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don't want to make you paranoid, but...

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#21 scruffy1

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Posted 10 July 2018 - 11:57 AM

presently medical records have a mandatory retention of 7 years, or for minors, 7 years after then become majors, which is defined as 18 years old

 

thereafter, paper records were routinely purged, and even records only a few years old were moved to storage, which was often at a different physical location

 

 

 

despite the feds enthusiasm, no-one has educated us (the interface) with where the info will actually "happen"

 

equally, from a medico-legal standpoint, as the receivers of information, we are supposed to instantaneously "know" the content and thus take on the responsibility for any failure in assimilating it into a current issue, even though it may be from years ago and not actually ever told to us personally

 

 

 

thus we are currently not inclined to have patients hand us an old pile of notes should their previous gp retire, or they simply choose us - either it's a simple summary (which might be the myhealth idea), or we require them to sit in on a paid consult to sift through wheat is often a large amount of mostly irrelevant data

 

 

like other paperwork, the insinuation that "well, can't you do that in your spare time" neglects the reality that as a busy gp, i don't have spare time, and if i do, it's MY time, not for more unpaid workload, of which there is already plenty (checking results, reading replies to referral letters and formulating a plan for care)

if people complain, i usually check their occupation, and suggest that they might barter - "oh, i see you're a senior chef... i'll do it while you rip round to my place and prepare dinner for me..."

 

 

 

when we were first dong work on the "core data set", it was clear that the useful things would be - age / sex / names / allergies / current (and past) medication / known illness / surgical procedures / injuries / any old pathology and investigations (pure data, not rambling notes) / concise reports from senior parties

 

even wrt pathology - numerous providers mean comparison of cumulative numbers is nigh on impossible - the data isn't granular or even often showing prior results from the same lab on the current sheet

 

 

all that stuff WOULD be useful, and even moreso if the medical record in the gp rooms was a standardised interface - which it isn't; swap practice and you may have a whole new system to comprehend - not unlike windoze . mac . linux... not dissimilar, but nothing like "the same"

 

 

enough !  it's my day off, and i don't really need the aggravation of a reasonable concept delivered with all the rationality of a tony abbott speech


ummmmmmmmmmm............


#22 SquallStrife

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Posted 10 July 2018 - 01:32 PM

I was amazed by how cool microfilm was!


Film in general is pretty awesome.

Kodachrome-64 colour slide film is estimated to yield something like 50MP of resolution, and archival microfilm goes well beyond that.
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#23 Master_Scythe

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Posted 10 July 2018 - 02:58 PM

 

I was amazed by how cool microfilm was!


Film in general is pretty awesome.

Kodachrome-64 colour slide film is estimated to yield something like 50MP of resolution, and archival microfilm goes well beyond that.

 

 

I'd believe that.

 

We had A4 paper blown up to what must be bilboard size by default (accidentally), and it was clear as anything!

Just, my god!


I haven't seen a SCSI card for years.....

 

Yeah, it was amazingly cool to see such fast data transfer on such archaic hardware. I'd never have expected it.


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#24 Kothos

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Posted 10 July 2018 - 06:45 PM

 


So now we know 3 things.

1. They just gave someones high level access passwords to someone on the phone, who has not proven their identity.

2. They do NOT require any sort of password length or complexity.

3. The passwords are stored in plain text because he was able to read them back to me!!!!

 

Good god.

 

 

That's insane.  I mean I know a lot of support people are just too lazy/bored/untrained to withstand some of the more sophisticated social engineering tactics, but that's just INSANE.



 

all that stuff WOULD be useful, and even moreso if the medical record in the gp rooms was a standardised interface - which it isn't; swap practice and you may have a whole new system to comprehend - not unlike windoze . mac . linux... not dissimilar, but nothing like "the same"

 

 

Come to think of it, it sounds like they should have set interface standards for retail medical record software before they tried to implement the MyHealth system.  Otherwise, what's the point?


