as requested. Nobody need go anywhere near your doctor or medical facility for the corporate world to know you intimately--inside and out. Wonderful.

[Cooley Hurd]

67. In the case of my company's EMR/Billing system...

...nothing leaves the US. The entire system is contained and maintained in the dr's office. The databases aren't shared at all...

[moondust]

68. Your company

may actually be the exception to the rule now although I don't know what the statistics are. Lots of medical facilities now have some of their records processing done in India and other offshore locations where U.S. laws do not apply and what laws are on the books are not enforceable by U.S. authorities: billing, transcription, likely coding, reading x-rays and other radiology exams, etc.

[Dervill Crow]

76. The US laws are enforceable

At least for offshore transcription. There has to be a chain of accountability from the health care provider all the way to whoever is doing the actual transcription. I heard of one case a couple of years ago (unfortunately I don't remember the details) where someone was holding patient's medical records hostage because the person she was subcontracting to hadn't paid her. There was a HUGE brouhaha over that. I think it was transcription for a hospital in California who contracted with someone in Texas who contracted with someone in Florida . . . and so on . . . and so on. So now things have been tightened up immensely.

The HMO I work for purposely has their contract work done by a service outside of our area just because it is much less likely that anyone will know a person whose report they are transcribing. As for the work that is done inhouse, it is strictly need-to-know and anyone even so much as checking a phone number for a friend via our computer system is immediately shown the door. I don't know how they know, but they do. In fact, if I wasn't such a valuable employee I'm sure I would be catching hell for being on DU during work hours. I'm sure my keystrokes are being monitored by someone somewhere.

[mainer]

72. As a former medical professional, I'm all for it

Maybe none of you have had to wade through a huge medical chart, full of chicken scratches, on a patient you've never seen before. Believe me, it'd be SUCH a help to have every drug clearly listed in a database. Especially since many older patients aren't really clear about their diagnoses and which pills they're taking. They just know they take the "little white pills in the morning and the little blue ones at night and the little tan ones when I'm feeling woozy." Sometimes, medical records aren't even available (a function of filing systems -- papers get lost) and you have to guess at the patient's past diagnoses.

And consider the hospital pharmacist's job. He can get an electronic prescription that's absolutely legible, plus he can check for possible drug interactions with the patient's other meds.