4 ms·

Apple Health already had the ability to view medical record documents, using the CDA standard. I think this is a huge step in the right direction for the Health

by sjroot 9y ago

Apple Health already had the ability to view medical record documents, using the CDA standard. I think this is a huge step in the right direction for the Health app. Here's a question for HN people: what do you use to manage your medical records on Android?

hpaavola 9y ago
Why any individual should manage their medical records?
- pm90 9y ago
  Because its their personal health record? I would be curious to know what doctors see when they read my records.
  - jbob2000 9y ago
    People are bad at managing themselves, especially when they are ill. It is a bad idea to expose patients to their health records. It will get lost, they will change things, they will fight with their doctor over what is put in the record, they'll want things clarified they don't understand putting undue burden on overworked doctors. Health records need to be impartial and unbiased so future medical care can be given with the best possible information.
    - moonka 9y ago
      >they'll want things clarified they don't understand putting undue burden on overworked doctors. People should be able to have things they don't understand about their body clarified. There's fewer things scarier than not understanding why your body isn't reacting the way you'd expect.
    - macintux 9y ago
      People can't be trusted to write their own records, but they can't not be allowed to see them. The consequences of that access have to be managed, for better or for worse.
    - jmull 9y ago
      Patients just get a read-only copy of their records. Also, providers don't use the patient as an intermediary when updating and exchanging medical records. That addresses most of your concerns. - "they'll want things clarified they don't understand" This is, by far and overwhelmingly, the reason it is a good idea to expose patients (and their defacto caregivers, AKA, their families) to their medical records. When it comes to preventative medicine and chronic conditions people have far more control over their health than the doctor does and the better they understand their health, the better they are able to do something positive about it.
      - macintux 9y ago
        I'm reminded of a sad story about a kid, probably 10ish, who overdosed on prescription meds designed to help him not sleep so deeply (he had problems with bedwetting because his bladder wasn't noisy enough to wake him). Failing to understand the purpose of the pills, he decided that if he just took all of them, his problem would go away. Granted, adults (usually) have better judgment than a 10-year-old about things like that, but nonetheless patients almost inevitably are able to make better decisions when they understand why they're being asked to do things.
      - jbob2000 9y ago
        The things that are in your medical record are technical and won't help you at all. "Patient's CD4+-T-Cell count reduce from 5^9/L to 5^6/L, advised increase Prolenaslezapam from 50mg to 75mg" (I'm making this up). Your doctor won't tell you this, instead they'll say "Your HIV is progressing and we're upping your dosage". There's no benefit to reading the technical note, you'll just ask for the clarification... which the doctor already gave you. Or you're going to waste his time having him explain undergrad biology to you. Think of it like this: Would you want your customers reading the comments you leave in your code? Probably not! They'll waste your time asking you about the comment you left saying "this could cause an error and bring the servers down". Or they completely misunderstand something and cancel the service. Or they'll complain that you left a swear word in. Etc. etc.
    - robbiemitchell 9y ago
      > Health records need to be impartial and unbiased Sorry, but they're already neither. Medical records are also the same mechanism used to determine reimbursements, meaning the codes in them that represent diagnoses and treatments are subject to multiple incentive structures.
      - criley2 9y ago
        Care plans and diagnosis codes are very different things. Just because a coder massages the specific codes in use doesn't mean the clinicians are altering care. Honestly, there's a lot of new incentive structures on care givers and their institutions focused on so many things, like reducing readmissions (thereby reducing all forms of medical error in the process), or forming provider cohorts and using comprehensive comparison metrics between similar hospitals in similar areas and situations, to incentivize and reward those facilities which achieve the best care. And, on the subject of the MR/EHR itself, of course most of it is unbiased! Do you think your lab results, prescriptions, vital signs, demographics are subject to bias? Your medical record isn't where a doctor leaves a long note about their opinion of you. It's where all that stuff above, and allergies, and outpatient care history, and inpatient history, and all kinds of factual unbiased things go.
    - EamonnMR 9y ago
