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Latest Posts

Do-It-Yourself Health Care: A New Form Of Outsourcing?

Jessie GrumanThe outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years.  It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free.  It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and service reps.

This was particularly salient to me this week: I spent an hour online browsing, comparing prices, reading customer reviews and filling out the required billing and shipping information to get a great deal on a new lamp.  An airline would charge me 99 cents to talk to a person but provides information for free online.  Calls to Amtrak to make train reservations are routinely answered with a message that the wait to talk to an agent is 30 minutes, but that I can book travel myself – plus get better deals – if I do it online.  My bank has a small staff, limited hours and it charges extra for paper checks and mailed hard copy statements… but its Website is welcoming and useful, even at 3 a.m. Read more »

*This blog post was originally published at CFAH PPF Blog*

WikiLeaks: What It Means For Healthcare Privacy

From the official White House statement yesterday regarding WikiLeaks disclosure of diplomatic cables:

“By releasing stolen and classified documents, WikiLeaks has put at risk not only the cause of human rights, but also the lives and work of the individuals. We condemn in strongest terms, the unauthorized disclosure of classified documents and sensitive national security information.”

No matter what people think of WikiLeaks disclosure of approximately 250,000 classified diplomatic cables to the Internet yesterday with the help of the New York Times, The Guardian, Der Spiegel, and Le Monde, the implications to electronic healthcare information security are significant.

Day in and day out, I type huge volumes of information on my patients on a computer and my fellow physicians do the same. As a result, vast healthcare information warehouses are at the disposal of the government, insurers, and major healthcare institutions eager to become more efficient, strategic, or competitive. We are promised the information is private, confidential, and even stripped of its identifiers for group analysis. It is even protected to remain so by law. Read more »

*This blog post was originally published at Dr. Wes*

Health Data Rights – Facilitating Personal Responsibility

My colleague, Alan Greene, has been in the lead with a group of professionals putting forth a declaration of health data rights and, as founder of eDoc, I am completely in support of it. He points out that more than 7 percent of abnormal tests results fall through the cracks, according to a study released today in the Archives of Internal Medicine. According to Alan, as quoted today in his blog: “Whether we use this power to track our family’s medications, BMIs, lead levels, vaccines, or allergies, by being more actively engaged I believe we can make better health choices, reduce costs, reduce errors, and enjoy better health. Too often, bureaucracy, old thinking, or paternalistic concerns keep people from having their own health data or from having the courage to act on it.

I believe this is about to change. On June 22, 2009, we released a Declaration of Health Data Rights a profound, simple statement that, among other things, we all have the right – the license – to take possession of a complete copy of our health data without delay and at minimal cost, in a computable form if our lab data or pharmacy records or growth charts or other health data exist in that form….This doesn’t mean that we won’t value physicians and others who have devoted their lives to a study of health, but it does mean that we will engage with them in a new and more effective way…I hear concerns from some doctors that patients shouldn’t have a set of keys: they won’t make safe drivers. And it would be dangerous, for instance, for patients to be able to get worrisome lab results or biopsy results without someone present to reassure them. As I’ve heard more than once, what if this led to suicidal behavior?

Yes, I think it’s valuable to have support when getting bad news, but I also think the choice of whether to have support, when, and what kind belongs to the person getting the news. Our routine of keeping people in the dark until we are ready for them to get information is too a high price to pay. What if people misinterpret or misuse their own health data in less extreme situations? No one has a greater interest in an individual’s health than that individual and their loved ones. Armed with up-to-date data, they are free to consult experts and other resources as they wish. Our health is our responsibility, and having our own data is essential to taking charge.

The Declaration of Health Rights is simple, clear, and self-evident – but I expect the implications of this Declaration will continue to unfold over the years to come What if people misinterpret or misuse their own health data in less extreme situations? No one has a greater interest in an individual’s health than that individual and their loved ones. Armed with up-to-date data, they are free to consult experts and other resources as they wish. Our health is our responsibility, and having our own data is essential to taking charge…One natural extension of this will be people’s ability to order lab tests for themselves.

Of course, insurance will only pay for the tests if the situation warrants, but if your child has a sore throat and a fever, why shouldn’t you be able to order a strep test? Or if you’re a parent in your thirties or forties and have high cholesterol, why shouldn’t you be able to have your child’s cholesterol levels checked? We live in a country that allows people to smoke cigarettes and carry guns. Having our health data is far less dangerous and carries with it the possibility of great good. Let’s shake hands; let’s pick up our keys.

To learn more about the Declaration of Health Data Rights, click here.

To become a signer of the Declaration, click here.”

Thanks, Alan, for stating this so well. I couldn’t do it better than you, so thanks for allowing me to quote you!

*This blog post was originally published at eDocAmerica*

Joan Lunden Loves Personal Health Records

Photo of Joan Lunden

Joan Lunden

Former Good Morning America host, Joan Lunden, is getting behind the personal health record industry. As the daughter of a physician, Joan grew up believing that she’d become a doctor one day. She told me that all that came to a screeching halt when she “realized that she didn’t like blood or stitches.” But Joan has always kept women and children’s health advocacy initiatives close to her heart.  She will soon be starring in a new Lifetime TV show called Health Corner. I caught up with her about her recent work with PassportMD.


Listen to the podcast here, or read a summary of our discussion below.

Dr. Val: Tell me about your experiences in taking care of your mom, and what led you to become involved with a PHR company.

Lunden: I lost my brother to type 2 diabetes a little over a year ago. As it happens, he had been managing my mom’s medical care, and so with his loss I needed to step in and take it over. Of course she lives on one coast and I live on the other. I’ve got 4 little kids (two sets of twins) and three young adult children. It becomes really daunting to keep track of everyone’s medical care. Around that time I met some folks from PassportMD, and when they showed me how easy it could be to keep everyone’s records in one place, I said, “this is exactly what I need.”

I think I’m really typical of a lot of women out there in what we call “the sandwich generation.” Today a high percentage of women with small children are working outside of the home. It’s really a lot to juggle – a career, raising a family, and getting everyone to the doctor on time – forget about getting YOU to the doctor on time. As good as we women are at nurturing others, we tend to be at the bottom of our own to-do lists.

What I really love about PassportMD is not just the organization (I can immediately see all my kids’ vaccination schedules for example) but the fact that I’m building a family medical history. It’s so important to know your family history so that you can engage in appropriate screening tests and take preventive health measures. This PHR even sends you reminders when its time for immunizations, mammograms, or other appropriate screening tests.

Dr. Val: As a doctor I’ve encountered resistance to PHRs from patients because they don’t want to have to enter all the data themselves. They’d like it to be auto-populated with their medical record data so that they don’t have to start from scratch. Has the PassportMD tool solved that problem?

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Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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