October 28, 2024 • 32 mins
As technology becomes more and more prevalent in the way we receive and even schedule our care, what role do patients play in embracing health information technology to improve health and the health care experience? We wrap up our empowered patient series with Dr. K talking about how technology can prevent health issues or track and help you better understand your health, your care plan and communication with your providers.
If you have a question for Dr. K, email QandAwithDrK@mpqhf.org. Your question will remain anonymous.
Additional resources for this episode
Health IT: Advancing America's Health Care: https://www.healthit.gov/sites/default/files/pdf/health-information-technology-fact-sheet.pdf
Mayo Clinic Personal Health Records and Patient Portals: https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/personal-health-record/art-20047273
Johns Hopkins Medicine Benefits of Telemedicine: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine
HealthIT.gov Your Health Information Security: https://www.healthit.gov/topic/your-health-information-security
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Beth Brown (00:00):
Music.
(00:10):
Welcome to Q and A with Dr. K, apodcast by Mountain Pacific
Quality Health, where we sitdown with Dr. Doug Kuntzweiler
and get your health questionsanswered, because on Q and A
with Dr. K, the doctor is alwaysin.
(00:36):
Hello, everyone. This is BethBrown, your host, and joining
us, as always, is the wonderfulDr. Doug Kuntzweiler, Mountain
Pacific's chief medical officer.
Thanks again for always beinghere with us, Dr. K, to answer
our questions.
Dr. Doug Kuntzweiler (00:48):
Thanks for having me, Beth.
Beth Brown (00:49):
So we're back with what is going to be the last
episode in our series. We'vebeen talking about how to help
patients feel empowered and tobe more confident in the way
that they are getting theirhealth care and taking care of
their health. And so in ourfirst episode, we dove into the
importance of asking questions,and how asking those questions
can improve the communicationyou have with your providers and
(01:12):
to help you better understandyour health. And so I would
invite people to go back andlisten to that episode if they
haven't already. And then wetalked with you, Dr. K, and with
one of our pharmacists, Kyla,about truly knowing your
medications and taking advantageof your pharmacist, because your
pharmacist is such an amazingand available health resource
for your health care and foryour health. So today, what
(01:32):
we're going to talk about issome of the ways that technology
can help us better manage ourhealth and better navigate our
health care and how to feelempowered and more confident
about how we use healthinformation technology, or HIT,
or health IT has differentnames. So Dr. K, let's start
with what are we talking about?
What all can HIT, or healthinformation technology,
(01:55):
encompass?
Dr. Doug Kuntzweiler (01:58):
Everything that I don't understand.
I am one of the boomiest of theboomers, and almost nothing that
I was using at the end of myactive medical career existed
when I started in practice. Igrew up during the polio
epidemic in the 1950s, and I,over the course of my life, had
(02:20):
gone from iron lungs used toventilate people to home
ventilators. So healthinformation technology takes in
all of this, mostly electronic,not exclusively, but mostly
electronic technology thatcenters around every aspect of
health care. So it encompassesthings like electronic health
(02:43):
record. Do the electronicmedical record instead of
handwritten notes. Now,everything is digital and
available digitally. It includesthings like patient portals,
which are they sound likesomething you crawl into, but
basically, it's just a websitethat allows you to access
information about your healthcare, all of the monitors, the
(03:04):
sophisticated monitors that weuse in the hospital. Now, even
the billing is all doneelectronically. Now, nothing
gets mailed anymore. It's alldigitized, and it also
encompasses things like medicaljewelry, like fitbits and the
rings and other watches thattrack how active you are during
the day, how many steps youtake, some of them even track
(03:26):
your sleep. Continuous glucosemonitors, it used to be that
diabetics were poking themselvesin a finger twice, three times a
day, and they wound up withnothing but scars on their
fingertips. Now there aremonitors that go on their their
arm, around their abdomen, andthey continuously monitor the
glucose. And some of them thenwill Bluetooth it to their
(03:48):
telephone so they know minute tominute what their blood sugar
is, just to see change in in themanagement of diabetes. And
there's just almost no end toit. Blood pressure monitors are
all digitized now and record andit's just incredible. When you
you think about the technologythat we are surrounded with that
(04:10):
relates to our health, it isamazing.
Beth Brown (04:13):
And to your point, a lot of these technological items
were very much used by providersand were not so much used by the
patient, but now that has beenanother big shift over time that
it's not just the providersgetting into those electronic
medical records or electronichealth records, but we're
encouraging patients to get intothem too via those patient
(04:35):
portals. So can you talk aboutthat shift a little bit of why
it really is becoming somethingthat patients use as much,
arguably, as providers, and whythat is important, and maybe
people should try to overcometheir fears or their discomfort
with some of these electronic ordigital tools.
