Medical records available across a network...what's your opinion?  

I'm glad you didn't have a stroke, too, and it does sound like you have an excellent hospital to go to. Because my husband has so many different medical issues it does make me more comfortable that anyone who treats him has all of his information available. We did go outside of the V.A. once, for surgery on his right carotid artery (mainly because we chose not to wait which, as it turned out, would have been safe to do) but adding those records to his V.A. files was a simple matter of filling out a form which they sent to the surgeon. Now they have those, too.

Yes, it is annoying and I also believe that a system like this can be lifesaving when it comes to heart disease. Before my husband had his heart attack he was not covered by the V.A. We went to the local ER several times due to chest pains, dizziness and shortness of breath. Each time he was given an EKG, diagnosed with angina and sent home. Had the ER doctors been able to access his records and see the previous test results, they may have order additional ones that would have identified the narrowing of his arteries before it became life threatening.

Dragon, the Veteran's Administration's medical centers are government run so the government does have it's grubby hands in it. It's headed by the U.S. Secretary of Veterans' Affairs, which I believe is a Cabinet position appointed by the president.

As with any networked system, everyone who accesses patient records at the V.A. has to have the ability to log into the system but their access across the network is limited by protocol based on their job. As a former network administrator I can tell you that most networks are tiered in some way, limiting user access to some groups and giving full access to others. The in house pharmacy, for instance, can see the patient's medication information only and the staff who schedule appointments can only see that area of the patient's file...which comes in very handy for us since it takes over an hour to drive there so being able to schedule multiple appointments for the same day is helpful to us. Physicians, of course, have full access all patient files while the people who work in the Canteen have no access to patient files.

No one can guarantee that any system will always be hackproof but there are ways to keep a network safe and the protection up to date. My question though would be, does that concern outweigh the benefits of using a networked system and are those concerns legitimate? How could an individual's medical information be used for criminal gain the way that an individual's financial information could be? My primary bank is a national chain so my personal and business financial data is on a massive network. Checks clear faster than back in the old days because of this which is something that definitely benefits my business. Does the fear of possible hacking outweigh the benefits and convenience of online banking? The Social Security Administration, Motor Vehicles Administration, Railroad Retirement Board are three other large networks that I'm aware of.

ya and my dad and husband have both gotten letters from the government letting them know that their information has been compromised. The VA lost a few laptops with their SS numbers and other information on it...information that could be use for someone to steal their idenity and ruin their credit. SS has had the same problem. Idenity thefts are getting more tech savy...as we put more and more personal stuff on computers and databases...they find more ways to steal it. Every had your idenity stolen? It is very expensive and takes years to get fixed. Until you get it fixed your life can be ruined. It can effect your ability to get a job, get a loan, buy a house, car, all kinds of stuff.
I am just saying there are risks and those risks are big. Especially to those that have their information compromised.
Also I want to know who exactly would have access to the information legally. Just your doctors? Or can the government see it too?

I heard about the laptops that were stolen...and also recovered. It was a theft of convenience following a break in of the employee's home if I'm remembering correctly. Forensic examinations of the equipment determined that the database had not been accessed or copied. Although I didn't see the details, I do know that according to security protocols, the database was password protected so, even though this equipment was in the hands of a thief for a period of time, the information contained was still protected.

Yes, identity thieves are getting more savy but security protocols are also keeping pace. With my online banking, for instance, when I enter my login, I'm taken to another screen that includes a photo that I selected along with a title for the photo that I created. This is called secondary login protection. If the screen does not look like it should, I'm not really on my bank's website so I don't enter my password. This protects customers from clicking on a fake link to the bank's website and giving a thief their login and password information.

No, Lil, I've been fortunate...and careful...so we've never had our identities stolen. I'm not saying that people don't try and won't continue to try to steal the identities of others...I just don't see medical databases being targets when there are too many financial ones available to target.

As far as access to medical information, I don't know the details but there are standards when it comes to the administration of any network as well as laws on the books (HIPAA) that would dictate who could access what level of information. Again, using the example of the V.A., the Pharmacy staff only have access to patient medication information, the staff who schedule appointments have less access, the phycians have full access. You use the word "government" too generally, Lil. The government is many entities. Even within the V.A. medical system, my husband's rating as 100% disabled is indicated but they have no way of knowing what his financial compensation is because that is based on other variables in addition to the 100% disability rating.

