15 ms·

As read from Europe, it's really scary to realize that this question makes sense in a first world country.

by fab13n 7y ago

jotm 7y ago
How so?
- frabert 7y ago
  Every medical interaction is recorded on a nationwide network - at least here in Italy. Every time I go to my doctor and they prescribe me something / they give me a shot / vaccine, it gets recorded and every other doctor can access the same data when I present my "health smart card"
  - c0restraint 7y ago
    That sounds both amazing (from a patient in need POV) and scary (from a privacy POV). I’m interested in both
    - judge2020 7y ago
      It sounds like a great system assuming the smart card is a like a credit card with the chip in it, and you needed that to view medial records. Unfortunately I seriously doubt that's the case.
      - frabert 7y ago
        It's actually a smart card with a chip in it. It also has a magnetic stripe, I guess for legacy purposes. Here is a sample: https://www.sanita.puglia.it/documents/20182/134679/TSCNS+fronte+%28puglia.gif%29/eeaf006f-5db5-4b6f-bb2c-fa45ace23196?t=1448290285227 https://www.sanita.puglia.it/documents/20182/134679/TSCNS+fr...
  - n0on3 7y ago
    well, to be honest, this sounds like kind of overselling reality. There is a system in place that tracks and records some things, like days off prescribed by base doctors, prescriptions for which national care pays and few other stuff, but most of everything else, including charts from when you are admitted in most hospitals and of course whatever you do outside of the public care (which kind of sucks and has insane waiting times, which means you most often do) is not included in that. So.. nope.
    - davidw 7y ago
      > public care (which kind of sucks and has insane waiting times, which means you most often do) You should see what it's like in the US. Italy's certainly not perfect, but faults and all, I'd happily go back to that system from the one we have here in the US. It does make a difference where you are in both countries, though; in Italy I lived in Padova, where things mostly work pretty well.
  - gerardnll 7y ago
    Pretty sure you talk about the NHS.
- BjoernKW 7y ago
  In Germany, for example, medical records are scattered across medical practitioners, hospitals and health insurance providers. There's no central, distributed or federated EMR system. Each practice or hospital basically runs its own system, sometimes dating from the 1980s. MS-DOS is still widely used in surgeries. Data transfer (i.e. lab results, consultation results) happens mostly on paper, that is the patient usually gets handed a letter with the results to present to their GP. Lots of information is lost this way. Examinations and analyses often are duplicated or done repeatedly.
  - martin_a 7y ago
    Ah come on, it's not that bad anymore. My mother recently had some x-rays done because of a broken knee and all the files were sent digitally to the doctor and he forwarded them to a specialist. So, it's not that bad...
    - BjoernKW 7y ago
      The last time I got a PET scan (about 3 years ago) they handed me a CD with the images and an accompanying piece of paper with a summary of the results. At least that CD included a DICOM viewer for macOS as well so I could have a look at the images myself. It's the same with other medical imaging procedures. They have machines literally costing millions but they can't afford to have a secure system for keeping and exchanging medical data. Up until a few years ago (according to my knowledge, perhaps this is still happening) paramedics routinely used WhatsApp for sending information to A&E while en route because there simply is no proper system in place to do so.
      - martin_a 7y ago
        Hm, not sure, maybe this differs from doctor to doctor. To be honest, I was also suprised when she told me that as she lives in a rather rural area and not some big town. But at least that hospital/doctors seem to be really up to date with their tech.
  - DataWorker 7y ago
- feiss 7y ago
  In my area (Northwest Spain) medical info is recorded in the public health system, which is universally free. I can go to any public medical center and they can access to all my history, no need to carry anything with me apart from my card.
deleted 7y ago
[deleted]
jacobwilliamroy 7y ago
As an American, I cant afford to see real doctors or use perscription medicine, so it's not very important that they know very much about me.
- DailyHN 7y ago
  Also as an American, my medical record mostly just consists of how many days since the last time I went to the doctor. For those without insurance, less is more when it comes to number of visits. If you have insurance, the opposite is the case.
  - jacobwilliamroy 7y ago
    Yeah! It's like golf!
    - DailyHN 7y ago
      > Yeah! It's like golf! Yes, and par would be like needing a doctor about once every three months. Keep it less frequent than that, and you're winning the game. A friend of mine without insurance skateboards at a skate park. And I'm like "dude, that's pretty risky for not having insurance." He explained the math to me, as long as he doesn't break a bone or need stitches more than once every few months, then not paying for insurance saves him money even if he has to pay $300-500 out of pocket at a walk-in clinic. For young people in America, it seems that the only time that insurance isn't a net negative is when: 1) you have a chronic illness that requires regular treatments, 2) you have been diagnosed with cancer, and 3) pregnancy.
      - dragonwriter 7y ago
        > For young people in America, it seems that the only time that insurance isn't a net negative Insurance inherently is on average a net negative, but it constrains the risk that your needed costs unexpectedly are significantly above average, which can be catastrophic otherwise, especially in a system where care beyond immediate stabilization is gated by ability to pay. so that not having resources doesn't just mean a debt dischargeable in bankruptcy but potential denial of care.
dsfyu404ed 7y ago
The quality of any given countries healthcare system is mostly tangential to which parties of the system are responsible for getting patient data where it needs to be. It doesn't really matter in the grand scheme of things whether the patient, patient's physician or some central 3rd party is the record holder.
tim333 7y ago
The question can make sense in any country really. Even if you are some place like Spain say which I gather has a sane electronic records system you still have issues if you get treated by someone outside the system, say in another country. The UK's system, where I'm from is famously a mess. I think we hit a record with "£12bn NHS computer system is scrapped..." My aunts doctor has a GP system and the local hospital has another and when she collapsed and was treated in the hospital the doctor can't see the records as different systems. I guess unless they print it out and shlep it over somehow.

