- The Washington Times - Monday, May 4, 2009

People underestimate how vulnerable their medical records are, even on paper, said Dr. Brian Wicks, an orthopedist who heads a Washington state medical practice.

“Just about anybody walking by the records room in a hospital, for example, could potentially get a hold of a patient chart …,” said Dr. Wicks, president of the Doctors Clinic, practice that is making the transition to electronic health records at all of its locations.

Dr. Wicks says the chances of unauthorized personnel gaining access to a computer at a clinic would be small because electronic health records have a very high level of security and require passwords at every step.

Nigel Jones, director of the Cyber Security Knowledge Transfer Network in Britain, is less confident. “Nothing is 100 percent risk-free. Sensitive information always has the possibility of being released by an insider, an Internet hacking or accidentally.

“If I were someone giving medical details electronically,” Mr. Jones says, “I want to know where the data is held, how it is stored and if it is being held in one place.”

The question of electronic security has become more compelling as private companies, with big incentives from government, relentlessly push the technology in the medical and public health fields.

Britain, like the United States, is trying to convert medical records electronically and is trying to build security health systems “from the bottom up.”

Among the companies taking the initiative to incorporate technology-based applications and devices into the medical field is Connectyx Technologies of Palm City, Fla.

The firm distributes the MedFlash Personal Health Record (PHR) product internationally, which is made up of PC software, a portable flash drive, an emergency call center and Web portal, which allow its users to manage health care, lifestyle, insurance and personal information for themselves or as a caretaker for someone else.

MedFlash is not an Electronic Medical Record (EMR), which is a record required by health care providers to document patient encounters; it is rather a personal counterpart to the EMR.

Because MedFlash is a PHR, it stores information that is not stored on an EMR, such as prescription doses and expirations, doctors’ instructions, important contact information, family histories, future appointments, and living wills, just to name a few.

“MedFlash gives its user peace of mind knowing that they have all their information at their fingertips,” the president of Connectyx, Ronn Schuman, said. “Everyone should have one, specifically business travelers, patients with multiple illnesses, and caregivers.”

“If someone were to lose their MedFlash, our PHR Web portal is secure and Health Insurance Portability and Accountability Act (HIPAA) compliant, so outsiders cannot access personal medical records,” Mr. Schuman said.

The emergency information that is located on the MedFlash drive is not secure, since that type of information needs to be available in the event someone becomes unconscious.

“The consumer controls what they want made public; therefore, it is typically minimal contact information,” Mr. Schuman added.

Google Health and Microsoft HealthVault are examples of two free Web sites that put people in charge of their own health information by organizing health information in one place. MedFlash is able to connect members to unified EMR information on these Web sites.

Another organization utilizing Google Health and HealthVault is Physicians Wellness Network, which is based in Jackson, Wyo., and has 250 physicians in all 50 states. The network founded a Web-based platform called WebLab, which enables its customers to take a variety of health assessments, get laboratory testing and receive prompt results in a “private and secure way.”

“The purpose of WebLab is to help break down barriers in health care for the consumer,” the founder of the network, Brent Blue, said.

Barriers include cost and time, he said. Time is spent waiting for an appointment, waiting in the doctor’s office, and then waiting for the test’s results.

“For example, say someone had a family member who had a heart attack and they were concerned with their own cholesterol and want to know if they are at risk,” Mr. Blue said.

This person would go on WebLab, select a cardio risk panel test, which is sent to a physician in their state who looks at the demographics, then authorizes a test for him or her to take, he said. “This person can then go to a laboratory near their home to have blood drawn and receive the test’s results on WebLab within 24 hours if there are no abnormalities.”

Currently, there are WebLab laboratories across the country but no international laboratories because WebLab is continuing to establish relationships with labs abroad.

“WebLab is compliant with the HIPAA regulations, and our consumers can feel confident that their results and health information are secure,” Mr. Blue said.

Danya International, based in Silver Spring, is a communications, research and technology firm that has taken the medical field a step further with technological advancements using video-enabled cellular phones.

Danya recently conducted a 30-day pilot study with its Mobile Direct Observation Treatment (MDOT) device to monitor 13 English-speaking individuals from Nairobi, Kenya, who are battling tuberculosis. The World Health Organization recommends that tuberculosis patients have their medication intakes monitored through directly observed treatments, because of the disease’s deadliness, especially when mixed with HIV.

“These patients in Third World countries aren’t able to get to the clinics everyday to be observed, due to limits on transportation, and it puts a burden on the individual’s employment, lifestyle and limited finances, making it difficult for them to follow a recommended protocol,” said Danya’s chief executive, Jeffrey A. Hoffman.

With Danya’s Mobile Direct Observation Treatment, Mr. Hoffman said, patients were provided with video-enabled cellular phones capable of sending and receiving video and text messages. Patients were captured on video taking their doses of tuberculosis medication from their homes, and at a central database, health care workers then viewed the videos to insure its compliance with the direct-observation-treatment protocol.

“Our goal was to see if mobile technology would be an effective alternative for both the patient and the health-care worker,” Mr. Hoffman said.

The participants in the study expressed overall satisfaction with the MDOT program.

Ideally, MDOT programs can be used in other countries and with other diseases. “Danya will be seeking additional funding to evaluate the scalability and cost-effectiveness of the MDOT program,” Mr. Hoffman said.

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