Dr. Doug Kuntzweiler (04:54):
Yeah, when I started in medicine in the
late 70s, the chart was createdby the people providing care,
the physicians and the nurses.
And the thinking was that, isour chart, and patients weren't
granted access to it. They hadto go to extraordinary measures
if they wanted their chart orwanted to be able to read it.
(05:16):
And it was this sort ofNeanderthal thinking that, well,
I made this chart, it's mine.
Even though it is about the mostintimate details of your health,
you're not allowed to look atit. And so over time, there was
this change where patientsdemanded to be able to look at
their charts. And that hasgradually changed. And now what
(05:37):
providers have come to realizeis that the patient who has
access to their chart and seeswhat's going on is a better
patient. They're more involvedin their health care, they are
more likely to be compliant withrecommendations and with the
decisions that they have helpedto make about their treatment.
So it has gradually shifted, andwho is more concerned about your
(06:00):
personal health than you are,and this access to your chart
and to your information allowsyou to be intimately involved
with that. And if it's going tobe useful, your medical record,
all of these technologicalthings we've talked about that
relate to your health, they needto be accurate, and you are the
only person who really canprovide that that accuracy. I
(06:24):
I've had charge where my birthdate was wrong or where my name
was spelled wrong. If you thinkabout things like reconciling
your medication list, you know,if you're young, it's probably
not very relevant, but as youage, you wind up getting put on
more and more meds every fewmonths, one is stopped, another
is started, and it doesn't takeany time at all before nobody
(06:47):
knows what you're actuallytaking, probably including
yourself. But with an electronicmedical record in the
digitization in the pharmacies,it's much, much easier to keep
that medical record accurate,and it needs to be complete.
People see different providers,and they sometimes, you know,
when they're asked about theirmedical history, they will
(07:09):
forget that, oh, a cardiologisttwo years ago said I had a
mitral valve problem, that sortof thing. And if that's all in
your chart, then it is going tobe complete, and you should have
it because it is. It's readilyavailable to all of your
providers then, and everythingcan be in there, including your
advanced directives, which we'vetalked about on other podcasts.
(07:30):
So the health technology is notgoing anywhere we we have to
live with it. I know it getsfrustrating, especially people
in my generation can get prettyfrustrated with it, because I'm
not as computer savvy as youngerfolks, but it's not going
anywhere, and on the whole, itleads to better care, I believe.
So we need to be involved.
Beth Brown (07:51):
Okay, that's great.
And you talked about our chartof our electronic health record,
and some of the different itemsthat might be in there about us,
including medications. What sortof information needs to be in
there for that electronic healthrecord to be complete? What are
some of the other differentthings that people can expect to
see or that our providers usewhen we're getting health care
that are in that electronichealth record or in our chart,
(08:13):
as you said?
Dr. Doug Kuntzweiler (08:16):
Yeah, the things that are important to
your health and so an accuratehistory of your health,
including all the problems, allthe surgeries, anything that's
been a problem for you, yourfamily history, everything you
know about your family historythat you can find out that
should be in there, things aboutyour social history, like how
(08:38):
ambulatory you are, whether ornot You have food safety,
whether or not you live in asafe environment, whether or not
you are engaged in society, orwhether you know you're living
by yourself. All those thingshave huge impact on our health,
our health status, and so all ofthat needs to be in there, and
it needs to be kept up to dateand kept accurate.
Beth Brown (09:00):
And yeah, I appreciate talking about where
you live or some of the otherthings that may be affecting
your health that we might notthink of, beyond the surgeries
we've had or the conditions thatwe've been diagnosed with, and
mental health as well, correct?
We're talking more about some ofthe things that we're feeling or
experiencing emotionally andbehaviorally, beyond just
physically.
Dr. Doug Kuntzweiler (09:21):
Yeah, and things like habits like, Are you
a smoker? Do you drink alcohol?
How much exercise do you get ona regular basis? All those
things should be in there.
Beth Brown (09:31):
So when we think about how we can be a proponent
for our health, where we're inthere advocating for ourselves
and using that electronic healthrecord to do that, what does
that look like?
