So, my new doctor wants me to do a medical history online.

[Ilsa]

Not just a general medical history, this is a history of my reproductive system.

Sure, it has a log-in, password, etc, and I sure as hell am not running for office, but I wasn't comfortable with all this information being digitally record via servers and the Internet.

It wasn't enough to ask how many pregnancies, deliveries, etc, but it asks about sexual history including the number of partners. I put "0" just to fill it in and make the dr ask me if the dr really wants to know.

Some things are too personal to put online. I don't think anyone would really care to know this much about Moi, but if I was Sen. Elizabeth Warren or someone like that, I'd insist on a more private record.

[tridim]

1. Your kids will thank you for it.

I wish I had access to my family's medical history. It would likely help me live longer.

[hlthe2b]

3. Maybe... I just assume the worst and try to act accordingly (My Mom was adopted and no records

will ever be available as she lived and died before it became possible to obtain such information).

I think everyone would likely live longer if they simply assumed themselves to be at risk for most things and acted accordingly in terms of those preventive actions one can take..


I have to agree with the concern for some information to be entered in an online medical record. I think much of it will end up there, regardless, though.

[Ilsa]

4. No. There is no reason for my kids to

access this information. They dont have access to it, only the dr and hackers and NSA.

I can give my kids a family medical history that is much more complete and appropriate for them without all of the detail of whether I've had miscarriages, etc. I haven't had any cancers of the reproductive system that would be in this file that would affect them either.

[Shrike47]

2. If you've ever been married, '0' may be hard to sell.

[Ilsa]

8. Not trying to sell it.

Trying to get dr to ask me in person if that tidbit is really critical.

[customerserviceguy]

35. You've never been married, have you?

[TexasTowelie]

5. Could you have put greater than zero or multiple?

I don't see the need to have that information recorded in a database. Personally, I would continue shopping for another doctor or simply tell the doctor that I'm not completing an online medical history.

[Ilsa]

17. Not that easy where I am.

Limited number of Drs that are only GYN that are covered by my insurance.

[TexasTowelie]

21. Another reason for single-payer healthcare.

I also had a limited number of practitioners in various fields on the last job.

[Mojorabbit]

40. My husband is a family doctor and this is his one big concern with the new health care

system. Medical records are all going electronic. There are a ton of things people tell him that they would never ever want anyone else to know. He is worried these records will not be adequately protected.

[madrchsod]

6. brand new system that is actually very good.

i`m on medicare and my medical history is online. let`s say i`m 100 miles from home and i end up in a hospital. they look up my ss number at up pops my medical records and prescriptions. it`s an excellent system. i agree that number of partners is a bit much but one can always tell a little white lie.

[Ilsa]

12. No SSN as far as I know.

Last edited Wed Jul 31, 2013, 06:46 PM - Edit history (1)

And it is not a complete medical history. It is only "complete" with regards to my reproductive system.

My concern is for people who may be public and might want to keep their medical history, including whether they take anti-anxiety meds, etc, private and out of the prying eyes of NSA and people who would use it politically.

On edit: AFAIK, this is not the Medicare system.

[Jackpine Radical]

7. I would think that the record-keeping system is HIPAA compliant,

but still, I think this is highly intrusive.

The example that keeps coming up in my field is when mental health records go online and become available to anyone in the system. As a result, most psychotherapists are very circumspect about what they put into the online records (often keeping what they need to keep track of but don't want floating around the system in "a second set of books" offline). Your podiatrist really doesn't need to know that you were sexually abused as a child, for example.

[Hekate]

24. Your example is spot on

Because of that consideration, when I sought a therapist I always went outside my insurance system. Sad. As far as I know it's fairly common practice to keep two sets of books.

[Jackpine Radical]

25. Yes, you sign away your privacy rights when you involve your insurance co.

A whole lot of therapists do most of their work for sliding-scale private pay just for that reason. Also, insurance cos. don't like any kind of mental health care except cheap generic medications, regardless of the therapeutic demands. Psychotherapy is too expensive. I've seen ins. payments to therapists cut in half in the last decade or so, combined with fewer authorized sessions, etc.

The average patient is with a given insurance plan for something like 18 months before being switched one way or another. There is no incentive for an ins. co. to actually pay to permanently resolve a problem when they can use medications as a stopgap until the patient gets off their plan. Otherwise they'd be paying to fix the next company's problems for them. Everything gets reduced to a short-term bottom line, much to the detriment of the patient.

[Quantess]

9. I can't claim to know what the right answer is for you,

but I know what I would do. I would be passive aggressive and just never complete the questionnaire.

[NightWatcher]

10. My doc and hospital have all their records on a server

Any Dr that I go to within the system has all my records on file. My Dr knows what my lab results are as soon as they are done. If I should slip into a coma and be taken to my hospital, they'll know my detailed history.

Online records are the way to go and the way of the future.

[Ilsa]

14. A medical history isn't just about lab results.

A thorough psycho-social reproductive health file includes a section on rape and sexual abuse, abortions, miscarriages, STDs, etc. There are things in that kind of medical file that your ER doc doesn't need to know about.