As read from Europe, it's really scary to realize that this question makes sense in a first world country.

by fab13n 7y ago

As read from Europe, it's really scary to realize that this question makes sense in a first world country.

jotm 7y ago

How so?

frabert 7y ago
Every medical interaction is recorded on a nationwide network - at least here in Italy. Every time I go to my doctor and they prescribe me something / they give me a shot / vaccine, it gets recorded and every other doctor can access the same data when I present my "health smart card"
- c0restraint 7y ago
  That sounds both amazing (from a patient in need POV) and scary (from a privacy POV). I’m interested in both
  - judge2020 7y ago
    It sounds like a great system assuming the smart card is a like a credit card with the chip in it, and you needed that to view medial records. Unfortunately I seriously doubt that's the case.
    - frabert 7y ago
      It's actually a smart card with a chip in it. It also has a magnetic stripe, I guess for legacy purposes. Here is a sample: https://www.sanita.puglia.it/documents/20182/134679/TSCNS+fronte+%28puglia.gif%29/eeaf006f-5db5-4b6f-bb2c-fa45ace23196?t=1448290285227 https://www.sanita.puglia.it/documents/20182/134679/TSCNS+fr...
- n0on3 7y ago
  well, to be honest, this sounds like kind of overselling reality. There is a system in place that tracks and records some things, like days off prescribed by base doctors, prescriptions for which national care pays and few other stuff, but most of everything else, including charts from when you are admitted in most hospitals and of course whatever you do outside of the public care (which kind of sucks and has insane waiting times, which means you most often do) is not included in that. So.. nope.
  - davidw 7y ago
    > public care (which kind of sucks and has insane waiting times, which means you most often do) You should see what it's like in the US. Italy's certainly not perfect, but faults and all, I'd happily go back to that system from the one we have here in the US. It does make a difference where you are in both countries, though; in Italy I lived in Padova, where things mostly work pretty well.
- gerardnll 7y ago
  Pretty sure you talk about the NHS.
BjoernKW 7y ago
In Germany, for example, medical records are scattered across medical practitioners, hospitals and health insurance providers. There's no central, distributed or federated EMR system. Each practice or hospital basically runs its own system, sometimes dating from the 1980s. MS-DOS is still widely used in surgeries. Data transfer (i.e. lab results, consultation results) happens mostly on paper, that is the patient usually gets handed a letter with the results to present to their GP. Lots of information is lost this way. Examinations and analyses often are duplicated or done repeatedly.
- martin_a 7y ago
  Ah come on, it's not that bad anymore. My mother recently had some x-rays done because of a broken knee and all the files were sent digitally to the doctor and he forwarded them to a specialist. So, it's not that bad...
  - BjoernKW 7y ago
    The last time I got a PET scan (about 3 years ago) they handed me a CD with the images and an accompanying piece of paper with a summary of the results. At least that CD included a DICOM viewer for macOS as well so I could have a look at the images myself. It's the same with other medical imaging procedures. They have machines literally costing millions but they can't afford to have a secure system for keeping and exchanging medical data. Up until a few years ago (according to my knowledge, perhaps this is still happening) paramedics routinely used WhatsApp for sending information to A&E while en route because there simply is no proper system in place to do so.
    - martin_a 7y ago
      Hm, not sure, maybe this differs from doctor to doctor. To be honest, I was also suprised when she told me that as she lives in a rather rural area and not some big town. But at least that hospital/doctors seem to be really up to date with their tech.
- DataWorker 7y ago
feiss 7y ago
In my area (Northwest Spain) medical info is recorded in the public health system, which is universally free. I can go to any public medical center and they can access to all my history, no need to carry anything with me apart from my card.