You know who would LOVE to have access to that information...drug companies. Instead of spending millions on commericals for TV...they could just direct market people who have a certain conditions...call them, send them mailers, free samples....it would be a gold mine for them. And I hope they don't have access to it.
Get dianogised with a condition...next thing you know you are getting tons of junk mail from the drug companies trying to get you to take their drug for it.

Now THAT would irritate the he11 out of me! My stepson uses our P.O. box as his address and he got a traffic ticket not too long ago. Suddenly there was junk mail in our box from all the various driving course businesses...the ones that you can take to reduce the cost of the ticket and the points. He never paid the ticket so he got a letter threatening him with the suspension of his license. NOW we're getting offers from attorneys in our box!

I do think that HIPAA regulations would keep the drug companies from getting that information...although I do agree that they would love to have it.

Thank you for your good wishes, hofferp. Since you trust the government to handle your retirement benefits is there a specific reason why you wouldn't trust the government to handle...and safeguard...your medical records and would instead place your trust in a private entity?

In my case, the Government was my employer. So my employer is handling my retirement benefits. I don't want the Federal Government handling my medical records because I don't want a bigger federal government. I'd like the Federal Government to perform the functions set out in the Constitution, not much more.

Social Security benefits are not mentioned in the Constitution, neither are veterans' benefits. Do you also have an objection to those?

My only object to social security and veterans benefits are they are mismanaged and poorly run by our government. They have proven themselves to be unable to run either program properly.

I'm not very familiar with the SSA, lil, but I do agree that the automatic denial of disability benefits 99% of the time is unfair. I don't believe that's due to mismanagement but, rather, policy...and that's really the only area I can speak to regarding them I am very familiar with the veterans' administration though, both the benefits side and the medical side. What complaints do you have or are aware of with regards to the way they run their benefits program?

My family has had a lot of bad experiences with VA. My dad does not even bother with them anymore. Too slow...too much red tape...too little funding.

As for SS...it is just about bankrupt. I have no hope of ever seeing the money I have paid into social security when I get old enough to get it back. The money paid in has been mismanaged.

I guess it depends on where you are when it comes to the V.A., Lil. When you initially apply there is a delay and let me tell you about red tape! We fought for 4 years for my husband's PTSD rating because they were still iffy about this disorder when we first started. Thanks to the Gulf War vets, it's easier to be approved for service connected benefits for PTSD now. Recently 4 other diseases attributed to the spraying of Agent Orange have been added to their list of what they will compensate veterans for. One of those is coronary artery disease...something I've been aware of for several years now. I don't know what you mean by too little funding though.

I do agree with you that SS funds have been mismanaged but I don't agree that it's going to collapse and go away.

laglen, if you were retired and applied for a job, can the employer access your social security benefit information to see how much you're getting every month? If you're collecting unemployment benefits can he access them? Only authorized users can access any network so the fear that any Tom, D1ck or Harry employer would have access to a medical network is unreasonable and also a violation of HIPAA. Another thing you have to remember about networks is that they have back up protocols. At the college I worked for we had the primary network and the satellite locations had secondary networks which were also part of the primary one. All of them ran backups overnight, every night, so if there was any kind of cyber attack, we could revert to the most recent back up to recover lost information if that became necessary.

Spall, you are right and I agree. My concern is for the future. Do you realize that there is lobbying for opening medical record for jobs and credit right now?
Do you know that they can look at you credit report for a job now? I understand the need for electronic records at this time. My issue, I DO NOT TRUST THAT IT WILL STAY PRIVATE.

Yes, laglen, employers have been doing credit checks for a while now and I am strongly opposed to that...especially now when so many people have taken hits to their credit rating due to the poor economy. People lobby for all kinds of stupid things. There's no way HIPAA's patient privacy legislation is going to be overturned in this way...not now or in the future.

Spall, I am glad that you have faith in that. I bet 50 years ago people thought the same about credit. Or how about the fact that your social security card primary purpose is to track individuals for taxation purposes.
Now you need it for a drivers license, insurance anything you do. I cant think of any information that the government has collected that is used strictly for its original purpose.

I've never experienced a computer crash while at the V.A. but I'm sure that was frustrating! What always impresses me whenever we're there is how short the wait time is and how none of my husband's doctors or any staff member ever makes him feel like he is being rushed. Since he has anxiety, making him feel rushed is very stressful for him and brings out a fairly quick irritable response.

I'm not sure what you're saying but we can connect to anywhere via the internet.

