Accessing Your Health Data

It is becoming easier and easier to access one's own health data. Many healthcare organizations offer patient portals, and many patient portals support the Blue Button and Get My Health Data movements. Although I have heard horror stories of some patients having to jump through an endless number of hoops (both administrative and financial) to access their health data, I have been relatively fortunate to be able to access lab tests, request medication refills, schedule appointments, and email my doctors through the Kaiser Permanente patient portal.

Recently I underwent a study whose results were not posted to the patient portal, and I was told that I needed to request my results through the medical records department. I was hoping for the best while fearing the worst case scenario that I would have another horror story to add to the numerous patients who found it unnecessarily difficult to access their health data.

Fortunately, the process at Kaiser was quick and easy. Upon calling my local Kaiser facility and being transferred to the Release of Information Department, I was sent an Authorization for Use or Disclosure of Patient Health Information form via email which arrived within a couple minutes of my call. The form was 1 page long and asked for my demographic information, medical record number, the recipient of the information, purpose of the request (eg, personal use, worker's compensation, FMLA, legal), which records I was requesting, media type (electronic or paper), delivery preference (electronic, mail, or pickup), and a few other simple questions. I completed the form in about 5 minutes, scanned it to PDF format, and sent it to the specified email address (alternatively I could have sent it via US mail or driven to the Kaiser facility to drop off the form in person). Within 24 hours, I received an email reply with a link to a secure file download of the study results that I requested.

Since it was my first time accessing Kaiser's Secure File Transfer, I had to verify my email address which took about 1 minute. I was then able to download my study results in PDF format. I felt that overall the process was quick and easy and that most people with access to email and a printer would be able to complete the process quickly and without much difficulty. Kudos to Kaiser Permanente!

Have you had any positive or negative experiences with accessing your health data?

Using Technology to Prepare for Doctor's Visits

How much meaningful progress can you make in a 10- or 15-minute outpatient visit to your doctor? How much of that time might be spent on reconciling details (such as medication reconciliation – that is, what medications are you currently taking and not taking?) that could have been easily addressed beforehand so you can spend your precious time talking to your doctor about your active issues?

After scheduling a routine primary care visit, I was pleased to see that Kaiser Permanente understands this challenge and is using health information technology (IT) to address it. Within a couple days of scheduling my appointment, I received the following email message:

Upon clicking the link to take me to my personal action plan and logging in to the patient portal, I was presented with options to do the following under the "Actions for next visit" section:

• Check my medications: I was able to acknowledge whether or not I was still taking previously prescribed medications
• Complete lab work: it turns out that I had forgotten to get some blood work that had been automatically recommended for me, and nearby lab locations were provided
• Prepare for my vision visit: since I had also scheduled an optometry visit, a link to an eyeglass FAQ was provided so I could understand my options ahead of time

Additionally, the "Recommended media" section included the following data and resources:

• A video with general tips on heart-healthy diet
• An automated body-mass index calculation based on my most recent height and weight
• Tobacco use documentation, including status (never smoked, BTW) and last date of documentation
• Flu vaccination status (I'm immunized!)
• Pneumococcal vaccination
• Blood sugar
• Heart/stroke risk
• Blood pressure
• Medication list, including days left for current prescriptions along with refill dates and options to do the following:
• View my prescriptions
• Contact a pharmacist
• Email my doctor

For each of the above, there were links to additional information. This is all made possible by health IT and in my opinion is a far better approach to doctor's visits that trying to address everything in the clinic. That being said, the successful implementation of health IT is necessary but not sufficient to improve health status and maximize efficiency of the healthcare delivery system. We must also get people engaged in leveraging health IT resources to manage their personal health information and make the necessary lifestyle changes to lead healthier lives.  Have you done your part?

I Want the Truth!

In the past few months I've been receiving a lot of unsolicited calls on my iPhone, so based on some online reviews I decided to see if Truecaller (https://itunes.apple.com/us/app/truecaller-number-search-spam/id448142450?mt=8) would help me identify "spam" phone calls ahead of time. Truecaller leverages feedback from its user base to determine if calls are "spam" and populates its database from this feedback.  If a call originates from a phone number in the Truecaller spam database, I see this warning on my phone:

Based on a limited number of calls over the past 2 weeks, I estimate that roughly half of my spam calls had been correctly identified as such (true positives). For the most part, the other half of my spam calls slipped through Truecaller (false negatives), after which I dutifully reported those numbers to Truecaller.

Today I received a call which Truecaller identified as spam, only to find out later when listening to the voice message that it was an automated call from Kaiser Permanente reminding me to get a flu shot. To me, it felt like an error (false positive) for the call from Kaiser to be identified as spam. While I can understand that some folks would prefer not to receive flu shot reminders, appointment reminders, or other automated communication from Kaiser and would report it as spam, it felt to me like a legitimate call. This initially made me wonder if people simply do not value calls from their healthcare providers. I then hypothesized that it would be more appropriate for people to opt out of phone messages from Kaiser, but when I went to the Kaiser patient portal, I could find any settings to opt out of phone calls (there were settings to opt out of automated email messages). So from that perspective, maybe it was fair to label it as spam after all.

Overall, despite intercepting only about 50% of my spam calls, that's a lot better than 0%, so Truecaller is an app that will stay on my phone for the foreseeable future.