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> Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password)

> Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password) into the electronic medical record That's IT infrastructure incompetence, not an EMR issue. At the two healthcare systems I go to, both utilize RFID badge readers plus PIN. In the ER and urgent care, nurses need only tap their badge and enter a quick pin and they're in. It's taken them seconds to pull up my records and I've never noticed a delay in care. In the PCP's network, everyone seems to get smooth and quick access often while we're conversing, and I can see all my visits, lab results, and so on. The major annoyance is that I get emails notifying me I have a "message", instead of even offering me the option of receiving an email with the actual message. I don't think people understand how expensive and time consuming the non-electronic stuff was. I remember my mother spending considerable amounts of time trying to get records from labs and doctors and having to shelp a lot of it by hand.

Spivak 3y ago
> That's IT infrastructure incompetence, not an EMR issue. The two cannot be unlinked so easily when I have never met someone so doesn't have the same story of hospital IT. Even the IT workers hate hospital IT. The deployment of an EMR has to take into account the regulatory and security requirements imposed on all digital systems. > I get emails notifying me I have a "message", instead of even offering me the option of receiving an email with the actual message. You need to bash the right heads together and get your email provider and sender in DirectTrust https://directtrust.org/what-we-do/direct-secure-messaging https://directtrust.org/what-we-do/direct-secure-messaging Not gonna say it's not a bitch and a half to implement but you can send sensitive data directly via email. And if you're the SaaS provider you're part of DT that's a huge value add for your offerings.
mrcarruthers 3y ago
The email thing is probably a privacy requirement. Email isn't encrypted meaning your email provider (and the EMR's) can fully read the contents of said email.
- 8organicbits 3y ago
  I think people want to waive that privacy concern. My email provider has access to tons of my private data including lots of health data. Given the option, I suspect many would prefer to just get an email.
  - kQq9oHeAz6wLLS 3y ago
    In the US, that's a HIPAA violation, which opens the provider up to massive fines.
    - jrockway 3y ago
      It's definitely not. As a patient, I can do whatever I want with my medical records. I can copy them right out of MyChart and put it on my blog if I want to. I feel like I should have the right to sign a form saying they can email me.
      - lostlogin 3y ago
        This agrees with you: https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hipaa-permit-health-care-providers-to-use-email-to-discuss-health-issues-with-patients/index.html https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hip...
      - 8organicbits 3y ago
        Agreed, I often email results to my spouse so they can review as well. I don't think many health care systems permit spousal access to results (although I can see my young kids' data).
    - 8organicbits 3y ago
      My comment was implied aspirationally. US legal issues may (or may not, see sibling comments) prevent a provider from sending health info via email. If it was/is allowed, I think many would like to opt in (but never the default). As I understand HIPAA (I'm not a lawyer), the patient can send info to the provider via email. In fact, since my last comment I emailed a test result of mine to my doctor (in the US). Outside the US, email is sometimes used. I've had a couple non-US doctors send me my health data via email. I don't know which foreign laws applied, but I assume they were permitted to do so.
jrockway 3y ago
Yeah, as a patient I don't have any problem with EMRs. When I visit a specialist I can fill out all the forms and pay the copay online. The app notifies the office when you arrive, so you just sit down and get called in. I used to go to NYU Langone but switched to Mt. Sinai and all my records came over fine. I'm a "visit the doctor once every 0.9 years" kind of a person, so I guess my needs are not incredibly complicated, but I've found the experience to be pretty fine overall. Good, I'd say, honestly.
bongodongobob 3y ago
I could see that badge system easily costing a million+ dollars, fyi. RFID identity management is an entire platform in itself and is extremely expensive.
- Scoundreller 3y ago
  A lot of hospitals already use it for things like door access. Sometimes parking tagged on too.
  - bongodongobob 3y ago
    Door access and stuff like that is orders of magnitude cheaper. Integrating identity with all the proprietary systems is crazy expensive, I specced it out for about 100 users and it was 10's of thousands of dollars just for the hardware and thousands a month for the software.

Spivak 3y ago

> That's IT infrastructure incompetence, not an EMR issue. The two cannot be unlinked so easily when I have never met someone so doesn't have the same story of hospital IT. Even the IT workers hate hospital IT. The deployment of an EMR has to take into account the regulatory and security requirements imposed on all digital systems. > I get emails notifying me I have a "message", instead of even offering me the option of receiving an email with the actual message. You need to bash the right heads together and get your email provider and sender in DirectTrust https://directtrust.org/what-we-do/direct-secure-messaging https://directtrust.org/what-we-do/direct-secure-messaging Not gonna say it's not a bitch and a half to implement but you can send sensitive data directly via email. And if you're the SaaS provider you're part of DT that's a huge value add for your offerings.

mrcarruthers 3y ago

The email thing is probably a privacy requirement. Email isn't encrypted meaning your email provider (and the EMR's) can fully read the contents of said email.

8organicbits 3y ago
I think people want to waive that privacy concern. My email provider has access to tons of my private data including lots of health data. Given the option, I suspect many would prefer to just get an email.
- kQq9oHeAz6wLLS 3y ago
  In the US, that's a HIPAA violation, which opens the provider up to massive fines.
  - jrockway 3y ago
    It's definitely not. As a patient, I can do whatever I want with my medical records. I can copy them right out of MyChart and put it on my blog if I want to. I feel like I should have the right to sign a form saying they can email me.
    - lostlogin 3y ago
      This agrees with you: https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hipaa-permit-health-care-providers-to-use-email-to-discuss-health-issues-with-patients/index.html https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hip...
    - 8organicbits 3y ago
      Agreed, I often email results to my spouse so they can review as well. I don't think many health care systems permit spousal access to results (although I can see my young kids' data).
  - 8organicbits 3y ago
    My comment was implied aspirationally. US legal issues may (or may not, see sibling comments) prevent a provider from sending health info via email. If it was/is allowed, I think many would like to opt in (but never the default). As I understand HIPAA (I'm not a lawyer), the patient can send info to the provider via email. In fact, since my last comment I emailed a test result of mine to my doctor (in the US). Outside the US, email is sometimes used. I've had a couple non-US doctors send me my health data via email. I don't know which foreign laws applied, but I assume they were permitted to do so.

jrockway 3y ago

Yeah, as a patient I don't have any problem with EMRs. When I visit a specialist I can fill out all the forms and pay the copay online. The app notifies the office when you arrive, so you just sit down and get called in. I used to go to NYU Langone but switched to Mt. Sinai and all my records came over fine. I'm a "visit the doctor once every 0.9 years" kind of a person, so I guess my needs are not incredibly complicated, but I've found the experience to be pretty fine overall. Good, I'd say, honestly.

bongodongobob 3y ago

I could see that badge system easily costing a million+ dollars, fyi. RFID identity management is an entire platform in itself and is extremely expensive.

Scoundreller 3y ago
A lot of hospitals already use it for things like door access. Sometimes parking tagged on too.
- bongodongobob 3y ago
  Door access and stuff like that is orders of magnitude cheaper. Integrating identity with all the proprietary systems is crazy expensive, I specced it out for about 100 users and it was 10's of thousands of dollars just for the hardware and thousands a month for the software.