Dr. Doug Kuntzweiler (09:40):
Well, I think one of the first things is
look at your chart, and if thereare discrepancies or things that
are inaccurate, you know, talkto your provider about
correcting them. And thatshouldn't be any kind of an
argument is, you know, you hadyour gall bladder out and that's
not in there, then it needs tobe. The other thing I think of
(10:00):
that is one of the big benefitsof this is that there are
programs that will translate ifEnglish is not your first
language and that's probably thelanguage your chart is going to
be in. There are translationapps that can translate all of
that for you. There should bethings in there that deal with
the preventative measures,things like, what's your
(10:20):
vaccination status? Are youcurrent? Are you up to date?
Have you gotten all the vaccinesthat you should at your age? And
almost anything in there isrelevant, and you just want to
make sure that it's complete andthat it's accurate, and then
you're in a position to helpshare in decision making. You
(10:40):
will have a better understandingof your health status. You
should have a betterunderstanding of what your
provider has talked to you aboutin terms of treatment and and
there should be a note that yourshared decision making is to do
this or do that do the otherthing.
Beth Brown (10:56):
So you talked about notes. Let's build on that a
little bit because, yeah, a lotof times now, when we go in to
see a doctor, they're on alaptop, or they're on a tablet
or something, and they're takingnotes, or they have someone in
there with them that's helpingthem take those notes. So what
can you tell us about thoseappointment notes? I guess
sometimes they're also calledoffice visit summaries. What is
(11:17):
happening there, and how canthat help improve what we're
doing as patients and whatproviders are doing?
Dr. Doug Kuntzweiler (11:24):
Yeah, you have a provider sitting down
with somebody who has some kindof a problem, and you got to
look them in the eye. You haveto touch them and let them know
that you're there and that youcare about their health. Now
there are different ways than totake notes. You can have a
scribe who watches theinteraction, and they have
training, and they learn thelanguage, and they can take
(11:47):
notes, and then after that, youcan go and meet your notes. I
used to just jot down littlenotes to jog my memory, but I
did it very sparingly, and mostof the time I was engaged face
to face with the patient, but Iwould turn and make a little
note on paper. You could do thesame thing with a laptop, but
I've had providers who were juststaring at their laptop the
(12:07):
whole time and hardly everlooked at me. And frankly, it's
it's not a good experience. Now,what's in the notes the
electronic medical record shouldhave all of that historical
stuff that we talked about, yourpast medical history, to your
family history, all those suchthings. Your medication must
blah, blah, blah, theappointment note, or what we
(12:28):
always refer to as a progressnote, then, is a record of what
is happening during thisparticular visit, and it might
be a follow up for a chronicproblem. Maybe you've been
switched to a new medication,and the provider was to check
in, see how you're getting alongwith that, see if it's working,
see if you're having any sideeffects. So it's it's more
(12:50):
focused on today's problems, andthere are various formats that
are used, but it's a way torecord in some sort of routine
fashion. What's going on withyou today?
Beth Brown (13:03):
I have had providers that have headsets, too, that
they just talk into those sothat could be a little bit
better than having your nose ina laptop.
Dr. Doug Kuntzweiler (13:10):
Yeah, one thing I do like I have a
cardiologist who dictates theprogress note, and he does that
in front of me at the end of ourvisit. And I like that because
it gives me an opportunity. Ifthere was something I didn't
understand, or if he sayssomething that it actually is
inaccurate, then I can, I cancorrect him right there. And it
shows a level of confidencebetween the two. I trust him and
(13:34):
he trusts me and and there'ssome interesting research as to
how all of this electronic stuffaffects patients. One of the
studies I read shows that if thepatient has access to his notes,
there's about a 60% increase inadherence to their
recommendations. You're morelikely to keep follow up
(13:56):
appointments, you're more likelyto fill your prescription,
you're more likely to take themedications or to do whatever
therapies exactly the way theywere prescribed to you. So it
really is important.
Beth Brown (14:10):
That's awesome, yeah, because sometimes we don't
catch all those details whenwe're just having a conversation
with our provider, but if we cango back and look at what was
written down, then it sinks inand we understand it better. So
that makes a lot of sense. Sowe're going to talk about
telehealth a little bit, youknow, speaking of digitalizing
healthcare and some of thesethings that are becoming more
(14:30):
electronic, we're even gettingsome of our health care via
digital means. But before wereally jump into that, let's
talk about a term that peoplemay be hearing called electronic
prescribing, or e-prescribing.
What is that? Does that tie intotelehealth? Is that something
different?
Dr. Doug Kuntzweiler (14:46):
So what used to happen if a medication
was going to be prescribed is,towards the end of the visit,
the provider pulls out aprescription pad and writes
generally, allegiably themedication. And the dose and how
it's to be taken, and how muchmedications to be given, whether
or not to be refills. And theyhand that to the patient, who
(15:08):
then has to keep the dog fromeating it, take it to the
pharmacy, hand it to thepharmacist, who has to try and
decipher the handwriting.