      Let's solve the issue of healthcare providers not playing nice with each other (will only communicate via fax, etc) before we worry about the very rare case of mentally ill patients falsifying records and such (which does happen, but not nearly on the scale of healthcare companies simply being difficult to wrangle.)
- Waterluvian 9y ago
  Manage a local copy. Every individual should be in possession and have a basic understanding of their medical records. Medical professionals are there to help you manage your health. As the manager, you need that information.
- macintux 9y ago
  For multiple reasons, but here's one that strikes close to home: not every person who you may wish to have access to information contained in those records will have it via the health care system. E.g., I need a personal trainer to help me work around my back problems. It's useful to be able to answer his/her questions by referencing my records, instead of vague shrugging about some random disc. Another e.g.: my aunt does a good job of sharing family medical records so that we know who in our past had conditions that may be relevant to our healthcare as well.
- dave5104 9y ago
  Why wouldn't you want to have a copy of all your medical records? Perhaps this isn't super useful if you've gone to the same doctor your entire life, but I've gone to multiple doctors (and I know I'll be going to more in my lifetime). It'll be nice to have the ability to pull up my full history if I needed to provide a new doctor with some (more accurate than memory) history.
  - hycaria 9y ago
    Because some people don't have any medical history.
- tammer 9y ago
  Not sure if you live in the US but my experience with the US healthcare system (I work adjacent to one of the top US research hospitals) is that there is a critical problem of patient identification between institutions. Because we have no national ID system, patient data is coded for individual institutions (with some limited exceptions). So, transporting your medical data between institutions is a headache that can result in lost information. Further, access to this information for your own knowledge, research or simple interest is quite limited if you don't have a healthcare provider using one of these established secure platforms Apple Health can pull from.
  - deleted 9y ago
    [deleted]
- lostlogin 9y ago
  Move countries and watch what happens if you don’t take charge. My grandparents did and 3 years later it still hasn’t come straight.
  - Redoubts 9y ago
    Move counties... Kaiser still can't sort out my past records after I moved from SoCal to NorCal, and remained with Kaiser the whole time.
  - gumby 9y ago
    Much confusion ensued when my pregnant wife and I arrived in the US. I translated the medical records and gave them to the obstetrician. She was quite worried and sure that I had left something out -- there were all these tests that are routine in France but in the US are only done when something goes wrong. Needless to say nothing was wrong.
- maxxxxx 9y ago
  You absolutely should own your records. In my view there should be a central location for all your records that is controlled by you. Then you should be able to give doctors access to them as needed. But the owner of your records is you, not the doctor, not the hospital.
- EamonnMR 9y ago
  Because good luck getting your old doctor to talk to your new doctor, for example.
- cmiles74 9y ago
  If you are moving from one health care provider to their competitor, you will find it is difficult to get the data successfully (and entirely) moved from one organization to another. Typically you will need to personally gather the data from the one provider and physically move it to another. In some cases they may provide a CD, DVD or thumb drive but it's more likely you'll have piles of paper. Having a copy of your medical record in a format that is easy to carry and, even more important, easy for your clinician to read will go a long way towards insuring your new doctor, etc. has enough information not to do you more harm.
Psilidae 9y ago
I don't use any apps at the moment for tracking medical records, but if I did, I'd be using Microsoft's HealthVault.
house9-2 9y ago
My medical records are made of paper and in a folder in a file cabinet :) I rarely go to the doctor so not much to keep track of, yet...
mikeymop 9y ago
Android has an option to display Medical Information however I do not know if it can import using CDA or HL7.
dynofuz 9y ago
We're an early startup called 1upHealth (https://1up.health https://1up.health) that has a similar web based product (https://1up.health/products/patient https://1up.health/products/patient) supporting 90+ health systems. Additionally for all the devs on here, we make those health system integrations available to your app via an API.
brynlewis 9y ago
Not android specific, but a means of viewing your records in a browser is here: http://backbeachsoftware.com.au/challenge/index.htm http://backbeachsoftware.com.au/challenge/index.htm Renders CDA documents.
joe5150 9y ago
The last time I got medical records, it was a thick stack of papers (the images were on a CD at least). Another provider sent an "electronic" record, which was just a PDF of essentially the same stack of paper. This was way back in May 2017.

