Thoughts About Digitization of Medical Records
6 min readIf you have been online at all in the last several months you have come across the Health Care debate. Reform, re-do, insurance for all, single payer, etc… One aspect that is being left out of the discussion is a significant shift that will actually make a huge change, digitization of medical records.
I am not going to write about the process or semantics around the work involved, I am going to focus on the benefits and huge shift to the positive this move will do. I want to make sure that there is a point of view to clarify and reduce the FUD (Fear, Uncertainty, and Doubt) about making something as personal as medical records digital and available on the “Internet”. I say “Internet” in quotes because I tackle that first as a misconception. Now there are pros and cons to digitizing medical records but there are far more pros than cons and I hope to break some of the big ones down.
The Internet
Generally speaking when you mention the Internet to the masses they think chat rooms, games, websites, viruses and email. That is the impression of the Internet to most people and it’s a frustration on how wrong that impression gives the greatest advancement in human history a bad name. The Internet is so much more than what you can do from your laptop watching TV.
When it comes to medical records being digitized and being placed on the Internet does not mean by any stretch that it’s freely accessible by anything and anyone. The Internet is the means to inter-connect multiple locations into a centralized cloud of focus for the data.
What does this mean?
It means that no more are your medical records locked in each individual clinic or doctor’s office updated only by your visits. Centralizing it can make your history accessible from anywhere, by any authorized professional. It improves time that you have to spend with a professional telling your back story because they could access it ahead of time regardless where you got treatment. It will give you more power to choose and more freedom to change medical facilities without worrying about getting your records from one place to the next.
This move is not a bad thing. Your personal records, more damaging personal records are all digital today! Bank records, credit records, mortgages, credit cards, tax filings…. each one of those are out there on the big bad Internet already and many sources can and do access it. Why not your medical records too?
Digitizing medical records is far more secure than the system we have today. Significantly more secure. This aspect is what I think people are most scared about, primarily because they lack the understanding and true comprehension on what the technology today does.
Take a step back and look at today’s system and you decide if it’s more secure than moving to digital or not.
As a patient you go to Clinic A. You make an appointment and if you have not been there before they create you a file specifically for that clinic. Then a plethora or nurses, specialists doctors access that file to add their piece to it. But they can see your WHOLE file and past visits as well. Even though they only need to enter blood test results, they can flip through your file without restriction. If you pay attention, generally the files are all in one huge open cabinet against a wall some where. If you are behind the counter no one can stop them from peeking around.
No, if you decide now to go to Clinic B, they don’t have any information on you so what do you do? You call Clinic A and tell Clinic A to send them your medical file to Clinic B… if you ask them for the file so you can transfer it yourself you are always denied. I never understood why. The manner of transfer is unsecure in an of itself as well. It’s either faxed, so your medial files are sitting in the fax tray printed out usually gathered and collated by a NON-medical personnel, a temp admin or secretary. Do you think they are authorized to see your records? Or they are physically shipped across town… who knows what happens from point A to B. Or worse they are scanned and emailed through open unencrypted email over the Internet.
Now, I hope they taking things for what they are you can see the flaws on the amount of open unauthorized access the current paper system is. It is not secure by any stretch of the imagination. If you dig farther, you can see in the news hospitals and clinics dumping those paper records in the dumpster for god knows who to get at.
So What? What does this move buy us?
Like I has said before I am not going to get into the logistics of the technical challenges on how to do this. I want to focus on the immense benefits we will get as patients, as doctors, and as a society on the global level by digitizing medical information.
With all of the pros, let me point out some of the large obstacles that need to be overcome first. The government as a governing body needs to step up and step in and enforce, quite harshly, Security Regulations on protecting this electronic frontier. You have a breach, you goto jail. That is how severe these punishments should be. Will there be a central authority in control of the information? Much like your financial information, I foresee a ‘credit bureau’ type organization that will be in ultimate control of the data. Are we there today? Absolutely not? Is there where it’s headed, yes. For the time being it’s going to be a spiral outward movement starting with individual clinics and going outward.
So now we have all the data digital and accessible. Now what?
As a patient
Now, you can have your history at your fingertips. Think about it, advanced software where you can go in and enter your symptoms. It can check your past medical trends, medicine that you are on, and give a high level diagnosis and send it to your doctor before you step foot in an office. Your doctor then can analyze and decide if you need to come in for further tests or give a treatment right there. You now have vast efficiency increase by not wasting your time, getting info back quicker, not having to wait for appointments, and slowing the spread of disease if you are contagious.
As a doctor
When patients come in you would have the complete history on the patient. More data = more accurate diagnosis and treatment. If laws mandate data to be placed in the patient’s file and punishments to be severe, you will see all prescriptions for a patient. Pharmacies by law can’t fill a prescription unless it’s in the patients profile from a doctor. Drug addiction could be reduced by eliminating writing prescriptions to anyone for anything. Accountability.
As a doctor you could sit down and do patient reviews from the submitted information from the patient ahead of time before they step foot in the office. All recorded, tracked. Treating patients will become vastly more efficient and accurate… you could even receive warnings if a drug prescribed might interfere or be deadly in combination with another drug from a dentist that you or the patient didn’t bring up.
As a society
Centralizing the medical information, not the personal information about you, but the symptoms would be society saving at a global level. If you could see, globally, medical symptoms and information you can trend and identify potential outbreaks before it is realized that one is occurring. Identifying patterns of cancer in a certain area, say 50 miles. Today those little clinics and hospitals don’t communicate that information and the only way they it would be found today is a long, drawn out study by the CDC using very old data. With medicine, the more accurate and the more recent data is the best. We as a country and as a globe want to know if Swine Flu is happening now, not where is started 6 months later.
If it’s done right technically, legally, medically we can work toward better treatments and more important of better prevention/protection of something far worse than Swine Flu that might be lurking on the horizon.
End of Line.
Binary Blogger has spent 20 years in the Information Security space currently providing security solutions and evangelism to clients. From early web application programming, system administration, senior management to enterprise consulting I provide practical security analysis and solutions to help companies and individuals figure out HOW to be secure every day.
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