UP4014
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Without trying to catch you out, can you please give examples as I simply can't find them.
Matt
My Health Record
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Without trying to catch you out, can you please give examples as I simply can't find them.
Matt
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No published data as far as I am aware, personal experience (the worst level of evidence I'm well aware). I was working with different sexual health groups regarding the point of care ('instant results') HIV testing that they were trying to roll out a few years ago, despite the tests having a terrible positive predictive value (ended up being 0 in the pilot study). As part of that we had input from other groups who showed us several examples of suicides based on positive results that were available direct to patients (in Canada, they had examples of people who illegally imported test kits; in Brazil they had slightly dodgy online portals where you could mail in your test and they would email you the result). Several of these were false positives when they had definitive testing. These were just autopsy reports; not the sort of thing that get published in publicly accessible areas.
Whenever I make a critical, unexpected diagnosis, I always phone the treating clinician straight away so they can arrange to see the patient quickly. But not everyone does that; so yes I'm a big believer that you need a delay built into the system.
If I can add my two cents!
I wrote an article about the My Health Record recently:
"Although 15th October seems far away, you don’t have long to opt out of My Health Record. The idea behind the record is simple. All of your paper records will enter the digital world. The aim is to make it easier for clinicians to find information. Currently, every Australian will see their record transform into a digital format. You can opt out, but the deadline is October 15th. Opting out after this date is possible. But, the government can continue storing information they already hold until 30 years after your death.
There are lots of arguments for and against the My Health Record system. It’s worth knowing the arguments on both sides. Reading the arguments helps you to make an informed decision. Before you do, it’s worth knowing that you’ll still receive great medical care. In either case, you’ll find that a Mediband will compliment how you use healthcare in the future.
Arguments Against My Health Record: Data Input Errors and Privacy
Like all areas of IT, My Health Record could suffer at the hands of human error. During the first phase, the data is only as reliable as the person inputting it. Should they miss vital details, the risk of poor care is higher. For example, someone may miss data about your current medications.
Busy Clinicians Could Make Errors if Records are Wrong
If your My Health Record is incorrect, it could lead clinicians to make costly mistakes. One classic example is allergies. An analysis of electronic health records in 2017 found 5023 penicillin allergies. Some didn’t give a description of the patient’s reaction. Around 10-percent showed signs of an intolerance, not an allergy. In such situations, recording a bad reaction as an allergy could result in poor care. Patients may not access the best antibiotics.
At the dangerous end of the scale, patients allergic to penicillin may encounter it. Although most staff ask patients about allergies, there are some places where this is hard. For example, in trauma scenarios where the patient isn’t conscious. In such cases, relying on an incorrect health record could prove fatal..........."
The Arguments For My Health Record: Informed Care Decisions, Safer Communication, and Better Confidentiality
Many of the arguments against the use of My Health Record are also relevant to the for camp. One example is accurate transfer of information. While there’s always a chance that someone will add poor data, it’s unlikely that this will happen regularly. As such, there are lots of areas where the accurate transfer of data could sharpen medical care in all settings.
In some areas of medicine, obtaining records is challenging. Making data access easier can reduce poor outcomes. Although you might worry about who could see your health record, there are many ways physical records pose problems.
Accurate Electronic Records Make Patient Care Easier
Producing accurate electronic records makes patient care easier for clinicians and those receiving treatment. For example, a doctor who sees children regularly will want to know about the mother’s pregnancy. Also, the birth, and any time the baby spent in hospital after is helpful. Such information is very important when treating young patients. Accessing it fast makes it easier to plan tests in advance.
At the other end of the age scale, patients fall into the Care of the Elderly (COTE) category. Those who suffer from memory loss could fail to deliver vital details. One common scenario is COTE patients who present with a fever that doesn’t have a clear origin. If their doctor knows that they have a heart valve and a poor oral health, they’ll use tests to exclude certain heart diseases. If they’re correct, they’ll deliver lifesaving care quickly.
Sometimes patients skip important details, through no fault of their own. For example, a person taking blood pressure medication may answer ‘no’ when a clinician asks if they have heart problems. They do so because their medication is controlling their blood pressure. In their mind, that means there aren’t any problems. Ideally, doctors will ask for a drug history and uncover this. My Health Record gives them the chance to shape their questions appropriately. Patients will then benefit from faster appointments and better care.
