Tag: medical records

Bioethics Blogs

E-H-ARRGH: The Frustrating Costs and Benefits of the Electronic Health Record

April 28, 2017

by Jami Starr, MD, Clarkson University Bioethics Policy Certificate 2017

E-H-ARRGH: The Frustrating Costs and Benefits of the Electronic Health Record

 The concept of electronic medical recordkeeping was first introduced in the late 1960’s but it did not really become established until this century. Electronic Health Records (EHRs) are expected to provide a number of benefits, including: ability to track data over time, monitoring use of interventions (i.e. vaccinations), and identifying patients in need of preventive screening. Data are forthcoming as to how effectively EHRs meet these goals. What is clear, however, is that it is third party payers profit from EHRs as a result of improvements in claims processing.

The use of EHRs carries implicit hazards with respect to confidentiality. It seems no cyber security system today is impenetrable.  We have witnessed multiple breaches in the past few years involving government agencies, major retail chains, and financial institutions. If a hospital database were hacked, not only would pertinent demographics be exposed (social security numbers, insurance policies, etc.) but also personal information about diagnoses, socioeconomic circumstances, and the like.  While this is a risk with paper medical records as well, the rapid and potentially widespread dissemination of information though a computer data system is far more menacing in scope.  In most clinical settings where EHRs are employed, paper charts have been eliminated and patients do not have an option as to how personal data are maintained.  Vulnerability has been increased de facto by reliance upon this new medium.

Aside from the issues related to cyber security, there are start-up costs related to productivity, burnout and physician-patient relationships.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Medical Records and the NFL Combine

This post is part of our Blog Symposium “Applying the Americans with Disabilities Act and Genetic Information Nondiscrimination Act to the NFL Workplace.” Background on the symposium and links to other blog posts are here.  By Jessica L. Roberts In our … Continue reading

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

How to Get Patients to Take More Control of Their Medical Decisions

March 9, 2017

(The Wall Street Journal) – Now researchers and health-care providers say they’re at last figuring out how to untie this doctor-knows-best knot and get patients to take charge of their own health. They’re designing decision aids, for instance, that walk patients through different options, translating complicated medical jargon and statistics about risk into simple language and visual aids. They’re offering patients full access to their own medical records, including their doctor’s notes about them. And they’re training doctors to help guide patients to make informed choices.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Jahi McMath – Hearing to Unseal 2013 Records

The Alameda County Superior Court is holding a hearing on Thursday afternoon to determine whether to unseal medical records from the 2013 disputes over whether Jahi McMath was brain dead.  


Judge Pulido already issued his tentative ruling granting the defendant physician’s motion to unseal.  Basically, by filing the instant medical malpractice lawsuit and again contesting that Jahi is not dead, her right to privacy is outweighed.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Predicting Psychosis: Exploring Pre-Clinical Signs for Mental Illness

By Sunidhi Ramesh

This post is based on the January edition of the “Neuroethics and Neuroscience in the News” series in which Dr. Elaine Walker from Emory University discussed the ethics of assessing risk and treating brain diseases before they can be diagnosed.
This self-portrait is often used to depict the distorted
reality that many schizophrenia patients face.
(Image courtesy of Wikimedia Commons.)

“This calculator,” a 2016 headline states, “can predict your risk of developing psychotic disorders.”

Psychotic disorders, including schizophrenia and bipolar disorder with psychotic features, are characterized by noticeable deficits in “normal” behavior accompanied by hallucinations, delusions, paranoia, an early onset (the average age of onset is in the late teens or early twenties), and a derailed life course.
Because of its early age at onset, the DALY (disability adjusted life years) value for psychosis is significantly greater than that of other illnesses (1). It’s no surprise, then, that researchers are asking questions. Are there measures that can be taken to keep at-risk populations from enduring a life-hindering disability?
Fifteen years ago, the answer would be no. Today, it (just might be) yes. 

