Health records firm Epic, some 60 client hospitals urge against data sharing rules support...

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Comments

  • Reply 21 of 45
    A bit like H&R block lobbying against simplified personal tax filing.
    GeorgeBMacJWSCMplsP
  • Reply 22 of 45
    I personally don't see any technical difficulties except sheer size of the (complicated) system. Why? It all has been done.

    I and all my compatriots enjoy 'ownership' of personal medical data including all medical records; vaccination passport; all invoices to my insurer; logbook to see who, when, what and why have  accessed my health data (integrity provided with blockchain technology); all prescriptions and their history (we have only electronic prescription, no paper); organ-donor declaration of intent; managing  access to my medical data; access to all data about my children etc. Fun fact: for last 3 years my insurer has spent whopping 372 euros on my medical bills (while I paid for that ~15K euros insuarance tax); my medical records have been accessed 51 times (to enter, edit or look up information) in same period.

    This system has enabled to detect fraudulant doctors/hospitals (for billing for healthcare not provided; writing prescription on your name used by other person etc) as anyone can see all records concerning themselves. Of course there are problems too but as general it's working as one can expect. 



    FileMakerFeller
  • Reply 23 of 45
    DAalsethDAalseth Posts: 1,993member
    I understand that these records need to be kept private. HIPPA rules were created for a reason. But I've lost track of the number of times I wanted a copy, or even to see, my own records but was told they "couldn't provide them", or "it was against policy", "It would violate HIPPA rules". They had no problem with sending them to another doctor's office, insurance company, lawyer's office, or the government, but the records of what is happening with MY body, and what treatments I'VE received, are secret from ME. They've used privacy as a weapon against us. EPIC is just trying to maintain that control.
    GeorgeBMacJWSChmlongco
  • Reply 24 of 45
    Isn’t the government dictating a medical record standard similar to the EU dictating a cable standard?  I want this to happen, but not because of government regulation.
  • Reply 25 of 45
    mjtomlinmjtomlin Posts: 2,566member
    we are concerned that ONC's Proposed Rule on interoperability will be overly burdensome on our health system and will endanger patient privacy,"

    -- that's just the shield they hide behind.

    "Think of the children!"
    JWSC
  • Reply 26 of 45
    The heck? Whoever is opposed to me easily accessing MY HEALTH RECORDS is scum. 

    Actually, they aren't your records.   From a legal standpoint, the healthcare provider owns them.  
    In truth, they own the information that they keep about you.  And, in reality, they can sell it and share it as they will -- just as Facebook owns its data about you.  HIPAA only blocks them from sharing it with you and you family -- not other so called healthcare providers -- even if one of them is Google.

    They want to maintain control over what they consider their data about you.

    That doesn't make it right.   But it is reality as it exists today.
    That is not completely true.
    If you pay a hospital to test your blood, you should own the result and fully control its data. We may dispute the ownership in the case where the hospital pays for your blood test to be performed, but also in that case many would argue against hospital ownership.
    Furthermore, the article is rather generic when calling “hospitals” those who oppose such new law. In a world where public healthcare systems is the rule in most advanced countries (except USA) i.m.o. it would make sense to call the opposing hospitals in the article “private” or “commercial “ hospitals, underlining the fact that a public hospital would never oppose such proposed law.
    Finally, such proposed law reminds me a lot (albeit in a different sector) of the EU PSD2 directive on the portability of personal financial data, which similarly breaks the data silos model among the financial players.
  • Reply 27 of 45
    As much as I dislike EPIC, they sorta have a point.  The regulations about healthcare data are extensive and complex.  Health systems are very complex with thousands of employees who need to be trained and retrained on HIPAA (and other) rules.  EMR systems are complex beasts.  I talked to a CIO at a single hospital who was still having nightmares about the $100 million project to adopt EPIC.  Given all this, it's not unreasonable for parties involved to request a few years to prepare for and implement any changes.  Sure 12 months + 36 months seems overly conservative, but you can't blame them for making their case.