Probably can't. Has to call theprovider. Says, What on earth
did you write here? I'mexaggerating some, but this
stuff really does happen. Youknow, when you write 30 or 40
prescriptions a day, yourhandwriting gets worse and worse
(15:28):
as time goes by and soe-prescribing is doing this
electronically, and mostcommonly, what happens is you,
you make a decision about whatyou're going to prescribe, which
medication it should be a jointdecision along with the patient.
And then you go to the pharmacythat is going to supply it, and
(15:48):
from a list, you pick themedication, and you click on
that, and then it will give youoptions for you know, are you
taking it twice a day or once aday, or how are you taking it.
And so you click on the correctoption for that, and then the
number and refills. So it takesthe whole handwriting thing out
of it. It takes the wholepassing the prescription from
(16:10):
provider to patient who has tokeep track of it and get it to a
pharmacy, because thingslegitimately did get lost
occasionally, or ringing down orwho knows what. So it takes that
out, as long as the prescriberhas done his clicks accurately,
and this is where mistakes canhappen, but no system is mistake
free, but as long as they arecareful in their clicks, then
(16:32):
you get the correct dosage andthe correct instructions on how
to take it, and there's a recordright of the way the pharmacist
doesn't have to remember or fileit, or, you know, do something
else to record that you got it.
It's it's right there in theircomputer banks, and so it
automatically reconciles yourprescription list. And most of
(16:54):
these programs also incorporatethings like alerts, like if
you're prescribing twomedications that might interact
adversely with each other,you'll get an alert if the
patient happens to be allergic,say, to a particular type of
antibiotic, and that's what wasprescribed, an alert will sound.
And so it's it's much better atdoing that than human beings
are. So it really is a betterway to prescribe medications.
(17:19):
Now there, there are somecontrolled substances that, in
order to make sure there isn'tany any fraud or abuse, that you
still have to have a writtenprescription for it. But in
general, most everything at thistime is electronic.
Beth Brown (17:35):
Okay, so that's when, you know, my doctor asks
where my pharmacy is, and thenthey're just sending that
prescription right over, thatwould be another reason why
having one pharmacy is good tojust simplify that whole
process, even though it's beensimplified so much already by
the electronic process.
Dr. Doug Kuntzweiler (17:52):
Yeah, one thing we haven't talked about in
all of this is that there's alot of proprietary stuff, and
like electronic health records,it would be nice if they all
transferred to each other. Andso if you are in hospital, a
that uses Meditech as their EHRsystem, and you're traveling and
you go to a different hospital,and they use Epic as their
(18:14):
electronic health record, it'sit's not guaranteed that
Meditech is going to send yourrecord to Epic, and they're very
proprietary. They're veryworried about people stealing
their trade secrets and whatnot.
It's getting better, and thereare government offices that are
working on this. Legislation hasbeen passed to try and make
these all more uniformlyavailable, and we're getting
(18:36):
there, but it's been slow, and alot of it is because, you know,
corporations are worried abouttheir secrets being stolen.
Beth Brown (18:46):
Sure, yeah, I think that's where health information
exchanges come into and stateshave been trying to work on that
as well, by creating a higherlevel system that helps those
specific hospital systemscommunicate to one another
better. So I know healthinformation exchanges have come
into play there too to supportsome improvement there. That
might be for a differentepisode. That's an explaining
(19:09):
what a health informationexchange does. But okay, so
let's talk about telemedicine alittle bit. In about two years,
from 2019 to 2021, the use oftelemedicine exploded from just
about 15% of patients usingtelemedicine to 86%, so almost
nine in every 10 people wereusing telemedicine to go see
(19:31):
their doctor. And of course, wehad a pandemic in the middle of
that, and so that really helpedpeople lean into using that
telemedicine. But now it's here,doesn't appear to be going
anywhere, but there are timeswhen using that telehealth or
telemedicine appointment makessense, and there are times when
you really should go see adoctor in person. So first,
(19:52):
let's talk about, if someone hasnever done a telehealth
appointment, what does that looklike? And then secondly, let's
talk about when should you usethose type of appointments
versus when should you reallytry to get in to see a doctor in
Dr. Doug Kuntzweiler (20:05):
Well, the appointment looks very much like
person?
