Friday, December 19, 2008

Online Follow up for Hospitalized Patients

I'm excited about a new program that we started today at the University of Arkansas, using the eDoc technology and team in partnership with the UAMS physicians.

We give every patient being discharged from the hospital a free subscription to our service, with the encouragement for them (or their family) to log on and ask a question or get a clarification about their recent hospitalization or other health questions that may be concerning them.

I don't know about your experience but, around here, when patients leave the hospital, it is not that easy for them to get in touch with one of the doctors associated with the hospitalization to get questions answered, etc.

So, anyway, they log on, ask our team questions and, if it is straightforward and we're comfortable answering, we do. If it needs to be passed on to one of the doctors who took care of the patient, we do that.

We're doing a three month pilot, then we'll reassess and see how we want to proceed.

What do you think of this idea? Let me hear from you.

Friday, December 12, 2008

Electronic Records and Confidentiality

At UAMS, we recently did a survey asking employees if they used the University for their health care and, if not, why not. A signficant percentage indicated that they elected to go elsewhere because of concerns about confidentiality of records.

Recently, at another local hospital, following a tragic homicide of a news anchorwoman at a local TV station, 7 employees were fired because they accessed her records without authorization.

At UAMS our compliance/HIPAA office indicated that, when they do audits of our EMR, they routinely discover MANY episodes of unauthorized access to our electronic medical records.

Electronic records have so many advantages, but this is one of the challenges that needs to be addressed. Communication, clear policies, and accountability measures are all critical to keeping folks' noses out of records where they don't belong.

One thing needs to be said in clarification, though. In the "old days" when paper records were the rule, I'm absolutely sure that confidentiality was just as big an issue, but we had no way of knowing if someone looked at records without authorization. Nowadays, if someone accesses a digital record, it leaves an electronic "footprint" that can be easily traced to the perpetrator. So, it could be that this is simply a problem that we now have more information about and can do something about, rather than actually being a new problem that is due to the EMR. On the other hand, it is likely that some occurrences of unauthorized access would not have occurred in the "paper era" because electronic lurking involves different settings, technology and skill than finding a paper chart and looking at it.

Can electronic records be constructed that assure that their confidentiality will be maintained? Probably not. Can more be done to safeguard patient online records? Without a doubt, yes.

This is an issue that the public needs to become educated about and weigh in on. What do you think? Do the advantages of an EMR outweigh confidentiality concerns? How concerned are you about this? Does it affect where you go and who you see for medical care?

Let us hear from you on this...

Sunday, December 7, 2008

What to be Sure to Eat if You are on a Diet

Most Americans are overweight, so dieting is very common. We all know that losing weight means eating less and burning more calories. As we eat less, what should we be sure to eat?

A study published in the Journal of Nutrition in early 2008 followed 130 overweight people on two types of diets. The control group reduced calories based on the traditional food pyramid, so they ate the right types of food. The study group ate a diet rich in protein and calcium, emphasizing lean meats and low-fat dairy products. Both groups lost comparable weight over 12 months. The group on the protein and calcium rich diet had stable bone mass while the control group had some loss in bone mass. The protein rich diet also helps with maintaining muscle mass.

So, if you plan to lose weight by any method, be sure to get protein at every meal, and pay attention to getting enough calcium, either from dairy products or through a supplement. Also take a multi-vitamin daily if you are eating less calories than you burn, and be sure there is vitamin D that is necessary for calcium absorption by the body. Also, get regular weight bearing exercise such as daily walking to help protect your bone mass.

Source: University of California, Berkeley Wellness Letter, December 2008