Limitations

Cambodia 527

I quickly read the flag sent to me in the electronic health record from an endocrinologist in the system:

So sorry! My staff scanned this document to your chart by accident.

One of the drawbacks of being employed by a system that requires anyone using their medical insurance benefits to be seen only by physicians within the system. This isn’t the first time someone has scanned one of my patient’s consult notes to my own personal medical chart. Knowing anyone has access to my medical record does not feel good.

Guess I will have to go back to lying on my social history forms. Sigh….

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59 thoughts on “Limitations

  1. And, of course, “anyone” includes the insurance company, which is one of the reasons you have to be so careful with diagnostic codes.

    Maybe you could comment some time on the uses and abuses of diagnostic codes.

    Liked by 2 people

    • We were told a while back that for ACO Medicare patients we needed use more serious medical codes to make our patients look sicker. If they had blood pressure that was generally well controlled but it was a bit elevated at an office visit, we needed to code as uncontrolled hypertension. Lose a few pounds? Code malnutrition. Grrrrrr. I am NOT doing that.

      Liked by 2 people

  2. I recently read a news article that medical records are the primary target of identity thieves these days. I also read that many medical facilities are ill-equipped to deter cyber attacks. So maybe it’s a good idea to have inaccurate info in your case file, just to throw the id thieves off track.

    Liked by 2 people

  3. Believe me, Doc, I am not very impressed with medicine these days, as in what is being allowed, for one. I really do try to keep my personal thoughts to myself because everyone is entitled to his or her opinion. Yet, this lack of privacy is extremely concerning to me and seriously wrong. And, to make someone look sicker then he/she truly is … you really don’t want to pick my brain on that issue. In a nutshell, the medical system is sick itself. My empathy totally goes out to the GOOD docs in the field who are doing all they can to make a difference. BIG (((HUGS))) Amy ❤

    Liked by 2 people

      • And I really HOPE that this generation of doctors and the next and the next, SEE what needs fixing, standing strong together, until those changes are done. I strongly believe medicine is going to be reshaped, resized, and many new aspects of “healing” will be incorporated into it. I probably will not live long enough to see all the changes, but I will live long enough to see the beginning of them. People are beginning to wake up. Which is a good thing!

        Liked by 1 person

  4. Ooo now I want to know what you’re hiding. Closet smoker, married with 12 children, runs with scissors? I don’t want everyone to know my weight as if they can’t tell by looking at me that I have 15-20 pounds to lose. Ha ha
    I agree this is a violation of your privacy. Our hospital does not allow access to charts that you aren’t directly responsible for. I think you should exert your personal rights. Tracey
    Yesterday’s rant about not referring to “those” doctors who bilk the system could have been written by me. I was too lazy to reply. Good work here doc.

    Liked by 1 person

  5. Seriously?!?
    I kinda wish I’d never read this.
    I do hate the questions on the forms, and often leave them blank. Then I’ll tell the doctor whatever. Not the dentist.
    At the eye dr once, I declined listing surgeries and said I’d had too many to list. The tech got super upset and demanding. I told her I’d discuss it with the dr. She was so mad at me, it was a lil crazy, in my opinion. The eye dr asked what surgeries I’d had in my head, and so I told her I’d had tubes in my ears and teeth removed. She said that’s all she needed to know.
    It was so bizarre. What a great job for nosy people, lol!

    Medical identity theft?!?

    Liked by 1 person

  6. Irked older-person comment here: In this area, at least, it seems rare for medical offices to hire any but very young staff, even hiring younger with no medical experience over older with, and even when there is often greater turnover with younger. Then, the docs complain about how bad their staff was and how difficult to find competent staff…

    Do you see any validity to that where you are located?

    I, seeking employment in a medical office

    Liked by 1 person

      • I wonder why not, in these desperate times? Has everyone older given up? I was applying for only part-time positions. While having no Med office experience (I didn’t say that!), in my systems analyst role, I had designed hospital systems including patient registration, encounter tracking (ICD9/CPT code capture), and billing. Wearing my Writer hat, I’d written grant proposals to the NLM and NIH. I thought this experience, plus that of supervising an international help desk, spoke to my abilities to handle a part-time front-office role.