a Zoom meeting. If you've everbeen in a Zoom meeting or a
Teams meeting, or used FaceTimeon your telephone when you're
talking, so it should be twopeople looking at each other on
a screen. You need to be able tohear and language needs to not
(20:27):
be a barrier. If there is alanguage barrier, then, as I
said, there are lots of appsaround that can do translation
for you, but that's what itlooks like. It's like watching
your provider on a TV screen inreal time. And that's good, you
Beth Brown (20:43):
Yeah, it seems like those sorts of follow up
know, you get some bodylanguage, you get some facial
expression, you might get betterunderstanding of what they're
saying. So it works pretty wellfor some things. Not so well for
others. It works pretty well forthings like psychiatry, which in
large part involves talking topeople and watching their
reactions. It can work prettywell for dermatology, if you
(21:05):
have a good camera. I knowdermatologists who love looking
at things through telehealth andmaking a diagnosis. It's pretty
good for managing chronicdisease, if somebody's not
having an acute problem rightnow, but let's say they're
diabetic and maybe their sugarsare a little bit out of control.
You're right there with theprovider at the screen, and they
(21:27):
can ask you about what yourdiet, what your activity level,
that you're doing with yourmedications. So it's it's good
for those kinds of things,stable, chronic and mild kinds
of problems. If, on the otherhand, you are genuinely sick,
maybe you have a new conditionthat hasn't been diagnosed yet.
(21:48):
Maybe you have symptoms that areworrisome to you more than
minor, then it's it's not sogreat. You shouldn't be trying
to diagnose people remotely,when what you really need is, as
I said earlier, to sit down faceto face and to touch them. That
touch is a huge component. Youget so much information when
(22:11):
you're face to face, watchingthe patient breathe, watching
them move. You know, you getmore subtle facial expressions
when you're really face to face,and then you can touch them. You
can see if their skin is sweatyor dry. You can feel if they're
warm or cold. You can pressaround, we call it palpation,
but press around and find tenderspots. You can feel masses.
(22:33):
Pretty difficult to do thatthrough a tele medicine console,
so you have to be a littlecareful how you use it. And I
think for the most part,providers love it because it
means better follow up withtheir patients, especially in
rural areas like Montana,Wyoming, Alaska, Hawaii, the
states that we are most activein, it's difficult, like if you
(22:53):
live in Jordan, Montana, it's ahell of a long way to anywhere
where you can see a providerface to face. And so it fills in
for that, but it has definitelimitations too.
appointments were sort ofmanagement of your conditions.
That's also where thosetechnologies come in handy, too.
(23:14):
If you do have something thatyou're using at home to monitor
either your glucose levels oryour blood pressure, or, you
know, those kind of things thatsend data right to your phone,
and then you can share thatinformation with your doctor.
Dr. Doug Kuntzweiler (23:28):
Right. And there are new technology, of
course, is advancing like crazy.
There are stethoscopes that youcan have in the home, and you
hold it up your chest, andprovider remotely can listen to
your heart, do you want the sameway blood pressures can be taken
that way? When I was in the ER,we had an agreement with
University of Utah Burn Unit,and they gave us a television
(23:48):
camera, really high quality,high resolution television
camera. And when we got burnpatients, we would call
University of Utah, and the burnresident would be there, and we
would move the camera around,show them where all the areas
were that were burned. And fromtaking that information, they
could advise us whether or notwe could take care of the
patient locally, or whether theyshould be transferred to the
(24:10):
burn unit. So it's prettyamazing, especially when I think
back on how things were when Istarted in medicine. It's it's
completely technological now,
Beth Brown (24:22):
Yeah, it is amazing, and that's a way for other
providers to connect withspecialists, like you said, for
those people to look at burns,that's just amazing. And you
mentioned the psychiatry thingtoo. So that's getting people
access to health care where,again, if they live in those
remote areas, they might nothave a psychologist or a
counselor of some kind, rightthere in their little town of
(24:44):
200 but they can talk tosomebody on FaceTime or on Zoom
or Teams and get the care thatthey need. So that's super cool,
and it's really breaking down alot of barriers. Are there other
ways that you can think ofthose? Are some great examples,
but how else is this healthinformation technology really
just improving our access tohealth care?
Dr. Doug Kuntzweiler (25:06):
Well, one of the things that when I talk
to people about this, one of thethings they're most exciting
about, is self scheduling. A lotof clinics and offices now are
allowing patients to selfschedule. And that is, is huge.
