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In my country in Europe the solution is quite easy: I have the right to get all papers and images from my doctors within 10 years of creation. But I have to pa
by andix 4y ago
In my country in Europe the solution is quite easy: I have the right to get all papers and images from my doctors within 10 years of creation.
But I have to pay the doctor the expenses, if there is some work involved (like burning a CD or buying a flash drive - bc of security reasons they don’t let you connect yours, you need to buy a new one).
If you have some kind of 3d images (also dentists create them nowadays), there is usually some kind of licensed viewer software on the disk, where you can view just your own images. And as far as I know, the doctors don’t have to pay a license fee for it. It’s included with their software. And it is a feature they need, to comply with the law, that they have to give images to the patients upon request.
- prepend 4y agoThis seems pretty dumb and an excuse for doctors to have expensive systems to retrieve and disburse records. It should be near zero to deliver these records. Or at least marginally zero. I’d rather records be free electronically and let healthcare providers plan for this. Having costs discourages information sharing, I think.
- Topolomancer 4y agoLiving in Germany, I can state that the costs are very low: 10 EUR for a DVD/CD/other media are the typical ballpark. You are essentially just paying a fee for an administrative assistant to pull your files and give them to you.
- gambiting 4y agoSame in UK. There is a fee but it's like £20, it's minimal.
- lozenge 4y ago£20 is not a minimal fee (meaning, would pay without a second thought) for most people in the UK.
- gambiting 4y agoWhat makes you think so?
- sorokod 4y agoPerhaps the fact that some need to use food banks or even disconnect from electricity providers https://www.theguardian.com/society/2022/may/15/watchdog-urged-to-step-in-as-uk-poorest-turn-off-energy-supply https://www.theguardian.com/society/2022/may/15/watchdog-urg...
- gambiting 4y agoSure, of course those people exist. I mean specifically what makes you say that for "most" of people in the UK £20 is not a minimal expense.
- tiagod 4y agoImagine I have a heart attack. I do an ECG, some CT, X-RAY, MRI. Suddenly its £200 just for the DVDs.
- gambiting 4y agoReally? Where did you get that quote? That's not how it's meant to work, not with NHS anyway. When I did that recently I rang my GP surgery, and they got EVERYTHING from my medical history. You don't pay £20 per result - it's £20 to get hundreds of pages of medical history(if you have that much) all at once.
- TheOtherHobbes 4y agoDo you get paper copies or PDFs?
- gambiting 4y ago
- DanBC 4y agoThis is out of date information. The fee was scrapped. The fee should only be charged where the request is manifestly unfounded or excessive.
- dicom_guy 4y agoYeah who owns a CD drive anymore. It should be a free web-based viewer that lets you login securely, manage temporary links to other providers, and download for offline use. It’s not that hard to build and the government could provide it but instead we’re stuck with expensive third party vendors.
- okl 4y agoI'd rather prefer my data not be available on the web.
- Snowworm 4y agoIt already would be, they have to transfer the data between hospitals somehow. The only difference is that you will have access to it, not just the doctors. The security depends entirely on the implementation though. I'm guessing that's why your concerned about it.
- makeitdouble 4y agoHow long did it take for your government to have a site with an up to date list of all the places doing co-vid tests ? For me it took months to have a site, and it’s been stale and broken every time I checked. Why should we trust it more to host such a critical service ?
- Max-q 4y agoIt took a few weeks, it work perfectly and I could book time for test. We also got a national EU Covid pass service where Covid tests and vaccines are show. It takes me a couple of minutes to do my tax return and I can deliver every form to any government organization from one single portal. All my health information is stored on another single portal (same one where I find the Covid pass). I don’t think the rule that all government software is bad is universally applicable.
- tveyben 4y agoWhich is several orders of a magnitude more expensive than just adding a CD-burner. Or use the pre-existing USB interface to write the files to a 5€ small memory stick (new as mentioned earlier) Ditto for the complexity regarding the security.
- makeitdouble 4y agoDon’t know andix’s country, but for France for instance sharing data with patient is widely accepted and I got by default a copy of most of my check ups without having to ask, and I don’t even noticed the price if there was any. For longer care history, it can be a bit more paperwork, but nothing complicated. One aspect to this is you are usually the one bridging the doctors dealing with your health, and might be hand handling the relevant data to whoever needs it (e.g. your family doctor can request an X-ray, but after taking you need to switch doctors for any reasons. As you have the actual X-rays, you can hand it to anyone else competent for the case)
- queuebert 4y agoIt's due to a lack of incentive ($$) to provide a service to easily deliver your electronic records. The standards and protocols exist, but no one yet has created a good one that has been widely adopted. We could vote with our feet, and only use providers that have electronic delivery available. Then they would feel the need to provide it.
- helsinkiandrew 4y agoI would guess the argument goes that very few people want or need their records so the cost of building and maintaining an online system that won’t leak medical information to hackers is very high. If you want it, paying a small amount and proving you are who you say you are isn’t that much of a burden.
- andix 4y agoThe insurance anyway pays the doctor only the minimal amount of money for taking X-rays, I understand that they charge you for doing extra effort. If you get your X-rays done privately, it is included for sure.
- peoplefromibiza 4y ago> an excuse for doctors to have expensive systems to retrieve and disburse records. They are free in Italy, if you go through the National healthcare. to answer the question: the images are of the patient, the National health care (SSN) can use them for research purpose only by authorized personel, the distribution must be authorized by the patient. In some regions the patient can de-authorize them through a web app, but it's not very common yet. If you go to a private medical center, the scans are included in the price and are yours.