Safer Communication in Healthcare
There are certain areas of healthcare where patients can’t advocate for themselves. They include:
Hope this helps and dispels any myths or worries.
I wrote an article about the My Health Record recently:
"Although 15th October seems far away, you don’t have long to opt out of My Health Record. The idea behind the record is simple. All of your paper records will enter the digital world. The aim is to make it easier for clinicians to find information. Currently, every Australian will see their record transform into a digital format. You can opt out, but the deadline is October 15th. Opting out after this date is possible. But, the government can continue storing information they already hold until 30 years after your death.
There are lots of arguments for and against the My Health Record system. It’s worth knowing the arguments on both sides. Reading the arguments helps you to make an informed decision. Before you do, it’s worth knowing that you’ll still receive great medical care. In either case, you’ll find that a Mediband will compliment how you use healthcare in the future.
Arguments Against My Health Record: Data Input Errors and Privacy
Like all areas of IT, My Health Record could suffer at the hands of human error. During the first phase, the data is only as reliable as the person inputting it. Should they miss vital details, the risk of poor care is higher. For example, someone may miss data about your current medications.
Busy Clinicians Could Make Errors if Records are Wrong
If your My Health Record is incorrect, it could lead clinicians to make costly mistakes. One classic example is allergies. An analysis of electronic health records in 2017 found 5023 penicillin allergies. Some didn’t give a description of the patient’s reaction. Around 10-percent showed signs of an intolerance, not an allergy. In such situations, recording a bad reaction as an allergy could result in poor care. Patients may not access the best antibiotics.
At the dangerous end of the scale, patients allergic to penicillin may encounter it. Although most staff ask patients about allergies, there are some places where this is hard. For example, in trauma scenarios where the patient isn’t conscious. In such cases, relying on an incorrect health record could prove fatal..........."
The Arguments For My Health Record: Informed Care Decisions, Safer Communication, and Better Confidentiality
Many of the arguments against the use of My Health Record are also relevant to the for camp. One example is accurate transfer of information. While there’s always a chance that someone will add poor data, it’s unlikely that this will happen regularly. As such, there are lots of areas where the accurate transfer of data could sharpen medical care in all settings.
In some areas of medicine, obtaining records is challenging. Making data access easier can reduce poor outcomes. Although you might worry about who could see your health record, there are many ways physical records pose problems.
Accurate Electronic Records Make Patient Care Easier
Producing accurate electronic records makes patient care easier for clinicians and those receiving treatment. For example, a doctor who sees children regularly will want to know about the mother’s pregnancy. Also, the birth, and any time the baby spent in hospital after is helpful. Such information is very important when treating young patients. Accessing it fast makes it easier to plan tests in advance.
At the other end of the age scale, patients fall into the Care of the Elderly (COTE) category. Those who suffer from memory loss could fail to deliver vital details. One common scenario is COTE patients who present with a fever that doesn’t have a clear origin. If their doctor knows that they have a heart valve and a poor oral health, they’ll use tests to exclude certain heart diseases. If they’re correct, they’ll deliver lifesaving care quickly.
Sometimes patients skip important details, through no fault of their own. For example, a person taking blood pressure medication may answer ‘no’ when a clinician asks if they have heart problems. They do so because their medication is controlling their blood pressure. In their mind, that means there aren’t any problems. Ideally, doctors will ask for a drug history and uncover this. My Health Record gives them the chance to shape their questions appropriately. Patients will then benefit from faster appointments and better care.
Safer Communication in Healthcare
There are certain areas of healthcare where patients can’t advocate for themselves. They include:
- Paediatrics; Some children can’t communicate. Others don’t understand the importance of certain details. A few may withhold information on purpose.
- COTE; Conditions such as dementia and Alzheimer’s prevent patients from offering the right information.
- Psychiatry; Many people will share details of their past medical history. But, those with conditions such as paranoid personality disorders may become obstructive.
- Trauma; When a patient is unconscious they can’t communicate.
- Theatre; Surgeons will often have the most important information. But, lapses in communication become difficult to address after a general anaesthetic. .........."