    Don't get me wrong, I would love major disruption of the healthcare industry and the EMR/EHR software business, but even small regulatory changes are very burdensome on hospitals and health systems.  
    SpamSandwichJWSC
  • Reply 28 of 45
    spice-boyspice-boy Posts: 1,448member
    As long as we have a Republican domination of the Senate and WH, companies like Epic will continue to bilk Americans for everything they got. The USA has the world's most costly health care system, and you level of wealth decides the quality of the care you receive. How much longer can this scam go on? 
    GeorgeBMac
  • Reply 29 of 45
    GeorgeBMacGeorgeBMac Posts: 11,421member
    pjohnt said:
    Isn’t the government dictating a medical record standard similar to the EU dictating a cable standard?  I want this to happen, but not because of government regulation.

    The government is not dictating.   It is the medical industry doing the dictating.   But the government did enable it.
  • Reply 30 of 45
    larryjwlarryjw Posts: 909member
    Glad to see more people wanting to take control of their own medical data. I wonder how much rampant fraud exists in bogus charges that is hidden somewhere in those records.

    it could be the catalyst for cheaper health insurance when the insured can get a better rate because fraud would be easier to detect.  


    What utter crap.

    Close to zero percent of people can understand their medical records. And having access to your medical and health cost records will give no one any idea of fraud. First, you have to analyze your records for fraud -- zero percent have the skill to do that. Secondly, you can't analyze anything unless you have access to everybody else's records for comparison -- and you're not ever going to get that. 

    As long as medical professionals can get access to your medical history, that is all that counts. Of course, you need to know your medical history to help guide the medical professionals treating you. That aspect of your medical records is important. And, you want to be sure medical pros can get timely access to your records. 

    Real time access to your medical conditions (sleep apnea, diabetes, cardio systems, exercise, calories, allergies, current status of vaccinations, etc) can be useful for the individual, but this is not in your medical records unless you upload your data to your medical provider's database. 

    For the most part, seems to me this push to "take control" of your own medical records has the simple purpose of further monetizing your health records for the benefit of third parties. 
  • Reply 31 of 45
    GeorgeBMacGeorgeBMac Posts: 11,421member
    dinoone said:
    The heck? Whoever is opposed to me easily accessing MY HEALTH RECORDS is scum. 

    Actually, they aren't your records.   From a legal standpoint, the healthcare provider owns them.  
    In truth, they own the information that they keep about you.  And, in reality, they can sell it and share it as they will -- just as Facebook owns its data about you.  HIPAA only blocks them from sharing it with you and you family -- not other so called healthcare providers -- even if one of them is Google.

    They want to maintain control over what they consider their data about you.

    That doesn't make it right.   But it is reality as it exists today.
    That is not completely true.
    If you pay a hospital to test your blood, you should own the result and fully control its data. We may dispute the ownership in the case where the hospital pays for your blood test to be performed, but also in that case many would argue against hospital ownership.
    Furthermore, the article is rather generic when calling “hospitals” those who oppose such new law. In a world where public healthcare systems is the rule in most advanced countries (except USA) i.m.o. it would make sense to call the opposing hospitals in the article “private” or “commercial “ hospitals, underlining the fact that a public hospital would never oppose such proposed law.
    Finally, such proposed law reminds me a lot (albeit in a different sector) of the EU PSD2 directive on the portability of personal financial data, which similarly breaks the data silos model among the financial players.
    Yes, you SHOULD own and control your healthcare data.   But you don't.   The hospital does.

    And, you seem to make a distinction between for-profit and non-profit hospitals.   In truth, the only difference is in the accounting for profits (do they go to retained earnings or to assets?) and how much tax do they pay?   In Pittsburgh we have a non-profit hospital system that has dedicated itself and publicly announced it plans to run its "competition" out of business.