- op00to 4y agoIn the ever expensive US health care system, I was able to get a free cd of my CT scan. Took 15 seconds to burn.
- LosWochosWeek 4y ago> In my country in Europe the solution is quite easy: I have the right to get all papers and images from my doctors within 10 years of creation. This doesn't answer the question in the article tho. The question isn't "Who has the rights to a copy of my medical images". It's "Who owns the copyright to my medical images". To answer that question, you'd first have to find out if your medical images are even protected by copyright in the first place. The answer to this question depends wholly on the picture itself. Let's say a medical image of yours is indeed protected by copyright, then -- even in your country in Europe (regardless of which country it actually is) -- the copyright holder is the person who took the image. Not you. It may very well be that in your country this copyright is restricted by other laws (i.e. Persönlichkeitsrecht in Germany).
- chii 4y ago> the copyright holder is the person who took the image. only if you didn't contract that person to take the image for you. So it makes sense, imho, that the person who paid for the image to be taken to own the copyright.
- dctoedt 4y agoUnfortunately it's not that simple under U.S. law: Under 17 U.S.C. § 201, the image-maker (more likely, his/her employer) is considered the "author," and thus will own the copyright. See https://www.law.cornell.edu/uscode/text/17/201 https://www.law.cornell.edu/uscode/text/17/201. Exception #1: The contract could provide for the image-maker to assign the copyright to the image subject. See 17 U.S.C. § 204, https://www.law.cornell.edu/uscode/text/17/204 https://www.law.cornell.edu/uscode/text/17/204. Exception #2: The parties could sign a written work-made-for-hire agreement before the image is created, IFF the work is specially ordered or commissioned for use • as a contribution to a collective work, • as a part of a motion picture or other audiovisual work, • as a translation, • as a supplementary work, • as a compilation, • as an instructional text, • as a test, • as answer material for a test, or • as an atlas. See 17 U.S.C. § 101, https://www.law.cornell.edu/uscode/text/17/101 https://www.law.cornell.edu/uscode/text/17/101. For the purpose of Exception #2 “supplementary work” is a work prepared for a publication as a secondary adjunct to a work by another author for the purpose of • introducing, • concluding, • illustrating, • explaining, • revising, • commenting upon, or • assisting in the use of the other work, such as • forewords, • afterwords, • pictorial illustrations, • maps, •charts, • tables, • editorial notes, • musical arrangements, • answer material for tests, • bibliographies, • appendixes, and • indexes; and an “instructional text” is a • literary, • pictorial, or • graphic work prepared for publication and intended to be used in systematic instructional activities. See 17 U.S.C. § 101, https://www.law.cornell.edu/uscode/text/17/101 https://www.law.cornell.edu/uscode/text/17/101.
- db48x 4y agoWorks the same way over here, though the software is invariably Windows–only, and proprietary. I was able to find a viewer for the xrays I recently got, but I suspect that one day I’ll be the one who has to write the viewer for others to download. I don’t recall paying anything extra for the cdr it was burned onto, or for the receptionist’s time.
- mlyle 4y agoThe data formats are largely standardized within DICOM and there's open source viewers that do a passable job of viewing the imagery. https://medevel.com/10-open-source-dicom-viewers/ https://medevel.com/10-open-source-dicom-viewers/
- andix 4y agoYou’re usually getting the standardized DICOM images too. I never managed to properly view them with open source software.
- nick__m 4y agoslicer.org is a great open source viewer, the learning curve is something but the results can be impressive.
- figomore 4y agoYou can use InVesalius https://github.com/invesalius/invesalius3 https://github.com/invesalius/invesalius3
- markus92 4y agoHoros/Osirix is - by far - the best open-source DICOM viewer, it's the only viewer I'd describe as being on-par with commercial PACS software. Unfortunately it's macOS only.
- dec0dedab0de 4y agoJimbo dicom viewer is pretty good at viewing different medical images
- limeblack 4y agoThere is an exception to this rule and that is mental health cases but otherwise yes this is true.
- Vladimof 4y agoI haven't had to pay here in the US for hospital images distributed on CD but my previous dentist was giving me shitty printed images and I could not get digital copies. But they probably charge you for it whether you get them or not.
- LightG 4y agoDoes anyone know the position on this for the UK since we ... you know ... fxcked it all up? Thanks
- _Algernon_ 4y ago>CD or buying a flash drive I guess on the positive side, they're not faxing it anymore.
- bscphil 4y ago> But I have to pay the doctor the expenses, if there is some work involved In the United States this would somehow be an excuse to charge you $300 for it. Some people might be lucky enough to have their insurance "cover" it, which means you still somehow end up paying $30 since the insurance only covers 90% for some reason.
- andix 4y agoNo, this doesn’t mean that in Europe. They may charge you 5-10€ for a CD or a flash drive. And maybe 2-3€ for 10 printouts. Maybe another fee of 20€ if it was already archived, and they need to pull it from the archive. It’s about covering their costs, and not about making money. 5 minutes of their work doesn’t cost 300 usd.
- thfuran 4y agoIt really isn't. You might have to wait a bit but you can get your DICOM in the us just fine and without exorbitant fees.
- thfuran 4y ago>the disk, where you can view just your own images. And as far as I know, the doctors don’t have to pay a license fee for it I certainly can't speak for all software, but I work on one such and can confirm that there's no licensing or other cost for the doctors burning the disk with embedded viewer aside from the media itself, which can be any off the shelf stuff. Though I know there is some fuckery in related areas—there's at least one company that makes a DICOM printer that only accepts extremely pricy first-party, rfid-tagged paper.