by sjroot 9y ago

hpaavola 9y ago

Why any individual should manage their medical records?

pm90 9y ago
Because its their personal health record? I would be curious to know what doctors see when they read my records.
- jbob2000 9y ago
  People are bad at managing themselves, especially when they are ill. It is a bad idea to expose patients to their health records. It will get lost, they will change things, they will fight with their doctor over what is put in the record, they'll want things clarified they don't understand putting undue burden on overworked doctors. Health records need to be impartial and unbiased so future medical care can be given with the best possible information.
  - moonka 9y ago
    >they'll want things clarified they don't understand putting undue burden on overworked doctors. People should be able to have things they don't understand about their body clarified. There's fewer things scarier than not understanding why your body isn't reacting the way you'd expect.
  - macintux 9y ago
    People can't be trusted to write their own records, but they can't not be allowed to see them. The consequences of that access have to be managed, for better or for worse.
  - jmull 9y ago
    Patients just get a read-only copy of their records. Also, providers don't use the patient as an intermediary when updating and exchanging medical records. That addresses most of your concerns. - "they'll want things clarified they don't understand" This is, by far and overwhelmingly, the reason it is a good idea to expose patients (and their defacto caregivers, AKA, their families) to their medical records. When it comes to preventative medicine and chronic conditions people have far more control over their health than the doctor does and the better they understand their health, the better they are able to do something positive about it.
    - macintux 9y ago
      I'm reminded of a sad story about a kid, probably 10ish, who overdosed on prescription meds designed to help him not sleep so deeply (he had problems with bedwetting because his bladder wasn't noisy enough to wake him). Failing to understand the purpose of the pills, he decided that if he just took all of them, his problem would go away. Granted, adults (usually) have better judgment than a 10-year-old about things like that, but nonetheless patients almost inevitably are able to make better decisions when they understand why they're being asked to do things.
    - jbob2000 9y ago
      The things that are in your medical record are technical and won't help you at all. "Patient's CD4+-T-Cell count reduce from 5^9/L to 5^6/L, advised increase Prolenaslezapam from 50mg to 75mg" (I'm making this up). Your doctor won't tell you this, instead they'll say "Your HIV is progressing and we're upping your dosage". There's no benefit to reading the technical note, you'll just ask for the clarification... which the doctor already gave you. Or you're going to waste his time having him explain undergrad biology to you. Think of it like this: Would you want your customers reading the comments you leave in your code? Probably not! They'll waste your time asking you about the comment you left saying "this could cause an error and bring the servers down". Or they completely misunderstand something and cancel the service. Or they'll complain that you left a swear word in. Etc. etc.
  - robbiemitchell 9y ago
    > Health records need to be impartial and unbiased Sorry, but they're already neither. Medical records are also the same mechanism used to determine reimbursements, meaning the codes in them that represent diagnoses and treatments are subject to multiple incentive structures.
    - criley2 9y ago
      Care plans and diagnosis codes are very different things. Just because a coder massages the specific codes in use doesn't mean the clinicians are altering care. Honestly, there's a lot of new incentive structures on care givers and their institutions focused on so many things, like reducing readmissions (thereby reducing all forms of medical error in the process), or forming provider cohorts and using comprehensive comparison metrics between similar hospitals in similar areas and situations, to incentivize and reward those facilities which achieve the best care. And, on the subject of the MR/EHR itself, of course most of it is unbiased! Do you think your lab results, prescriptions, vital signs, demographics are subject to bias? Your medical record isn't where a doctor leaves a long note about their opinion of you. It's where all that stuff above, and allergies, and outpatient care history, and inpatient history, and all kinds of factual unbiased things go.
  - EamonnMR 9y ago
    Let's solve the issue of healthcare providers not playing nice with each other (will only communicate via fax, etc) before we worry about the very rare case of mentally ill patients falsifying records and such (which does happen, but not nearly on the scale of healthcare companies simply being difficult to wrangle.)