Hope this helps and dispels any myths or worries.
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OATEK
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Well time is just about up to opt out - and it will be interesting to see how many have done so. Personally I have stayed in, having been there for a number of years.
I did a lot of work in the aged care sector, looking at the way inter-related systems could help improve outcomes (eg the triangle of care is the Care facility, the GP and the Pharmacist). The major cause of hospitalisation for older Australians in care is medications related, and having better control and review of these are the most likely way to reduce such admissions.
I opted in when doing some consulting around the systems side of the then named PCEHR (now My Health Record), and when I look at my record online there is very little to get excited about. But the upload of prescription data is something that I feel will benefit me into the future. Otherwise there are just a few hospital discharge summaries.
When I hear all the privacy discussion, I wonder about all those folders on the end of the bed or nearby on a shelf that have little if any security (my last stay was this month, and the folder was open to anyone who might have taken an "interest"). [As an aside, ask a nurse in a major public hospital about how often paper based files used to get lost, because an absent minded physician put them down somewhere unexpected, and how much time could be wasted looking for them if a critical care incident arose].
And I wonder how many people have sent off their DNA sample (with all the potential health related information it contains) to an unregulated foreign ancestor tracing service with links to the Church of Jesus Christ of Latter day saints (Mormons)? Wonder how safe their DNA record really is?
I did a lot of work in the aged care sector, looking at the way inter-related systems could help improve outcomes (eg the triangle of care is the Care facility, the GP and the Pharmacist). The major cause of hospitalisation for older Australians in care is medications related, and having better control and review of these are the most likely way to reduce such admissions.
I opted in when doing some consulting around the systems side of the then named PCEHR (now My Health Record), and when I look at my record online there is very little to get excited about. But the upload of prescription data is something that I feel will benefit me into the future. Otherwise there are just a few hospital discharge summaries.
When I hear all the privacy discussion, I wonder about all those folders on the end of the bed or nearby on a shelf that have little if any security (my last stay was this month, and the folder was open to anyone who might have taken an "interest"). [As an aside, ask a nurse in a major public hospital about how often paper based files used to get lost, because an absent minded physician put them down somewhere unexpected, and how much time could be wasted looking for them if a critical care incident arose].
And I wonder how many people have sent off their DNA sample (with all the potential health related information it contains) to an unregulated foreign ancestor tracing service with links to the Church of Jesus Christ of Latter day saints (Mormons)? Wonder how safe their DNA record really is?
Dr Ralph
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Can't afford to do this. Don't want my DNA in any data bank that may be able to match me to unsolved crimes and/or lost children
Same. Most were smart enough to realise how much of a disaster it will be.
I suspect the nation rate will not be very large though as many wont even know they have such a compulsory record in place. This should never have been an opt out system.
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And I wonder how many people have sent off their DNA sample (with all the potential health related information it contains) to an unregulated foreign ancestor tracing service with links to the Church of Jesus Christ of Latter day saints (Mormons)? Wonder how safe their DNA record really is?[/QUOTE said:
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Opting out because of ' concerns about privacy and data integrity' is all very well and virtuous, but it's not an end in itself.
I start from the premise that the digital MHR material will ultimately be as secure as my digital tax records, my health records in paper format, my passport data ( in dozens of countries and overseas hotels
) etc.
That is, it might be hacked / leaked / stolen.
So then you ask yourself, then what?
Well, basically nothing really, beyond what we all accept for all that other digital and health stuff that isn't MHR.
Given the choice, people jump up and down and are clever by opting out to safeguard their 'privacy'. But if there wasn't a choice, they'd just grumble and get on with life, just as I do when I have to hand over my tax return to get a credit card bonus, my passport to be scanned to get into a overseas hotel, or my credit card details just to buy a movie ticket online.
Yet none of these have the potentially life saving, or at least health outcome improvement of having your heath records available outside your chosen health professional.
Think about that next time you are unconcious and about to be injected with something you are leathally allergic to.
I start from the premise that the digital MHR material will ultimately be as secure as my digital tax records, my health records in paper format, my passport data ( in dozens of countries and overseas hotels
) etc.That is, it might be hacked / leaked / stolen.