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#25 scruffy1

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Posted 10 July 2018 - 09:25 PM

 



 

Come to think of it, it sounds like they should have set interface standards for retail medical record software before they tried to implement the MyHealth system.  Otherwise, what's the point?

 

 

 

 

 

 

aye, there's the rub

 

but that's like telling macs amd windoze and linux and android (add any o.s. you like) to co-operate

 

the differences between systems are their sales point, and like the white world of i-things, the idea is to lock you into a system that isn't easily swapped, without impossible extra expense

 


ummmmmmmmmmm............


#26 Rybags

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Posted 10 July 2018 - 09:53 PM

One country isn't going to dictate such standards.

 

And if there was a standard it'd be something that'd be affordable, so for a rich place like here we'd probably end up with something like chest X-Rays being stored as 1200x800 JPGs @ 70% quality which would be a joke.

As mentioned too, there needs to be standards for culling and summarizing the data as well.

 

Whether many or any of these and plenty of other things were considered, who knows?

The other thing is you have a big variability in the amount of technology in use in private practices and the efficiency of it's use.

Lowest common denominator bullshit can keep the system decades behind where it should be.



#27 eveln

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Posted 10 July 2018 - 10:06 PM

" Lowest common denominator bullshit can keep the system decades behind where it should be." << ain't that the truth ?!


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#28 Jeruselem

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Posted 16 July 2018 - 01:34 PM

You can use the web site to opt out now.

You need a medicare card !!!


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#29 scruffy1

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Posted 16 July 2018 - 09:44 PM

and.... i'm out

 

and mr 16, and ms 24

 

 

 

i would encourage anyone who feels the government is not a responsible enough entity to be trusted with their intimate details, to opt out now... you can always change your stance later in light of how well the system is progressing, but if you stand idly by and watch the shit hit the fan, it'll be your own entrails hanging from the chandeliers of parliament

 

apparently the online opt out server is buckling under the strain.... shades of the last census, anybody ?


ummmmmmmmmmm............


#30 Jeruselem

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Posted 16 July 2018 - 09:51 PM

And I'm out ...


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#31 scruffy1

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Posted 16 July 2018 - 10:05 PM


Lowest common denominator bullshit can keep the system decades behind where it should be.

 

it's bad enough when the power goes off, or the internet, or the local server dies - no results, no records, no nothing except personal memory of individuals

 

 

once the feds' centralised centre has a brainfart,it's gonna get ugly real fast


ummmmmmmmmmm............


#32 eveln

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Posted 16 July 2018 - 10:31 PM

...

 

apparently the online opt out server is buckling under the strain....

Lol. there's a great show of support for the Gov. system ...not :)


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#33 Jeruselem

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Posted 16 July 2018 - 10:56 PM

 

...

 

apparently the online opt out server is buckling under the strain....

Lol. there's a great show of support for the Gov. system ...not :)

 

On balance, most sheeple would probably keep their account. Us paranoid minority are crashing the system, when it goes live it would be have to handle the sheeple logging on - and it can't handle the few who are opting out.


Edited by Jeruselem, 16 July 2018 - 10:57 PM.

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#34 Kothos

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Posted 17 July 2018 - 12:24 AM

I opted in ages ago.  I have chronic health problems (not serious ones, but still) that I would like any doc I go to to have access to.

 

Of course, they don't, because the records aren't there!  But anyway, one lives in hope.

 

You can set up an alert system to get notified every time someone access a record.  That should at least reduce the risk of unauthorised access.  If the data is lost wholesale though, that's a different story.  But I'm assuming if that happens, millions of people will be in the same boat and the government would have to get rid of the system and start again.  (I'm not worried about my health records being public knowledge, I'm worried about identity theft).


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#35 Jeruselem

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Posted 17 July 2018 - 10:09 AM

I opted in ages ago.  I have chronic health problems (not serious ones, but still) that I would like any doc I go to to have access to.

 

Of course, they don't, because the records aren't there!  But anyway, one lives in hope.

