FUDiabetes

“Outside meds”

So this is something that’s been mysterious and concerning to me for a long time and I’ve never understood it. None of the people I know who are medical providers understand it… but I’d like to.

I went to a new doctor today. Had never been seen in this entire hospital system before… didn’t fill out a history form that detailed my rx history. Only gave the receptionist my insurance info, drivers license, and ss number.

By the time I was seated in the room the MA had my entire rx history listed on the computer… even asking me about my rx for lancets from 5 years ago! I asked her how she knew all that… she said “it just comes up as outside meds on the computer”

How is this possible? Where is this information held and available to anyone who types in your name?

And if your entire history is so readily available to any medical provider—- why on earth do states have to set up their own network to monitor opioid prescription and make sure they’re not being repetitively prescribed (that’s not the issue here—- I’ve never taken opioids in my life)… but if it’s all there at the click of a button what’s the story?

None of my family members who are medical prescribers can answer this… which further makes it confusing??

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So you didn’t ask your previous medical provider to transfer your medical records, you didn’t bring them yourself either, but they have your history anyway? Your hospital could be using an electronic medical record system that is connected to a centralized database. E.g. Epic has the Care Everywhere network that lets member organizations exchange patient records. Here’s a list of organizations on the Epic Care Everywhere Network:


Cerner may have a similar network for their customers. Try to find out what software your current and previous medical providers use.
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No, I didn’t arrange anything whatsoever, and I’d never been to this hospital group or any affiliate of it before

Your link does remind me—- both this new hospital and my previous family doc used the epic charting system so there may be some shared data in the epic system—- but I’ve seen it extend beyond this——— a couple years ago my mom prescribed muprocin— an antibiotic ointment— for a cut I had on my hand—- she picked up a phone and called it into a local pharmacy—- next time I went to my doctor I was asked “are you still using muprocin?” Somehow the fact that I’d filled an rx for it appeared in my e-chart

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Couldn’t that be it right there? The insurance company would have your Rx history and could share it with your medical provider (I think their contracts generally give them the right to do that.)

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Electronic health records (EHRs) are mandated at this point in time, and certainly any larger practice or system will have them. Most go through one of a select few companies, allowing for maximal portability across systems and removing the need to get unwieldy paper charts to transfer doctors. There are any number of flaws with the system (most notably how cumbersome some are to use), but they are also super convenient in many ways. I know it’s very helpful for me.

While anyone in the hospital system with access to medical records can theoretically look at yours, several security protections make that unlikely. One, the system tracks all activity and audits are routinely performed to determine access was warranted. Two, patients who are members of the hospital staff in anyway, family of hospital staff, famous people or otherwise likely to be of higher risk of people snooping on them, are all given added protections. That means if I, as someone with access, want to access one of those files, it first gives me a warning screen that prompts for confirmation that I need to access this file and also notification that I am “breaking the glass.” Breaking the glass is automatically audited. I’ve done it before because I’ve had patients in that category, so it was fine, and as hospital staff at one point, presumably all of my doctors/providers had to do the same. Anyway, it’s very clear that if you are caught in a file where you have no legit business being in (including your own, on the staff side of things anyway—you have to go through the patient side process to request it), you will likely be fired.

These days pharmacies are also digital, and I’m guessing linked to your record somehow, especially for your PCP. I wouldn’t be surprised if it updates the EPIC system. I do know it’s typically not hard for hospitals to get that info from pharmacies for patients, and you may have already consented to that without realizing it at some point.

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My endo clinic uses MyChart for EHRs. And my regular internist also uses MyChart but is associated with a totally different hospital system.

I, too, was surprised when my internist knew about my latest eye exam by my endo clinic. I wouldn’t have thought a totally different hospital would have access to my endo MyChart portal. I have never shared or permitted the data to be shared. MyChart does actually prompt on sign-in to ask if I’d like to share my data with the two different hospital systems. I always say NO! Strange.

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MyChart is a service provided by Epic. The two hospitals thus must be using the Epic EHR system and are probably part of the Epic network, which allows them to exchange your data. I guess that bypasses MyChart.

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Yeah MyChart is the patient portal, so it’s just about your access to your chart, not where your chart etc is stored. Epic is the EHR, where everything including the info you can access on MyChart, but also much, much more, is stored.

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That said, pro-tip, if you’re having trouble getting ahold of a dr, message them through a portal like MyChart. That creates a message for them in Epic, which is then a flag on their account as unresolved until they deal with it, unlike leaving a voicemail or emailing them directly.

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Oh, I didn’t know that. I don’t know why MyChart bothers to prompt then to allow Sharing!!

Thanks, I’ve done this, and they seem to get the message!

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And at least in my wife’s hospital group they are required to respond to messages within certain timeframes, among other things, to be eligible for their “quality care” bonus

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Love My chart. Has made everything so much easier, especially prescriptions and scheduling appointments.

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EHRs are not compatible across the board, so there are a lot of incompatibilities right now. In your case, though, your new provider’s EHR system is clearly compatible with one from at least one of your recent physicians.

I understand your privacy concern. The other side, of course, is that each practitioner gains a lot by knowing the info contained in all your other practitioners’ files. It is a difficult balance.

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I have a question if anyone knows. Are they inputing past medical history or just the current history once they are using a shared system?

My past group was managed by EPIC, but everything was not on a shared system at that point. When I moved I had to bring my last few years of medical history with me. I see they are both listed on the share network.

So I am wondering do they go back and put past records, just recent information, or current information into the system?

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My last physician asked for 2-3 years of past records when I moved to his practice. The past records are now part of the electronic records he has for me.

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