You're not sitting on the phoneforever, you know, waiting for
the front desk person to finallyget finished and get to you. And
(25:29):
there isn't a lot of trying tomash your schedule into there,
as you can see what's available,and you can pick out the time
that works for you, the timewhen you know you have
transportation, because thatsometimes is an issue,
especially in rural areas. Sothat's, that's something that
people don't often think about.
The technology this made itavailable, and that's, that's
really quite good, and that alsohas sped up follow up
(25:52):
appointments and has improvedpeople keeping those
appointments far fewer no shows.
So even though I'm an oldcurmudgeon, I have to say that,
on the whole, this technologyhas really made health care
better and the more involved thepatient is, the better it's
going to work.
Beth Brown (26:12):
So speaking of being a curmudgeon, there are people
out there who are a littleintimidated by but also
concerned by technology, andthat's not being a curmudgeon.
There are some legitimateconcerns there about I don't
want everyone to know about myhealth information. I don't want
(26:32):
that information to just get outover the internet. And so when
people have those real concernsabout the security risks of
sharing that kind of informationvia technology. What should they
know about that? Are therethings in place to help put
their minds at ease a littlebit? Or what do we have to tell
people about that concern, Dr K?
Dr. Doug Kuntzweiler (26:52):
Yeah, it really is a concern. And if you
followed the news at all, youknow that in the last few years
there have been a couple ofbreaches in some big health care
systems of people's medicalinformation. There's federal law
that all providers have tofollow the HIPAA Act, Health
Information Portability andAccountability Act that
(27:15):
guarantees that everybody thatgets federal dollars, which is
essentially every health careprovider, has to follow those
rules, and they have to havesafeguards to keep patients
healthcare information safe. Andthere are significant fines,
including even jail time,especially if you release
(27:39):
information maliciously. Butsignificant financial fines for
companies that allow sloppinessand somebody hacks into their
system, or, you know, theyinadvertently give information
out, because it's not just yourhealthcare information, usually,
there's access to your socialsecurity numbers, sometimes even
(28:00):
things like your credit cards,your bank accounts. So it's,
it's no laughing matter. Whereit's, it's very serious. And I
think it's fair game to ask yourprovider how they are ensuring
that HIPAA is followed in theiroffice.
Beth Brown (28:16):
That's great. And so I do think that we have
providers who do try very hardto follow those guidelines and
regulations. But like you said,there are breaches that happen
even when people have tried totake those steps. And so when
that does happen to a person,where their hospital or their
provider notifies them thatthere has been a breach, and of
course, they're working on it,what should the individual do in
(28:37):
that case?
Dr. Doug Kuntzweiler (28:39):
Well, I would first check and make sure
that they have reported theHIPAA violation, because that's
part of the law. They have afairly short time frame that
they have to report that they'velost some data, that there's
been a violation, and so thefirst thing I would do is call
the provider's office and seewhat they're doing about it,
make sure that they havereported it, because they are
(29:00):
mandated to report it. Healthand Human Services as an Office
of Civil Rights, you can callthem, they have ombudsman who
can help you follow through andfollow up on your reports and
make sure that you knoweverything is done. No way it
should be done.
Beth Brown (29:17):
So there are other risks, but I think what we
really want to say today istechnology is sort of taking
over health care in a lot ofways, and it's good to get
involved and understand thoseways better so that you can
again have those tools to bemore active in your own health
care.
Dr. Doug Kuntzweiler (29:35):
Yeah, absolutely. And I would say to
folks who are in my generation,you know, it really is going to
help you if you're not verycomputer savvy. You know, find a
niece, find a nephew, find aneighbor kid, somebody who is
very savvy with computers, andhave them help you navigate. I I
(29:55):
use about three differenthospital portals now, and I find
it challenging at times, but itreally is rewarding too, when
you'll get a much better pictureof what's going on and and I
think it will give you someassurance too, that, you know,
you see how much people care andhow much time and effort they're
putting into the care for you.
And so I think it's reassuringas well.
Beth Brown (30:19):
That's great. Yeah, so if you need the help, ask for
it. Especially young peopletoday, seem to have been born
with smartphones in their hands.
So they they get all that.
Dr. Doug Kuntzweiler (30:28):
Some of them, almost literally, were.
They can't speak yet, andthey're playing with mom's
iPhone.
Beth Brown (30:35):
That's so true.
Yeah, all right, any closingthoughts that you want to leave
us with today, Dr. K?
Dr. Doug Kuntzweiler (30:40):
No, there are lots of other places you
know, you can go to getinformation. As always, if
you're going to go to the weband learn about these things,
make sure you're on a reliablesite. But even places like Mayo
Clinic, Cleveland Clinic, JohnsHopkins, they will have a lot of
information on medicaltechnology, and there's a lot of
good information in the CDC toWorld Health Organization. If
(31:02):
you're concerned about security,you know, look up the HIPAA Act
and see exactly what it says.