  • Reply 32 of 45
    GeorgeBMacGeorgeBMac Posts: 11,421member
    spice-boy said:
    As long as we have a Republican domination of the Senate and WH, companies like Epic will continue to bilk Americans for everything they got. The USA has the world's most costly health care system, and you level of wealth decides the quality of the care you receive. How much longer can this scam go on? 

    We spend $3.5 Trillion a year on healthcare -- 5 times more than the defense budget.   So, yes, the end is near.  Very simply, we can't afford it (and it doesn't matter who's paying the bill or how, we just can't afford it as a nation).

    It is interesting that the only real fix is actual prevention -- meaning healthy lifestyles that prevent and delay the so called "age related" chronic diseases that eat up 80% of that $3.5 Trillion.   But that is the one thing our so called "healthcare" system won't touch:   Healthy Lifestyles.   Instead it is a disease management system that reaps enormous profits treating the effects of those unhealthy lifestyles.  The closest it comes to prevention is early detection -- which merely starts the process sooner.
    JWSCFileMakerFeller
  • Reply 33 of 45
    StrangeDaysStrangeDays Posts: 12,015member
     data interoperability would be "overly burdensome" on America's health system

    ....oh that's rich. Our health system is ovelry burdensome one patients alredy, filling out things in triplicate or more, and the astromical and plain made-up prices the hospitals and clinics charge for things, while the companies reap massive profits and the executives become multi-millionaires. Screw them. Deal with it, and make my life easier at your expense.
    JWSCGeorgeBMac
  • Reply 34 of 45
    mac_dogmac_dog Posts: 969member
    we are concerned that ONC's Proposed Rule on interoperability will be overly burdensome on our health system and will endanger patient privacy,"
    Bull!
    EPIC and the hospitals are not concerned about patient privacy or cost (When did our healthcare system ever worry about cost?)

    They ARE concerned about losing control of patient data for a plethora of reasons:  Once control of the data is taken away from "The System" the patient has a lot more knowledge and control -- which can put the hospital in bad spot.  Basically, our healthcare system, particularly at the hospital level, has always been adamant on maintaining total control of what goes on -- the patient is limited to refusing care, but even that is very difficult.   In addition, the patient's data would lose a great deal of its monetary value as they would not be able to sell it themselves to companies like Google (which one major system has already done).

    When thinking about why our large health care operations do something always think money and profits because that is all that they think of - just as any other corporation does.  This proposal will cost them both in money and control so they are opposed to it.   Their objections have nothing to do with protecting the patient -- that's just the shield they hide behind.
     It only that, the current “epic” system requires a majority of time on the part of doctors. My doctor has said he spends more time on the system than caring for his patients—which ultimately results in stifling progress. 

    But hey, it’s the American way. It’s so fucked up. 
  • Reply 35 of 45
    JWSCJWSC Posts: 1,152member
    we are concerned that ONC's Proposed Rule on interoperability will be overly burdensome on our health system and will endanger patient privacy,"
    Bull!
    EPIC and the hospitals are not concerned about patient privacy or cost (When did our healthcare system ever worry about cost?)

    They ARE concerned about losing control of patient data for a plethora of reasons:  Once control of the data is taken away from "The System" the patient has a lot more knowledge and control -- which can put the hospital in bad spot.  Basically, our healthcare system, particularly at the hospital level, has always been adamant on maintaining total control of what goes on -- the patient is limited to refusing care, but even that is very difficult.   In addition, the patient's data would lose a great deal of its monetary value as they would not be able to sell it themselves to companies like Google (which one major system has already done).

    When thinking about why our large health care operations do something always think money and profits because that is all that they think of - just as any other corporation does.  This proposal will cost them both in money and control so they are opposed to it.   Their objections have nothing to do with protecting the patient -- that's just the shield they hide behind.

    Totally agree with your cynical but unfortunately accurate assessment.  They don’t like change because change puts their revenue stream at risk.

    But the status quo is no longer acceptable (was it ever?) and if they don’t get on board, the rest of the healthcare industry is going to pass them by.