How? Researchers have recently identified patterns in pre-clinical psychotic symptoms— patterns that many psychotic patients exhibit long before they are formally diagnosed with a disorder.
In schizophrenia and other psychotic disorders that “interfere with a person’s ability to think clearly, manage emotions, make decisions and relate to others,” this pre-clinical period is called the prodromal period. During this time, patients often experience gradual disruptions in behavioral functioning (like being suspended from school or losing friends) that are accompanied by subclinical or reduced psychotic symptoms (like hallucinations and delusions).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Electronic Health Records May Help Customize Medical Treatments

Medical records don’t simply store facts about an individual’s health. There’s a big potential for a database of medical records to be mined to help shape an individual’s treatment

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Reflections on Egg Donation in Canada

Claire Burns recommends legal and practical changes for promoting the ethical treatment of egg donors within Canada.

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Have you heard? The Government of Canada plans to introduce regulations to support the Assisted Human Reproduction Act of 2004! Amazing! I’m jumping for joy! After more than 12 years, the government may finally make good on its promise to protect the interests of women involved in assisted reproduction.

I’m Claire, and I am an egg donor.  I am also an egg donor advocate. Much of my advocacy work is done through the We are Egg Donors website. As part of that work, sometimes I get asked to be speak on the radio or to talk to journalists. ALWAYS I am asked, “how much do you think egg donors should get paid?” Often the question is asked as if it’s news that women are getting paid to sell parts of their bodies. Yeah. That’s a real modern day news story.  Let me tell you Canada, illegal payments and reimbursement to so-called ‘donors’ is only the TIP of the ethical iceberg. Swim deep here with me friends, swim deep.

According to the Government notice from Health Canada, the Assisted Human Reproduction Act “was written to be a comprehensive legislative framework to help protect and promote the health, safety, dignity and rights of individuals who use or are born of assisted human reproductive technologies in Canada.” The problem with this statement is that egg donors don’t technically USE assisted human reproductive technologies. Rather, reproductive technologies are USED on us.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Novel system to get dying patients an experimental cancer drug raises hopes — and thorny questions

The drug was still experimental, but clinical trials suggested it could be a lifesaver for patients with a lethal form of blood cancer called multiple myeloma.

And those patients were clamoring to get it. They overwhelmed drug maker Janssen Pharmaceuticals with requests for the medication.

Most companies don’t know how to handle such requests. Often, it’s the richest patients, or the best connected, or those who run the most compelling social media campaigns who end up getting the drug. Everyone else is out of luck.

Janssen’s parent company, Johnson & Johnson, decided on a unique approach: Rather than try to deal with the barrage of requests itself, it asked a leading bioethicist to create an independent committee to determine which desperate patients could get access to the limited supplies of its experimental drug, known as daratumumab.

A year and a half later, the company and patient advocates deem the process a success — and the bioethicist, Arthur Caplan, is looking to replicate it with other drugs, starting perhaps with a psychiatric therapy.

But the novel system has also raised some thorny questions.

One ethicist who strongly supports the concept in general nonetheless asks whether it is truly wise to eliminate all personal lobbying and decide who gets access to drugs based only on anonymous medical records. What if someone like scientist Stephen Hawking is in the mix, he asked: Shouldn’t he get priority access to a lifesaving drug, for the good of humanity?

“Imagine if he wasn’t saved, what a difference in the world there might have been,” said Dr.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Special Report: ‘Superbug’ Scourge Spreads as U.S. Fails to Track Rising Human Toll

September 12, 2016

(Reuters) – In each case – and in others Reuters found – death resulted from a drug-resistant bacterial infection contracted while the patients were receiving hospital care, medical records show. Their death certificates omit any mention of the infections. Fifteen years after the U.S. government declared antibiotic-resistant infections to be a grave threat to public health, a Reuters investigation has found that infection-related deaths are going uncounted, hindering the nation’s ability to fight a scourge that exacts a significant human and financial toll.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

IBM’s Watson Diagnosed Patient in Ten Minutes

(Medical Tourism Magazine) – After months of physician-failed diagnosis, a super computer steps in and saves the life of a female patient from Japan, suffering from leukemia. IBM Watson Health has committed to developing a partnership between humanity and technology with the goal of transforming global health. With the ability to read 40 million documents in 15 seconds, IBM’s Watson –super computer powered with artificial intelligence- studied the patient’s medical records for ten minutes and was able to compare her type of cancer against 20 million oncological records, according to International Business Times.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.