        I was too foolish, back then, to leave my years of university graduation off the degrees on my resume.

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  7. To my lay-person’s thought process, so much seems to be generated from the “save-your-own-backside” mode of thinking, too. Why else would my dentist’s office ask me the same medical update questions — surgeries, etc. — yearly. It’s gotten so I’m relieved at the six-month cleaning when they don’t ask. As for your anecdote, Doc, I hope the time doesn’t come when somebody makes a wrong turn on your personal care because of improper attachments to your personal chart. That would be a catastrophe of the system.

    Liked by 1 person

  8. Oh Victo, I’ve always had serious misgivings about the security and privacy of all personal information but especially medical and financial. I was a Business Analyst for the IT dept of a major Canadian retailer for many years.As such I was kept in the loop on IT security and data security ( I had to investigate and price setting up a mirror system so that we didn’t lose any info in case of a disaster.) There were separate employees whose job it was to enforce security – and it was not easy.Our mainframe was attacked from outside many times per day. We had 5,500 employees all of whom had some access to the system. It was two full time jobs just to keep up with the changing security and malware landscape One small lapse for whatever reason – and the whole thing could be compromised. We hired two programmers who had experience hacking. whose job it was to try and break into our system using what ever means they could find. They were our insurance – as long as we could keep them out we felt confident we could keep out other hackers and thieves.

    As far as medical info is considered it is way too available to way too many people. During the depths of my medical issues dealing with cancer, kidney failure, DVT, internal bleeding (related to one kidney that was completely gone), brutal side effects from radiation treatment, onset peripheral neuropathy, loss of job, loss of a long term relationship, changing homes, changing colleagues and friends, doing a graduate degree, hell even changing my licence class and car(I decided to give up my commercial licence – that was truly emotionally negative) etc – I recognized the onset of depression, naturally. I went to see a psychiatrist for a consult (which did not go well – he wanted to medicate and i just wanted to talk). It wasn’t long before I realized that every single dialysis nurse, doctor, social worker, dietitian, etc had access to my electronic files including the psych review. I was upset and the next time I went to the psychiatrist I demanded that my file not be added to the electronic records. I explained why and I discovered there is a system to do that. My records could be kept separate in the psychiatrist’s office. I opted fr that.

    Anyway Victo – this is a big and dangerous topic and I must say to worries me. Thanks for the post. .

    Liked by 1 person

    • Our system does not have the ability to hide a chart or note from the system. All of my colleagues could “accidentally” access my records. When my husband was having his issues with alcohol we chose to pay through the nose to keep that out of the system. We have that luxury, being able to afford it. Nursing staff and everyone else does, not so much. This is why I am so angry about the system limiting care to only within the system. There is no doubt plenty of others dealing with the same issue who are trapped.

      Liked by 1 person

  9. Can’t wait to see your next post, if you do it on hiring the older worker. Until then I will shut up on that topic….
    One of my roles is to sit on the Mothership HIPAA education committee. It is so convoluted that they cannot get out of their own way. And the more they restrict and threaten, it seems we have more violations. It like instead of education, it is like we are proposing a dare…lolol. “Go ahead and look and see if you get fired…just try it!”

    Liked by 1 person

  10. Pingback: My Article Read (5-11-2015) (5-12-2015) | My Daily Musing

  11. I used to work the admissions desk in a hospital. The employees weren’t required to see doctors in the system, but a lot did. The access to people’s personal files was mostly on your honor–you weren’t supposed to do it and could get fired if you did, but I think a lot of people “accidentally” looked.

    Liked by 1 person

  12. Well, that just sucks! :/ When that happens, is it because you are also a patient of theirs, or can any doctor do that to you? Is there a way for you to ever get it removed, or once it is there, is it there permanently?

    Liked by 1 person

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