    Instead of spending energy fighting this, perhaps they might redirect that energy into finding new opportunities for new revenue streams in the new environment.  Otherwise, this could turn into an EPIC fail.

    GeorgeBMac
  • Reply 36 of 45
    GeorgeBMacGeorgeBMac Posts: 11,421member
    mac_dog said:
    we are concerned that ONC's Proposed Rule on interoperability will be overly burdensome on our health system and will endanger patient privacy,"
    Bull!
    EPIC and the hospitals are not concerned about patient privacy or cost (When did our healthcare system ever worry about cost?)

    They ARE concerned about losing control of patient data for a plethora of reasons:  Once control of the data is taken away from "The System" the patient has a lot more knowledge and control -- which can put the hospital in bad spot.  Basically, our healthcare system, particularly at the hospital level, has always been adamant on maintaining total control of what goes on -- the patient is limited to refusing care, but even that is very difficult.   In addition, the patient's data would lose a great deal of its monetary value as they would not be able to sell it themselves to companies like Google (which one major system has already done).

    When thinking about why our large health care operations do something always think money and profits because that is all that they think of - just as any other corporation does.  This proposal will cost them both in money and control so they are opposed to it.   Their objections have nothing to do with protecting the patient -- that's just the shield they hide behind.
     It only that, the current “epic” system requires a majority of time on the part of doctors. My doctor has said he spends more time on the system than caring for his patients—which ultimately results in stifling progress. 

    But hey, it’s the American way. It’s so fucked up. 

    Yes, it  IS  the American way!   EHRs in hospitals and large organizations were designed to maximize revenue and minimize liability for the organization.   They were not designed to help either the patient or the physician.

    Although, as an RN, I appreciated not having to try to guess what the physician scribbled in medical shorthand on his orders -- and that was often done simply by knowing the patient and what they needed!  Or, even worse, having to spot a sticky note sticking out of a patient's chart to even know that there was a new order written!   Those things definitely got improved.

    But, that perhaps points out one of the reasons why the physician now has to spend more / too much time on the EHR:   Previously they were able to omit a lot and take short cuts that the EHRs now do not permit.   For instance:  Sometimes they wouldn't even bother to write an order -- just catch a nurse in the hallway and give a "verbal order".
    edited February 2020
  • Reply 37 of 45
    larryjw said:
    Looks like commenters failed to read the article. Epic says they need 12 months to plan, 36 months to implement. 

    Given we're talking about health care records, it would probably be best to plan for security and implement correctly.

    How many would like their health care records handled like the Iowa caucus fiasco? 
    Look at the the actual letter content.  What EPIC is saying is "just do it the way we do it", and lists the existing solutions they feel are adequate.  Not a stretch to bet there is an existing revenue arrangement that would be disturbed by Apple's entry into the field.  

    My EPIC experience?  Victim of a breach and subsequent PHI theft, affecting 326K people.  Hospital had to set up a direct hotline to EPIC to handle patients who had their data compromised.  2 months from breach to customer contact.  Free ID / credit protection, etc.  Just like Staples, Target, Home Depot did in their sloppy work.  Oh, and it's a research hospital.  I've served on their IRB, and in this regard the data has a lot more ramifications than ID and credit card number.  

    At this point, Apple has a far better track record with my data than EPIC has.  EPIC has to get their own house in order, and really has no leg to stand on with regard to Apple integration per se being a data threat.  
    GeorgeBMacGG1
  • Reply 38 of 45
    gatorguygatorguy Posts: 23,365member
    spice-boy said:
    As long as we have a Republican domination of the Senate and WH, companies like Epic will continue to bilk Americans for everything they got. The USA has the world's most costly health care system, and you level of wealth decides the quality of the care you receive. How much longer can this scam go on? 
    Democratic congresses, some with an overwhelming majority, have had ample opportunity over the years to change it. In fact the ideal time would have been the "Obamacare" legislation IMO. Instead, they chose NOT to include any pharma or healthcare price controls, simply mandate insurance coverage. Not smart at all IMO, simply politics again so as not to upset the insurers or hospitals, but I'm a nobody and the country's leaders march to their own drumbeat and not mine. Or yours. 

