Look at your medical records online

[MillCreek]

"The recently released CMS-ONC 21st Century Cures Act requires that health care providers immediately release certain sets of data via online patient portals beginning Nov. 2. The ruling – referred to as “information blocking” – does allow for some very limited and specific exceptions related to safety/preventing harm, privacy and compliance with other state and federal laws."

What this means is that if your healthcare provider is using an electronic medical records system (most are) and they are not already releasing your records/test results (most are), they have to start doing this in a few weeks.

Most electronic medical records system have a patient portal; i.e.: MyChart in Epic.  You can log into the patient portal of your healthcare system and view the records that way.

[Ben]

I've been using these e-charts for years to see my test results, vitals, etc. Does this act make data available that I might not have seen before?

[lee n. field]

"The recently released CMS-ONC 21st Century Cures Act requires that health care providers immediately release certain sets of data via online patient portals beginning Nov. 2. The ruling – referred to as “information blocking” – does allow for some very limited and specific exceptions related to safety/preventing harm, privacy and compliance with other state and federal laws."

What this means is that if your healthcare provider is using an electronic medical records system (most are) and they are not already releasing your records/test results (most are), they have to start doing this in a few weeks.

Most electronic medical records system have a patient portal; i.e.: MyChart in Epic.  You can log into the patient portal of your healthcare system and view the records that way.

Are these full records including doctor comments, or just things like test results?

I'll have to poke through them.

Back when I was dealing with prostate cancer, I wondered if there was an actual plan, or if everyone was just blundering around.

[AZRedhawk44]

MillCreek:

I'm about 10 years removed from DBA work for Health care, but I used to host EHR systems for small practices that couldn't afford a dedicated IT department and infrastructure.  We had 50 practices and about 500 or so doctors as customers.  Each had their own isolated environment.

What is the architecture of this mandated portal?  Is data transmitted from the EHR of choice and its database, to a web portal that is administered elsewhere?  Is every practice required to develop or purchase their own web portal infrastructure?  Does the customer log on to a portal at the software vendor's site (i.e. NextGen.com), or at the practice website (i.e. desmoinescardiologyspecialists.com)?  Does the patient have any say to refuse transmission of his EHR data to an external portal?

[RoadKingLarry]

I've been using "My Chart/EPIC" for several years now. Test results are pretty good. Actual medical stuff regarding actual medical conditions has been mostly vague as hell with little more than executive summary level details.  Once in a while it seems something with detail accidentally get posted.
4 major surgeries and numerous tests and imaging, MRI, CAT scans and Xrays, in the last 3 years.
Better than what was available before which was nothing.

[Jocassee]

MillCreek:

I'm about 10 years removed from DBA work for Health care, but I used to host EHR systems for small practices that couldn't afford a dedicated IT department and infrastructure.  We had 50 practices and about 500 or so doctors as customers.  Each had their own isolated environment.

What is the architecture of this mandated portal?  Is data transmitted from the EHR of choice and its database, to a web portal that is administered elsewhere?  Is every practice required to develop or purchase their own web portal infrastructure?  Does the customer log on to a portal at the software vendor's site (i.e. NextGen.com), or at the practice website (i.e. desmoinescardiologyspecialists.com)?  Does the patient have any say to refuse transmission of his EHR data to an external portal?

I can't speak to the smaller EHR companies, but I know that Epic, McKesson, eClinicalWorks, the big ones, have the patient portal built in, and it's talking to the DB (or set of DBs) that the interface they are using in patient rooms uses.

As far as the other nuts and bolts, i can speak to Epic and how it moves data, but no idea about the rest. Typically the portal is just an Epic web portal with a customized URL.

[MillCreek]

https://www.opennotes.org/onc-federal-rule-interoperabilty-information-blocking-and-open-notes/#:~:text=The%20program%20rule%20on%20Interoperability,healthcare%20provider%20beginning%20November%202

Here is a good explanation of the types of information that will be available online from your medical records.  When I look at my records in MyChart, I see the exact same progress notes that are prepared by the clinician for the medical record.  I can either see the progress notes or the AVS: the after visit summary, which is a summary of the visit that we print off and hand to the patient as they leave.

What Jocassee says regarding each major EHR having their own portal is spot on.  Generally speaking, you log into the website of your healthcare provider and access the internal chart portal from there.

The major exception regarding records that will not be available are psychotherapy notes, which can in some circumstances be withheld from the patient if doing so causes danger to the patient or others.  This is no different than current standards for paper or electronic records.

PS: I have for years been a proponent of giving patients their actual medical records upon request, and did several pilot projects on this under the OpenNotes banner.  It is my opinion based on my experience, that patients have a better understanding what is going on, are more likely to follow medical advice, and have fewer questions afterward.  The VA was one of the early adopters of this concept with the Blue Button, and it was their positive experience with this that helped bring others along into the fold.

[Ben]

PS: I have for years been a proponent of giving patients their actual medical records upon request, and did several pilot projects on this under the OpenNotes banner.  It is my opinion based on my experience, that patients have a better understanding what is going on, or more likely to follow medical advice, and have fewer questions afterward.  The VA was one of the early adopters of this concept with the Blue Button, and it was their positive experience with this that helped bring others along into the fold.

I find that having historical records of my chart gives me an almost nerdish interest in my health history and causes me to want to improve scores that need improving.

[MillCreek]

I find that having historical records of my chart gives me an almost nerdish interest in my health history and causes me to want to improve scores that need improving.

Now this is the kind of motivated and self-aware patient that makes practicing medicine a joy.