Speaking of prescription medication, there's a real problem down here Pain Clinics. A local television station did an undercover investigation about it and discovered that people were going to multiple doctors in order to get prescriptions for pain pills. Since there's no cross referencing, especially with large insurance carriers and self pay...who had any way of tracking what goes on there? The majority of the pills are making their way into the streets.

Spalladino, it's been going on for 30 years all over this country. If it is ended now with cross referencing on a computer, it will probably save enough money to pay for a great big chunk of healthcare reform. There was a hugh expose in a major Philadelphia newspaper around 1979/80. However, back then there was no capability to put the records on line. Now there is that capability and no time could be better than now as far as I'm concerned.

My husband's medical records are matched to his social security number, name and birth date, DrMario, so there's no chance of a mixup with that combination. As far as identification, aside from showing our IDs to the personnel at the entrance, he's not required to show anything anywhere else in the facility. When he arrives for an appointment and gives his name he's asked for his last 4 and his birthdate. He and I both have picture IDs (I'm covered by ChampVA) and his ID photo appears on the first screen after his doctor accesses his records.

As far as a national type medical database, it also would be driven by a unique identifying number...most likely, once again, your social security number along with your name as a secondary identifier. When I was working and had Blue Cross/Blue Shield, my ID number was my social. BC/BS didn't have the birthdate identifier but I believe that's a good idea. My husband has been treated at outside facilities in the past and, in each case, we had his medical records forwarded on to the V.A. These outside facilities did, however, have to contact the V.A. if they needed additional medical related information.

Regarding the risks...is the information kept by the Social Security Administration not available at any office nationwide? I don't believe that the risk of having one's medical records accessed by unauthorized viewers would be any greater than having one's social security records accessed on a secure network. Your example of a burn victim with no ID presents the same problems that hospitals encounter now. Without a medical history the medical staff must rely on others...friends or family members...to relay any medical history they are aware of. With electronic medical records it would be, in my opinion, easier to locate an injured person's history using his/her name and birthdate (from a driver's license or friend/relative) combination to come up with an initial identification.

I'm not sure what intrusion you're referring to though. Right now, for instance, most people have their medical records stored in files in the offices of their doctors. How secure are these files from prying eyes? I do see where you're trying to go with this.

I'm actually referring to an individual "marker" or identification on or in a person that would make a positive ID. If we would make all medical records accessible at any medical facility, wouldn't we then need to make sure that "patient A" with records for "patient A" was indeed "patient A"?

We both know that any electronic record can be accessed if given the right circumstances, thats a given. That trade off doesn't worry me nearly as much as the identification procedure of any given patient.

If we use cards, they can be lost or not available at the time, a memorized SS number, may be acceptable for now, but the possibility for others to use a stolen number are still present.
Lets say we implement a UHC and medical records are electronic... do you think it will be long before the people responsible will suggest a permanent marker on or IN each citizen to identify them. There is talk that this "identifier" will hold critical and personal information... Is this something you'd be in favor of too?

I knew you were trying to go there!

No, I am 100% dead set against any kind of implantable ID chip for ANY reason and I don't believe it would be necessary either. As I just described to you, the V.A. medical system's ID process is actually four pronged...name, social security number, birthdate and photo. Kinda hard for someone to fake being him with his photo displayed on the screen, wouldn't you agree? If a social security number is stolen does the thief also automatically have access to the birthdate? I would also have to ask you, why would someone go to all of the trouble to obtain the information necessary in order to pretend to be someone else in a medical facility? The implantable chip technology has been around for a long time and, since it was first introduced in technical research papers, the majority view has been against using this technology on human beings. I don't see this gaining support and I don't see the general population agreeing to it so, really, it's a non-issue.

Universal Health care was a non issue ten years ago

I actually don't believe it all that hard to steal someones identity. Lets take illegals and wanted criminals for instance. They cannot go anywhere using their own identity, so common sense tells you that many will resort to manufacturing false identifications, licenses, social security numbers, much like its done now.

The trouble with things we don't think are possible or probable is that they sometimes DO become possible and by the time we get there, its too late to prevent it from happening.

Take for another example the mandatory measure under this HC Reform... I'll bet no one thought our government could mandate we all carry insurance even just a few years ago, and yet here we are. Many tried to prevent it and it was too late. Our leaders thought it was best for all, so they voted it in against the majority of her people.

I'm just saying that when we give away a few liberties, there is bound to see more taken. Its our past track record in government.