deleted 7y ago

[deleted]

jacobwilliamroy 7y ago

As an American, I cant afford to see real doctors or use perscription medicine, so it's not very important that they know very much about me.

DailyHN 7y ago
Also as an American, my medical record mostly just consists of how many days since the last time I went to the doctor. For those without insurance, less is more when it comes to number of visits. If you have insurance, the opposite is the case.
- jacobwilliamroy 7y ago
  Yeah! It's like golf!
  - DailyHN 7y ago
    > Yeah! It's like golf! Yes, and par would be like needing a doctor about once every three months. Keep it less frequent than that, and you're winning the game. A friend of mine without insurance skateboards at a skate park. And I'm like "dude, that's pretty risky for not having insurance." He explained the math to me, as long as he doesn't break a bone or need stitches more than once every few months, then not paying for insurance saves him money even if he has to pay $300-500 out of pocket at a walk-in clinic. For young people in America, it seems that the only time that insurance isn't a net negative is when: 1) you have a chronic illness that requires regular treatments, 2) you have been diagnosed with cancer, and 3) pregnancy.
    - dragonwriter 7y ago
      > For young people in America, it seems that the only time that insurance isn't a net negative Insurance inherently is on average a net negative, but it constrains the risk that your needed costs unexpectedly are significantly above average, which can be catastrophic otherwise, especially in a system where care beyond immediate stabilization is gated by ability to pay. so that not having resources doesn't just mean a debt dischargeable in bankruptcy but potential denial of care.

dsfyu404ed 7y ago

The quality of any given countries healthcare system is mostly tangential to which parties of the system are responsible for getting patient data where it needs to be. It doesn't really matter in the grand scheme of things whether the patient, patient's physician or some central 3rd party is the record holder.

tim333 7y ago

The question can make sense in any country really. Even if you are some place like Spain say which I gather has a sane electronic records system you still have issues if you get treated by someone outside the system, say in another country. The UK's system, where I'm from is famously a mess. I think we hit a record with "£12bn NHS computer system is scrapped..." My aunts doctor has a GP system and the local hospital has another and when she collapsed and was treated in the hospital the doctor can't see the records as different systems. I guess unless they print it out and shlep it over somehow.