Beth Brown (31:09):
That's perfect. And we'll include some of those more
reliable, top resources when wepost this about this topic today
with our podcast episode. And sothat's our show for today, and
that ends our series on helpingyou feel more confident about
getting your health care andtaking an active role in your
health. If you have anyquestions about that, or any
(31:30):
other questions for Dr K, he'salways here to answer them,
please email us at Q and A withDr k@mpqhf.org and we'll have
that email address with thisepisode as well, you can submit
your question, and we will keepit anonymous, but get you the
information you need. Thanks, DrK.
Dr. Doug Kuntzweiler (31:48):
Thank you.
Beth Brown (31:49):
Thanks everybody for listening. Have a great day.
Music.
(00:10):
Welcome to Q and A with Dr. K, apodcast by Mountain Pacific
Quality Health, where we sitdown with Dr. Doug Kuntzweiler
and get your health questionsanswered, because on Q and A
with Dr. K, the doctor is alwaysin.
(00:36):
Hello, everyone. This is BethBrown, your host, and joining
us, as always, is the wonderfulDr. Doug Kuntzweiler, Mountain
Pacific's chief medical officer.
Thanks again for always beinghere with us, Dr. K, to answer
our questions.
Dr. Doug Kuntzweiler (00:48):
Thanks for having me, Beth.
Beth Brown (00:49):
So we're back with what is going to be the last
episode in our series. We'vebeen talking about how to help
patients feel empowered and tobe more confident in the way
that they are getting theirhealth care and taking care of
their health. And so in ourfirst episode, we dove into the
importance of asking questions,and how asking those questions
can improve the communicationyou have with your providers and
(01:12):
to help you better understandyour health. And so I would
invite people to go back andlisten to that episode if they
haven't already. And then wetalked with you, Dr. K, and with
one of our pharmacists, Kyla,about truly knowing your
medications and taking advantageof your pharmacist, because your
pharmacist is such an amazingand available health resource
for your health care and foryour health. So today, what
(01:32):
we're going to talk about issome of the ways that technology
can help us better manage ourhealth and better navigate our
health care and how to feelempowered and more confident
about how we use healthinformation technology, or HIT,
or health IT has differentnames. So Dr. K, let's start
with what are we talking about?
What all can HIT, or healthinformation technology,
(01:55):
encompass?
Dr. Doug Kuntzweiler (01:58):
Everything that I don't understand.
I am one of the boomiest of theboomers, and almost nothing that
I was using at the end of myactive medical career existed
when I started in practice. Igrew up during the polio
epidemic in the 1950s, and I,over the course of my life, had
(02:20):
gone from iron lungs used toventilate people to home
ventilators. So healthinformation technology takes in
all of this, mostly electronic,not exclusively, but mostly
electronic technology thatcenters around every aspect of
health care. So it encompassesthings like electronic health
(02:43):
record. Do the electronicmedical record instead of
handwritten notes. Now,everything is digital and
available digitally. It includesthings like patient portals,
which are they sound likesomething you crawl into, but
basically, it's just a websitethat allows you to access
information about your healthcare, all of the monitors, the
(03:04):
sophisticated monitors that weuse in the hospital. Now, even
the billing is all doneelectronically. Now, nothing
gets mailed anymore. It's alldigitized, and it also
encompasses things like medicaljewelry, like fitbits and the
rings and other watches thattrack how active you are during
the day, how many steps youtake, some of them even track
(03:26):
your sleep. Continuous glucosemonitors, it used to be that
diabetics were poking themselvesin a finger twice, three times a
day, and they wound up withnothing but scars on their
fingertips. Now there aremonitors that go on their their
arm, around their abdomen, andthey continuously monitor the
glucose. And some of them thenwill Bluetooth it to their
(03:48):
telephone so they know minute tominute what their blood sugar
is, just to see change in in themanagement of diabetes. And
there's just almost no end toit. Blood pressure monitors are
all digitized now and record andit's just incredible. When you
you think about the technologythat we are surrounded with that
(04:10):
relates to our health, it isamazing.
Beth Brown (04:13):
And to your point, a lot of these technological items
were very much used by providersand were not so much used by the
patient, but now that has beenanother big shift over time that
it's not just the providersgetting into those electronic
medical records or electronichealth records, but we're
encouraging patients to get intothem too via those patient
(04:35):
portals. So can you talk aboutthat shift a little bit of why
it really is becoming somethingthat patients use as much,
arguably, as providers, and whythat is important, and maybe
people should try to overcometheir fears or their discomfort
with some of these electronic ordigital tools.