Like I said, if I was a public official like a senator, I wouldn't want anyone to be able to hack into my reproductive system file.

[NightWatcher]

19. I know its not just lab results. It's your complete and thorough medical history

Like it or not medical histories are going digital and online. If you want to keep something secret, don't tell anyone.

As far as privacy protection, there's HIPPA.

[dixiegrrrrl]

30. When I think of the mistakes I found in my medical record after the hospital system went online.....

Wrong marital status, wrong address, plus they listed me as a Baptist, and when I asked why the hell they were put religious denomination in medical records, they said they always do, in case a minister is needed.
Misspelled my last name ( left off a letter)
Hospital admin.could not explain to me where all of the erroneous information came from, since they had destroyed paperwork after it was incorrectly put into the computer. Apparently minions had been busy as hell all year getting their computer system installed as a requirement of Obama health plan.
Sadly no one in the entire hospital knew how to correct errors or even understood how the system worked, much less how to enter accurate info., as I discovered after a week of phone calls to various depts.
So now we have in this backwards burg a computer system connected to hospital, and doctor office and pharmacy, but no one knows what to do when there is a mistake.
Pharmacy, to me, last week.." We gave you 90 pills instead of 180 because your doctor only ordered 90, says our computer"
Doc's office, to me, when I called about the pharmacy screw up: " I wrote the order for 180 pills, it is in the computer"

Reminds of the Aisiana pilots who know how to use the plane's computer system but not how to fly visually.
( Yep...that was discovered after the recent crash)

[Smarmie Doofus]

11. I'm not doing that. n/t

[cbayer]

13. The medical privacy laws are pretty strict and I would suspect

that whatever system s/he is using has a high level of security attached to it.

And, FWIW, even if you filled it out by hand, the information is highly likely to be entered into an electronic medical record anyway.

At any rate, I think it's your right to refuse to answer part or all of it, stating that you would rather discuss this in person.

Electronic medical records are seriously needed in this country and will reduce overall medical costs significantly once fully implemented.

[Ilsa]

16. My concern isn't just for myself,

but for public officials who could have information hacked or stolen by individuals to be used against them politically.

[cbayer]

22. Well, having paper records doesn't really prevent that

And anyone who hacks or steals private medical information is going to face very serious consequences.

The ethical issues of EMR's are important to discuss, but, in the end, I think they will do much more good than bad.

[alarimer]

15. My health insurance company has a "HealthSmart" portal

where you are encouraged to enter your health data (weight, blood pressure, last exams, etc). So then it can offer you suggestions on what to do. This is separate from the portal where you can check the status of your claims. It's something separate and very intrusive.

I started to do this, then I realized it's just too creepy. So now I get phone calls and emails.

"We have noticed you have not had a mammogram. Call to schedule" or words to that effect.

I hate going to the doctor and basically only go when there's something wrong with me.

The next time they call, I'm going to answer it and ask them to delete all my information because I find it creepy as hell.

Are they going to raise my premiums because I refuse to participate? I have no idea, but I think it might come to that one day. If you don't enter the data, maybe it will assume you are an overweight smoker and charge you accordingly.

[Ilsa]

18. Yeah, the automated responses

are creepy. You've been pidgeon-holed as a particular patient. Did it ask you when your first period was? Mine did.

[Hekate]

26. We got a new insurance company when my husband changed jobs

Naturally transferred over all our existing prescriptions, stuff of long duration for both of us.

I started getting concerned letters and finally a phone call from one of their pharmacists about control of my diabetes. I don't have diabetes, but I do take a drug to control my blood sugar, and my internist is as happy as can be with the results. I had to tell the pharmacist that I had been taking the drug for several years already (he thought it was new) and then I had to go get my copy of my last blood test so I could tell him what my score was. Then he was satisfied. It was a bit weird -- and I still get info mailed to me about how to manage my non-existent diabetes.

Their system is actually okay so far. Early on I had to reassert that I cannot take the generic form of Wellbutrin (I've had to assert that for years and years -- the generic stuff puts me right over the edge of the known world with rolling panic attacks), but kept the pharmacist online to ask additional questions about generics that had given me adverse side effects. He was helpful to the limit of his knowledge and then transferred me to another division specializing in adverse effects, and the person there was likewise helpful.

Sometimes the system works well.

[trof]

20. The internet is totally secure. And everything you read on it is true. I'm a French model.

[Ilsa]

27. Bon Jour!!!

[trof]

28. That's the guy.

[Hekate]

23. It's all going electronic, kids, and has been for some time.

At my age I have several doctors. Some of them are in standalone offices, but others are networked in a major local clinic.

My internist is not in the clinic, but he has digitized all his records as of several years ago. I don't believe I can access them online. Everything stays in his office.

But in the clinic, every doctor I have seen there can pull up my complete record with them on a computer. When my internist prescribes tests at my annual physical I make sure to include the name of one of my "clinic" docs (usually my allergist) so that they all will have that record. It's actually pretty impressive, not to mention convenient. I can also access my own records online, if I so choose.