So then you ask yourself, then what?
Well, basically nothing really, beyond what we all accept for all that other digital and health stuff that isn't MHR.
Given the choice, people jump up and down and are clever by opting out to safeguard their 'privacy'. But if there wasn't a choice, they'd just grumble and get on with life, just as I do when I have to hand over my tax return to get a credit card bonus, my passport to be scanned to get into a overseas hotel, or my credit card details just to buy a movie ticket online.
Yet none of these have the potentially life saving, or at least health outcome improvement of having your heath records available outside your chosen health professional.
Think about that next time you are unconcious and about to be injected with something you are leathally allergic to.
utaussiefan
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The Opt Out period doesn't end until the 15th November so there is still another month until it closes.
drron
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Well if the My Health records are as safe as tax records god help us.
When I was political I was told by a journalist that my tax returns were in the hands of my opponent.He then showed me a copy.Couldn't nail me on anything but certainly was a bit scary.
When I was political I was told by a journalist that my tax returns were in the hands of my opponent.He then showed me a copy.Couldn't nail me on anything but certainly was a bit scary.
VPS
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amaroo
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What were they saying about keeping your heath record safe, secure, and private...
Queensland doctors and nurses use patient details to steal drugs
Queensland doctors and nurses use patient details to steal drugs
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I opted out due to security concerns, not so much for privacy as every query will be auditable. Yes I know my passport and tax information can be hacked but you have no choice with these two because if you don't then the former means you can't travel and the latter means you go to prison.
It should have been opt in as that's the positive approach to adopt. People, in Western countries at least, mostly do not like situations foisted on them. Look at how the advertising in cinemas works now for media piracy. It used to be "You wouldn't steal a car so don't steal a movie." Well, actually, there are many people who would steal a car if they knew there was no chance being caught. That was negative, confrontational. Now the approach, the positive and engaging one, is to have a procession of actors thanking people for not copying/downloading media.
It should have been opt in as that's the positive approach to adopt. People, in Western countries at least, mostly do not like situations foisted on them. Look at how the advertising in cinemas works now for media piracy. It used to be "You wouldn't steal a car so don't steal a movie." Well, actually, there are many people who would steal a car if they knew there was no chance being caught. That was negative, confrontational. Now the approach, the positive and engaging one, is to have a procession of actors thanking people for not copying/downloading media.
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I do
At some point along the way, the patient's hospital medical record whether paper or electronic needs to be accessed at the point of care and this is when S8 drugs are diverted. Its as simple as instead of giving the drug to the patient its been diverted for illicit personal use, or looking into the medicine chart and taking out an S8 and then diverting for personal use
The best way to prevent S8 diversions is for these drugs to not have a presence in any health setting which of course is not possible, or for health records to be permanently sealed and never opened in which case why have any health record at all.
This issue is a long standing one and predates and is completely unrelated to any electronic medical record keeping systems including the MyHealth Record. These incidences occurred in hospital settings where the MyHealth record is not in play. Your hospital medical record is the flowsheet of your care in hospital. The hospital record includes the medication chart MyHealth Record is the summary of your health record from diverse sources and is nowhere as granular as the hospital medical record.
At some point along the way, the patient's hospital medical record whether paper or electronic needs to be accessed at the point of care and this is when S8 drugs are diverted. Its as simple as instead of giving the drug to the patient its been diverted for illicit personal use, or looking into the medicine chart and taking out an S8 and then diverting for personal use
The best way to prevent S8 diversions is for these drugs to not have a presence in any health setting which of course is not possible, or for health records to be permanently sealed and never opened in which case why have any health record at all.
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It is not possible to Opt in/out of the creation of a hospital medical record when you are in Hospital.
And even if MyHealth Record did not exist, S8 drug diversions will continue to occur.
So I cant see How Opting in/out will prevent S8 drug diversions?
amaroo
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I posted it in this thread for a reason! The concern is not about S8 .... it is, and always will be about personal information and human behaviour. If the health system cannot control highly regulated drugs - they certainly don't deserve additional access to my records.
Will be interesting to see what the new government will do - anyone remember what's their position on this matter?
Will be interesting to see what the new government will do - anyone remember what's their position on this matter?
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