Having grown up with the advent of the internet, the idea of medical records being electronic and shareable seems like a no-brainer to me. When I arrived at VA, however, I realized that something that sounds so simple actually requires a lot of research, tests and trials in order to keep Veterans and Servicemembers, and their privacy, safe.
President Obama set a goal for DoD and VA to create a shared lifetime electronic records system, so, I’ve kept a close eye on new developments and achievements in this arena.
This morning an article from the Newport News Daily Press caught my eye. It highlights successes the Hampton VA Medical Center in Virginia is having with the Virtual Lifetime Electronic Record (VLER) pilot program. The Hampton VA Medical Center, in coordination with its partner, Bon Secours Virginia Health System, is the second such pilot (the first was conducted in San Diego), and it’s off to a great start:
Sharing medical records among providers electronically is speedier than the old paperwork way, said Richard Bone, a Vietnam veteran who lives in Newport News.
“The coordination between the facilities is outstanding,” the Army veteran said.
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Forget security, Let’s get to basic functionality first. For three years the VA has been pushing MyHealthEVet as the Greatest Thing Since _____ (fill in the blank). Other than prescriptions and what you, the veteran, enter yourself, no medical information is entered.
At first I though that the prescription function worked; but, then on the second use, the prescriptions weren’t delivered, and only after I called did I find out that one of the two prescriptions I requested was no longer available. Then they sent a substitute, which if I hadn’t read it closely, would have had me doubling the recommended dosages of one of the component medications. So, scratch the Prescription function as effective and safe.
Last Fall they proudly announced a secure messaging system within the application. The first time I tried to use it to detail the problem with the prescriptions, a screen telling me that I was timed-out appeared when I entered Submit. There’s no warning that you will be “timed out.”
If the VA can’t get MyHealthEVet right, how are they ever going to get the more sophisticated functional requirements of the Electronic Health Record correctly developed and properly tested? It became painfully obvious to me that MyHealthEVet was never properly tested.
What good is a secure system, if the application is ineffective and inefficient to begin with?
I really don”t think that there is no need to worry about the volnerability to the health system. It is a miracle to see technology in health moves forward these times
I too am afraid for the safety of my records. As with any system, humans are the biggest volnerability (google)
I, too, have grown up with the internet around and (fairly) easily accessible. Yes, dial-up was a bit of a pain when compared to today’s standards, but it was still there. I initially though electronic health records were something every office had, but I realized that many hadn’t and still haven’t incorporated it yet. The biggest concerns are privacy of patients, and sometimes the cost (financially and time) it takes to transfer everything over holds doctors back. But it is a great thing in the medical world, and all practices should take advantage of it!
Wellrn2002, the main excuse is privacy. If a bank cannot protect your personal information, an HIE or hospital can? If an insurance company gains access to your life’s health info, it will affect your premiums and you cannot say that they won’t try.
The other major problem is interoperability, which no one is even trying to fix. There are over 70 companies with an EHR system, with their own copyrighted, proprietary code. Do you think they are willing to share it with anyone so your record created with Company A can be read by the doctor that uses Company B? A nationalized system that bankrupts the country won’t fix that.
I must admit, this is a nice start. The concept of a non-identifiable Pt. I.D. number for medical record identifier would be great. After all, if I.D. theifs don’t know who the information belongs to what good would it be. This is not to say that the information on the patient record itself shouldn’t be secure also. There are other solutions to this on laptops. For instance, what about random number generators for access to the laptop itself? Many compaies are using these to protect access to their software. The fact is that there are so many ways out there, but everyone finds an excuse to not to have a electronic health record.
Most excuses deal with privacy, but the true cloud that hangs in the view of the this mission is that success will virtualy eliminate fraud and waste. I am obtaining my degree as a nurse informatician, and have 11 years as an ICU/ER/PACU RN. It is a fact that this country’s healthcare system is being abused daily. Emergency room hopping for narcotics, chest pain workups for a bed and a meal, and ever shrinking mental health resources due to the inability to sustain facilities through public and private funding are just a few reasons that healthcare costs are astronomical. The implementation of a central medical record repository with good structure would help eliminate waste and detect fraud. We must realize that in order to slay what has become a dragon we must first see universal health come to life. Without this step, it is doubtful that a nationalized healthcare record will be achieved. Too many people have financial motivation to see it fail.
Hello,
I appreciate the convenience of Electronic Record Sharing but I wonder about the security issues involved. I wonder about the identity theft and privacy issues involved.
Someone will inevitably bring their “laptop” home, with millions of patient records on it, and will be stolen out of their convertible while the top is down. Then again their private partner will probably lose a back-up tape or something of the like.