    So don't blame it on those bad ol' meanie Republicans. Doing the right thing for us is hard and I don't think either party has the stomach for it. Some would have to turn their back on a whole lot of financial support and fracture political allegiances. Dems absolutely share the blame and IMO unlikely to significantly change it for the better if they manage to take control of Congress and the Presidency again. It's gonna be a slow roll and some "emergency" will be required to push them to do what should be done instead of pushing the problem on to the next Congress to deal with the unpleasantries. Social Security is the poster child. 
    edited February 2020
  • Reply 39 of 45
    GeorgeBMacGeorgeBMac Posts: 11,421member
    gatorguy said:
    spice-boy said:
    As long as we have a Republican domination of the Senate and WH, companies like Epic will continue to bilk Americans for everything they got. The USA has the world's most costly health care system, and you level of wealth decides the quality of the care you receive. How much longer can this scam go on? 
    Democratic congresses, some with an overwhelming majority, have had ample opportunity over the years to change it. In fact the ideal time would have been the "Obamacare" legislation IMO. Instead, they chose NOT to include any pharma or healthcare price controls, simply mandate insurance coverage. Not smart at all IMO, simply politics again so as not to upset the insurers or hospitals, but I'm a nobody and the country's leaders march to their own drumbeat and not mine. Or yours. 

    So don't blame it on those bad ol' meanie Republicans. Doing the right thing for us is hard and I don't think either party has the stomach for it. Some would have to turn their back on a whole lot of financial support and fracture political allegiances. Dems absolutely share the blame and IMO unlikely to significantly change it for the better if they manage to take control of Congress and the Presidency again. It's gonna be a slow roll and some "emergency" will be required to push them to do what should be done instead of pushing the problem on to the next Congress to deal with the unpleasantries. Social Security is the poster child. 

    Well no... 

    But nice try at the false equivalency.
  • Reply 40 of 45
    gatorguygatorguy Posts: 23,365member
    gatorguy said:
    spice-boy said:
    As long as we have a Republican domination of the Senate and WH, companies like Epic will continue to bilk Americans for everything they got. The USA has the world's most costly health care system, and you level of wealth decides the quality of the care you receive. How much longer can this scam go on? 
    Democratic congresses, some with an overwhelming majority, have had ample opportunity over the years to change it. In fact the ideal time would have been the "Obamacare" legislation IMO. Instead, they chose NOT to include any pharma or healthcare price controls, simply mandate insurance coverage. Not smart at all IMO, simply politics again so as not to upset the insurers or hospitals, but I'm a nobody and the country's leaders march to their own drumbeat and not mine. Or yours. 

    So don't blame it on those bad ol' meanie Republicans. Doing the right thing for us is hard and I don't think either party has the stomach for it. Some would have to turn their back on a whole lot of financial support and fracture political allegiances. Dems absolutely share the blame and IMO unlikely to significantly change it for the better if they manage to take control of Congress and the Presidency again. It's gonna be a slow roll and some "emergency" will be required to push them to do what should be done instead of pushing the problem on to the next Congress to deal with the unpleasantries. Social Security is the poster child. 

    Well no... 

    But nice try at the false equivalency.
    LOL... False equivalency to what, only the Republicans fail to fix our health care expense problems? This article is about Epic and the control of health data. Epic was the same Epic under Democratic leadership, and dominate in their field since at least 2003. In fact the HIPAA rules that allowed Epic to flourish were constructed under a Democratic administration and Congress.

    Besides, how would false equivalency even come into play with my comment? This isn't the Republicans complaining and trying to delay, it's Epic, health providers. and companies like them. The false equivalency if there was any, came from the OP introducing the Republicans as equally comparable to Epic as reason for the delay. Heck, it's a Republican administration proposing the rules change rather than impeding it. Did you even read the article? 
    edited February 2020
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