Doctors offer patients online records access

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By CHERYL SARFATY
STAFF WRITER
csarfaty@thnt.com

What would the world look like if you had instant, electronic access to your medical records? The implications could have a profound effect on peoples' lives � some beneficial, some perhaps risky � but it's a goal President Bush wants in place by 2014.

Here in Central New Jersey, some doctor's offices and hospitals have already made the transition, tossing heaps of medical records into storage in favor of managing patients' charts electronically.

The idea is to centralize people's medical records to provide instant access to physicians, pharmacies, hospitals and the patients themselves.

Dr. Richard Goldstein, an internist in Woodbridge, has already computerized Woodbridge Internal Medical, the practice he shares with seven other doctors. It was a task that he personally tackled.

"I have a computer background and I started writing software several years ago to help address the needs of having multiple offices and what we were going to do with our charts," Goldstein said. Before, "the records that we had in any one office would have to be delivered back and forth in anticipation of people's visits. Not only that, if someone showed up impromptu, we wouldn't have their records."

Now Goldstein can simply call up any patient's file in seconds, view it and perform numerous tasks, including writing electronic prescriptions and accessing or sending a medical record to a specialist or hospital.

Going electronic, which the practice did one year ago, has saved time and increased efficiency, he said.

It has also saved money. When the internists relocated recently, they were able to move to a smaller office, saving about 600 square feet of storage space previously occupied by 50 years' worth of medical files, he said.

One hang-up of an all-electronic medical records system, Goldstein said, is the potential for impersonal patient visits, as some doctors (including himself) travel from room to room with a portable computer.

"In a lot of these systems, people look at the computer while they're talking to the patient. That's bad," he said. "It's totally impersonal. . . . to be looking at the computer, typing or tapping on the screen or clicking your mouse while there's a patient there trying to share potentially sensitive stuff with you."

Another drawback is that just because a medical practice has adopted the electronic-filing system, it doesn't mean the information is consistently error-free. People are still typing the information.

"Like a paper chart, errors get in," Goldstein said. "There's still a human factor."

And then there's the No. 1 concern � patient privacy and security.

"We go to some length to protect our records," he said. "We use secure technology the same way your bank would in order to prevent from being hacked."

So far, patients are expressing mixed feelings about having their medical files uploaded to the Internet.

"I think there are a lot of benefits to having this," Raymond Babecki, a patient of Goldstein's who lives in Fords, said. "First of all, there's convenience to the patient. For example, blood tests come back (quickly), which seems like a fairly routine sort of thing. But rather than them having to drop it in the mail or discuss it with me on the phone, (the doctor) can review it electronically, sign off on it electronically, and then I will receive a message on e-mail.

"I think that's great because this way, I can then access a copy at my leisure."

But Babecki, 43, a scientist with a penchant for technology, is concerned that his records may not always be private.

"In the electronic medium, I might be eventually denied insurance or employment because of that, or some other benefits, and I have no means to correct it," he said. "I want that information restricted."

Dora LoGrande, a 44-year-old Iselin resident, isn't worried about her information being broken into or somehow accessed by anyone outside of her medical circle, she said.

"When I first found out and (Dr. Goldstein) said to me last year that he was in the process of having a Web page, I was ecstatic," she said. "I thought it was a great idea."

LoGrande feels safe, she said, because she trusts her doctor and she has a password that no one else has access to. She also enjoys the benefit of being able to quickly view her records, though she understands how some people might have greater concerns.

"If someone maybe had an illness that was a little more serious, maybe that would have come to mind," LoGrande said.

Solaris Health Systems, which comprises JFK Medical Center in Edison and Muhlenberg Regional Medical Center in Plainfield, is ahead of the electronic-filing curve, having implemented its system about two years ago, according to Dr. Joseph Catapano, cardiologist and medical information officer. In addition to his affiliation with the hospitals, Catapano shares a private practice with two partners at Cedarbrook Cardiology in South Plainfield.

Solaris' system was designed with multiple security measures in place, he said.

"I have four log-ins, and I have something called a key fob, which is a security device that is given to the physicians by Solaris," Catapano explained. "So you've got four hurdles to get (past) before you can get into the system, and we change our passwords every three months. We haven't had any breaches."

Sometimes, depending on the situation, such as a mental illness, a patient's chart may be locked down, he said. The same goes for any patient considered a VIP, such as singer Luther Vandross, who died at JFK Medical Center.

"We locked that thing down right away," Catapano said. "There's a lot of crazy people out there."

Privacy concerns have also crossed William Auer's mind. The 58-year-old Milltown resident, who has not yet had hands-on experience with an electronic medical records filing system, thinks the idea has its pros and cons.

"I think it would be a good thing in the long run," Auer said. "If anything were to happen and one doctor in North Jersey needed the information that only a doctor in Central Jersey has, it would speed up the whole process."

Like Babecki, Auer has concerns about his personal information possibly traveling beyond the medical realm.

"As long as there's no abuse for employment or insurance companies getting information where you can't get life or health insurance," it would be OK, he said. "People always wonder about things like that happening."

http://www.thnt.com/apps/pbcs.dll/article?AID=/20050828/NEWS/508280450/1001

My doctor's office is paperless and has been for over a year. IT'S WONDERFUL!!!

I have a User Name and password, and can log into their system and have immediate access to anything regarding my medical records, visits, lab tests, doctor's notes, meds, etc. etc. They even encourage their patients to go online to book appts. with their doctors--yes, you book an office visit via their website.