HIPAA is supposed to protect your privacy. Access involves knowing the right codes.

Presumably the FBI or NSA or whoever you fear could hack into your medical records. But why would they? Blue Cross and Aetna already have them. They used to use them to exclude your pre-existing conditions, but they are not allowed to do that any more, so what would be the point?

Anyone who is that concerned about strangers knowing their intimate medical business should be sure to dispose of their empty prescription bottles in a secure manner.

The issue of computerized, and now online, health records has been coming on for years and years. It's not new and it's not a secret. The medical realm has been very proud of this technological innovation as it has come down the pike, and numerous articles have been written and numerous TV shows have mentioned it.

Like all potential issues about loss of privacy it has made me uneasy. Then I realized there was nothing I could do about it anyway -- and besides, I want modern medicine, and in the 21st century this is what you get.

Beyond that is the issue of what kind of questions a doctor will ask you. My internist has a litany of them -- but then, so does the intake nurse at the blood bank when I go to donate. They both would like to know if I have traveled to certain places where disease is rampant and in a spirit of adventure had sex there. They both would like to know what sort of drugs I have enjoyed recently, if any, and were they needle drugs. These are actually health-related questions.

If you feel uncomfortable filling in the medical form as presented to you online, rest assured your doctor will take notes during the exam, and will input the answers him/herself.

Best of luck.

[Ilsa]

31. Donating at a bloodbank is entirely voluntary.

I've donated in the "gallons" range. The questions cover foreign travel, medications, drugs, recent illnesses, and sexual behavior, and anyone attempting to donate knows that certain behaviors will preclude donation. That is one reason there are blood shortages. And no one at the blood bank asked me for a number on sex partners, just if I've engaged in specific risky behaviors, which I honestly denied. They are not asking specifics unless there is a "positive" on one of the questions.

My concern is still over the potential for abuse of detailed online information. And as I've stated, I doubt anyone would be interested in me personally. But people might be enemies of certain politicians. Information can be abused to discredit people in the minds of voters, possibly without the patient ever knowing for certain that there was a breach.

[Ilsa]

34. I Remove labels from empty prescription bottles

for myself and my kids.
I'm big on shredding almost everything that is business, medical, and personalized.

[pinto]

29. I fully support secure digital medical histories. And a patient's right to refuse providing info.

For myself, say I'm in an ER out of town, out of state or out of country - I sure as hell want ER staff to have my latest med info. ASAP. Digital makes my recent med history available in real time, when needed.

And I think password-protected digital files are actually more secure than your paper chart sitting in an office file cabinet.

[Ilsa]

32. I agree that there are certain levels of

information that an ER dr needs immediately, such as chronic conditions, meds on currently and recently, drug reactions, last surgery, etc.

They don't need the detailed level of information about someone's reproductive system unless they are being, or were recently treated for an illness in that system.

I think there needs to be levels of access, too.

[Harmony Blue]

33. I would not do it

Personally that crosses a line and is extremely unprofessional.

[pinto]

38. Unprofessional to take a comprehensive medical history? That's exactly part of their profession.

I think the issue here may be one of trust in either the medical provider, security of medical records or both.

Anyone who has those concerns should definitely bring them up with their provider(s). HIPPA regulations are pretty clear - here's the overview info from DHHS :

Health Information Privacy

The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; the HIPAA Breach Notification Rule, which requires covered entities and business associates to provide notification following a breach of unsecured protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.

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

And a patient has the right to informed consent, barring intent to harm, etc.

[Trekologer]

36. SSL is very secure

The typical encrypted connection between a web browser and server using HTTPS uses a 128-bit encryption key. That means there are 2 to the 128th power possible key values. That's over 340,000,000,000,000,000,000,000,000,000,000,000,000. An earlier, smaller key standard of 56-bit keys was estimated to take about 1.4 million years to break. It is estimated that the time it would take to brute-force 128-bit encryption is 6,000 trillion years, which is longer than science tells us that the Earth has existed.

Once you get to your doctor's office, he/she will ask you those questions and then have to enter your answers into the computer anyway. Manual data entry is often error-prone, especially when done in mass. Add in the stereotype that doctors have terrible handwriting and errors are certainly possible. If you do it yourself, you can at least ensure that you have entered the data correctly.

[Ilsa]

39. She didn't ask for a correction of

the obviously wrong stuff, so I guess it wasn't really necessary for the dr to know how many partners I've had. The important stuff is in my file.

[displacedtexan]

37. I was a little creeped out by my new Kaiser Permanente online stuff

but I've grown to love it. When I email my doctor, he replies. When I go to the OB-GYN, he has my internist's notes and my complete med history. He even noticed that I was prescribed a sulfa derivative, which my internist should've flagged because of my allergy. Good thing I hadn't started taking it yet.

Oh, and I love having the free shuttle service from my neighborhood in San Francisco to the doctor's office across town.

I had 100% Blue Cross coverage in Washington DC, but it was always a paperwork nightmare. This SF insurance is amazing. I also get my test results online in 1 or 2 days.