Waterluvian 9y ago
Manage a local copy. Every individual should be in possession and have a basic understanding of their medical records. Medical professionals are there to help you manage your health. As the manager, you need that information.
macintux 9y ago
For multiple reasons, but here's one that strikes close to home: not every person who you may wish to have access to information contained in those records will have it via the health care system. E.g., I need a personal trainer to help me work around my back problems. It's useful to be able to answer his/her questions by referencing my records, instead of vague shrugging about some random disc. Another e.g.: my aunt does a good job of sharing family medical records so that we know who in our past had conditions that may be relevant to our healthcare as well.
dave5104 9y ago
Why wouldn't you want to have a copy of all your medical records? Perhaps this isn't super useful if you've gone to the same doctor your entire life, but I've gone to multiple doctors (and I know I'll be going to more in my lifetime). It'll be nice to have the ability to pull up my full history if I needed to provide a new doctor with some (more accurate than memory) history.
- hycaria 9y ago
  Because some people don't have any medical history.
tammer 9y ago
Not sure if you live in the US but my experience with the US healthcare system (I work adjacent to one of the top US research hospitals) is that there is a critical problem of patient identification between institutions. Because we have no national ID system, patient data is coded for individual institutions (with some limited exceptions). So, transporting your medical data between institutions is a headache that can result in lost information. Further, access to this information for your own knowledge, research or simple interest is quite limited if you don't have a healthcare provider using one of these established secure platforms Apple Health can pull from.
- deleted 9y ago
  [deleted]
lostlogin 9y ago
Move countries and watch what happens if you don’t take charge. My grandparents did and 3 years later it still hasn’t come straight.
- Redoubts 9y ago
  Move counties... Kaiser still can't sort out my past records after I moved from SoCal to NorCal, and remained with Kaiser the whole time.
- gumby 9y ago
  Much confusion ensued when my pregnant wife and I arrived in the US. I translated the medical records and gave them to the obstetrician. She was quite worried and sure that I had left something out -- there were all these tests that are routine in France but in the US are only done when something goes wrong. Needless to say nothing was wrong.
maxxxxx 9y ago
You absolutely should own your records. In my view there should be a central location for all your records that is controlled by you. Then you should be able to give doctors access to them as needed. But the owner of your records is you, not the doctor, not the hospital.
EamonnMR 9y ago
Because good luck getting your old doctor to talk to your new doctor, for example.
cmiles74 9y ago
If you are moving from one health care provider to their competitor, you will find it is difficult to get the data successfully (and entirely) moved from one organization to another. Typically you will need to personally gather the data from the one provider and physically move it to another. In some cases they may provide a CD, DVD or thumb drive but it's more likely you'll have piles of paper. Having a copy of your medical record in a format that is easy to carry and, even more important, easy for your clinician to read will go a long way towards insuring your new doctor, etc. has enough information not to do you more harm.

Psilidae 9y ago

I don't use any apps at the moment for tracking medical records, but if I did, I'd be using Microsoft's HealthVault.

house9-2 9y ago

My medical records are made of paper and in a folder in a file cabinet :) I rarely go to the doctor so not much to keep track of, yet...

mikeymop 9y ago

Android has an option to display Medical Information however I do not know if it can import using CDA or HL7.

dynofuz 9y ago

We're an early startup called 1upHealth (https://1up.health https://1up.health) that has a similar web based product (https://1up.health/products/patient https://1up.health/products/patient) supporting 90+ health systems. Additionally for all the devs on here, we make those health system integrations available to your app via an API.

brynlewis 9y ago

Not android specific, but a means of viewing your records in a browser is here: http://backbeachsoftware.com.au/challenge/index.htm http://backbeachsoftware.com.au/challenge/index.htm Renders CDA documents.

joe5150 9y ago

The last time I got medical records, it was a thick stack of papers (the images were on a CD at least). Another provider sent an "electronic" record, which was just a PDF of essentially the same stack of paper. This was way back in May 2017.