The BEST part of the site is that I can communicate DIRECTLY with my doctor in the system--and HE personally replies to that communication. I've worked in physician's offices in the past, and my number one concern is that when patients phone in and discuss their issues with a nurse, who then "translates" what SHE DEEMS NECESSARY to the doc, that there's too much room for error, including error by ommission because SHE didn't feel something the patient said as important enough to bother the doctor with--when that ONE thing, could be VERY IMPORTANT.

Having the peace of mind knowing that MY DOCTOR gets EXACTLY what I say via this communication is WONDERFUL. I'm also a better writer than a phone speaker in that I often forget something or get flustered with a nurse trying to explain what I need the doctor to know.

The doctors there also love it because your notes become a permanent part of your medical record--therefore, you can never charge the doc's office with making an error, and you can never say that you didn't say something when you were the one to write the communication. It's sooooo wonderful, because I trust NO NURSE giving the doc my full message--we all know that they do not write word for word what you said, and they decipher what needs to be said--that's where a lot of medical errors happen as well.

Soooo, these electronic systems are out there, and if I had a choice of docs, I'd find one that has a website and this online system where the patient is very much a part of their own medical notes and has immediate access to anything they need in the office.

It's beautiful!!

Thanks for that info. I'm going to check into my husband's doctors office and see if they have this. If so do you just email that info to and ROP rather than having to ask your doctor for your files? My husband is a little "skittish" about asking for his records. (I guess so his doc is making a mint from him alone) JMO anyway.
thanks

Hello 5465,

I don't have to use OP's due to having an outstanding doctor who cares about me dearly. He's a dream and I'd be lost if he ever left this area. I would actually consider a move (seriously), if my doctor moved out of my area--that's how wonderful he's been to me. It's not about the meds he rx's me, but rather, he's a doctor like no other in my 40 years of dealing with them. He's truly a diamond in the ruff.

However, if I had the need to use an OP, I would, without question, use a ROP ONLY. NROP'S are illegal, although there are those who differ on that opinion. The dea's website clearly defines that solely filling in an online questionnaire does NOT constitute a doctor/patient relationship--therefore, they are illegal. Period. NROP's are drug dealers dealing on the internet. Despite what others say, there is no "gray area" when it comes to NROP's. They are illegal.

So if your hubby needs to use an OP, tell him to go the ROP route. And in answer to your question, YES, if his doctor's office in online, he can pull down physicals, office visits, all the doctor's notes and dictation, etc. etc. from that site once he's registered. Ask him if there's a computer in each patient room. If there is, and if the nurse uses it while he's in the room, odds are they are "paperless" and online. Does his doc walk into the room with a "chart" in his hand? If so, they probably are not online. But if the doc walks in with one little slip to take his personal notes (which he transfers into the computer once a patient leaves), then they are probably online. I'm guessing that large physician "groups" will all go this direction soon if they aren't already online. Man, that system is wonderful, and hopefully he can access his records online.

Do not use these NROP's, though. Some people say they don't have the money to see their doc. But somehow they find the money to pay the outrageous charges to these NROP's. A doc's office visit is far less than even one fill by these NROP's...all the ROP's want to see is a physical examination and also notation of the chronic pain a person is seeking medication for.

Take Care and good luck to you and your hubby!

Hi Nascarchick,
My husband actually does have a darn good doctor. And while I'm not at the visits with him he sees my husband so often that they are on a first name basis. That is part of MY beef, tho, because while my husband has insurance, this doctor isn't on this insurance plan. So he still pays out of pocket. My husband has to go see him just to have his scripts refilled which insurance DOES cover the meds (he gets generic) but he doesn't get enough to get him thru even a month. If he could get like a 3 month supply and see his doctor every three months or so (except when it gets real bad and needs additional therapy) than in the long term it would save some money. And let me say it is ALOT of moolah!!I want him to still see his doctor just trying to cut at least some corners if possible. Either way I'm not sure we can go this online record access yet or not. Just looking for alternatives. Thanks for your reply. You seem like one of the lucky ones that has a really good doctor. Thanks-5465

I think this is a great idea! It's been way too long that doctors can say any old thing about us---from calling us drug-seekers to their notes accuse us of lying. I know that right now we can actually get our own records, but it just about requires an act of God!

CatLady

5465, I do agree that if your husband needs to use an OP, that it is best to find a good Record OP. They are cheaper than using an NROP. However, and sorry if this is a little off topic, but since it was already mentioned, I feel I need to say something about the NROP comments. While they may be considered illegal some people that do not have insurance need to use them. I used a Record OP until my records were considered out-dated, and I can not wait till I can get them updated so if I need to use an OP, I can use a Record OP. I am not trying to start an argument in any way, I just feel that I have the right to stand up for reasons why some may use NROP's. Yes a doctors visit is far cheaper than the cost of a prescription from an NROP. BUT, what if the doctor will not do anything until, you get X-Rays?? OK, still not too bad. Well guess what, the X-Ray's turn out to be inconclusive so the doc wants an MRI. No insurance, doctors office visit, X-Ray's, then back to doctor, then MRI. Just went well over $1000 total. Without insurance I can not pay this kind of money. Actually not even close to this kind of money. To see doctors around me the average is $80-$120 just to talk to the doctor!! Like I said I am not trying to argue, but I thought I could maybe help some people understand a little better the reason why some have to use these NROP's.