 

You can set up an alert system to get notified every time someone access a record.  That should at least reduce the risk of unauthorised access.  If the data is lost wholesale though, that's a different story.  But I'm assuming if that happens, millions of people will be in the same boat and the government would have to get rid of the system and start again.  (I'm not worried about my health records being public knowledge, I'm worried about identity theft).

 

The government polices the data breach reporting system so there's breach in it's own systems, we wouldn't know and they wouldn't tell us.


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#36 Nich...

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Posted 17 July 2018 - 11:57 AM

On balance, most sheeple would probably keep their account. Us paranoid minority are crashing the system, when it goes live it would be have to handle the sheeple logging on - and it can't handle the few who are opting out.

I somehow never get bored of your lofty flights of paranoia.
 
 

it's bad enough when the power goes off, or the internet, or the local server dies - no results, no records, no nothing except personal memory of individuals
 
 
once the feds' centralised centre has a brainfart,it's gonna get ugly real fast

It's ok, they'll be fine with you just rebooking the clients and charging the DoH twice, right?
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#37 scruffy1

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Posted 17 July 2018 - 01:16 PM

 

it's bad enough when the power goes off, or the internet, or the local server dies - no results, no records, no nothing except personal memory of individuals
 
 
once the feds' centralised centre has a brainfart,it's gonna get ugly real fast

It's ok, they'll be fine with you just rebooking the clients and charging the DoH twice, right?

 

 

 

can't edit the quote string, but :

 

what "normally" happens if the system fails, is i have to wing it and write longhand notes that later still get transferred to the electronic notes once the system goes back up - at no payment for the time required, and unless i then generate all the stuff i did longhand (scripts / investigation requests / letters) a second time, there is no record

and no, d.o.h. will not homour a bill where i don't personally do domething with a patient present - so no show = no dough

 

how's that for efficiency ?

 

i don't have "clients" (that's hookers and business people; i have patients. old school style)

 

if there's opportunity, the front desk attempt to reschedule booked patients (which isn't appropriate for urgent stuff), and in any case, they don't generally know who will turn up as their records won't work either, and there is no automatic backup of the day's appointments that can be accessed from a dead system

 

 

 

on the plus side, i actually really enjoy not having a screen distract me from the person i am seeing - as my typing skill is crap, i find i need to look at the keyboard to generate records, and even though i am quite capable of listening and making noted at the same time, i can't make eye contact while i look at my fingers, and there are often subtle visual cues in a conversation that float past uncaught when the computer is in play

 

the consultations without a computer are far more natural, and i get nostalgic for days of yore when the notes were more for assisting care rather than protecting my butt from medicolegal reaming - the quality of care is no better with concise notes, but the toime wasted on documenting trivial detail is unavoidable


ummmmmmmmmmm............


#38 Jeruselem

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Posted 17 July 2018 - 01:19 PM

It will interesting how the "secondary use" clause on MHR gets used.


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#39 scruffy1

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Posted 17 July 2018 - 05:55 PM

It will interesting how the "secondary use" clause on MHR gets used.

 

most especially for welfare recipients i would expect


ummmmmmmmmmm............


#40 eveln

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Posted 17 July 2018 - 07:09 PM

" on the plus side, i actually really enjoy not having a screen distract me from the person i am seeing - as my typing skill is crap, i find i need to look at the keyboard to generate records, and even though i am quite capable of listening and making noted at the same time, i can't make eye contact while i look at my fingers, and there are often subtle visual cues in a conversation that float past uncaught when the computer is in play "

 

I thoroughly endorse the above thought process :)

 

When I visit our Doc. I enter the room with my paper record in my hand. Hand it over and he puts it down in front of him, then looks up and we talk. This is the bloke that kept an eye on me with the champix I used to help me step off the ciggs.

 

I've not opted out or in as my medical history for the last twenty years is pretty slim pickings. I dare say if I had some serious thing going on that needed up to date records then I'd feel differently. Tho with what I'm reading here, it's another half arsed attempt so far.

If somebody chooses to take my identity then I guess they will regardless of what I opt in or out of. Life's a real bitch like that.


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