Dr. Doug Kuntzweiler (04:54):
Yeah, when I started in medicine in the
late 70s, the chart was createdby the people providing care,
the physicians and the nurses.
And the thinking was that, isour chart, and patients weren't
granted access to it. They hadto go to extraordinary measures
if they wanted their chart orwanted to be able to read it.
(05:16):
And it was this sort ofNeanderthal thinking that, well,
I made this chart, it's mine.
Even though it is about the mostintimate details of your health,
you're not allowed to look atit. And so over time, there was
this change where patientsdemanded to be able to look at
their charts. And that hasgradually changed. And now what
(05:37):
providers have come to realizeis that the patient who has
access to their chart and seeswhat's going on is a better
patient. They're more involvedin their health care, they are
more likely to be compliant withrecommendations and with the
decisions that they have helpedto make about their treatment.
So it has gradually shifted, andwho is more concerned about your
(06:00):
personal health than you are,and this access to your chart
and to your information allowsyou to be intimately involved
with that. And if it's going tobe useful, your medical record,
all of these technologicalthings we've talked about that
relate to your health, they needto be accurate, and you are the
only person who really canprovide that that accuracy. I
(06:24):
I've had charge where my birthdate was wrong or where my name
was spelled wrong. If you thinkabout things like reconciling
your medication list, you know,if you're young, it's probably
not very relevant, but as youage, you wind up getting put on
more and more meds every fewmonths, one is stopped, another
is started, and it doesn't takeany time at all before nobody
(06:47):
knows what you're actuallytaking, probably including
yourself. But with an electronicmedical record in the
digitization in the pharmacies,it's much, much easier to keep
that medical record accurate,and it needs to be complete.
People see different providers,and they sometimes, you know,
when they're asked about theirmedical history, they will
(07:09):
forget that, oh, a cardiologisttwo years ago said I had a
mitral valve problem, that sortof thing. And if that's all in
your chart, then it is going tobe complete, and you should have
it because it is. It's readilyavailable to all of your
providers then, and everythingcan be in there, including your
advanced directives, which we'vetalked about on other podcasts.
(07:30):
So the health technology is notgoing anywhere we we have to
live with it. I know it getsfrustrating, especially people
in my generation can get prettyfrustrated with it, because I'm
not as computer savvy as youngerfolks, but it's not going
anywhere, and on the whole, itleads to better care, I believe.
So we need to be involved.
Beth Brown (07:51):
Okay, that's great.
And you talked about our chartof our electronic health record,
and some of the different itemsthat might be in there about us,
including medications. What sortof information needs to be in
there for that electronic healthrecord to be complete? What are
some of the other differentthings that people can expect to
see or that our providers usewhen we're getting health care
that are in that electronichealth record or in our chart,
(08:13):
as you said?
Dr. Doug Kuntzweiler (08:16):
Yeah, the things that are important to
your health and so an accuratehistory of your health,
including all the problems, allthe surgeries, anything that's
been a problem for you, yourfamily history, everything you
know about your family historythat you can find out that
should be in there, things aboutyour social history, like how
(08:38):
ambulatory you are, whether ornot You have food safety,
whether or not you live in asafe environment, whether or not
you are engaged in society, orwhether you know you're living
by yourself. All those thingshave huge impact on our health,
our health status, and so all ofthat needs to be in there, and
it needs to be kept up to dateand kept accurate.
Beth Brown (09:00):
And yeah, I appreciate talking about where
you live or some of the otherthings that may be affecting
your health that we might notthink of, beyond the surgeries
we've had or the conditions thatwe've been diagnosed with, and
mental health as well, correct?
We're talking more about some ofthe things that we're feeling or
experiencing emotionally andbehaviorally, beyond just
physically.
Dr. Doug Kuntzweiler (09:21):
Yeah, and things like habits like, Are you
a smoker? Do you drink alcohol?
How much exercise do you get ona regular basis? All those
things should be in there.
Beth Brown (09:31):
So when we think about how we can be a proponent
for our health, where we're inthere advocating for ourselves
and using that electronic healthrecord to do that, what does
that look like?
Dr. Doug Kuntzweiler (09:40):
Well, I think one of the first things is
look at your chart, and if thereare discrepancies or things that
are inaccurate, you know, talkto your provider about
correcting them. And thatshouldn't be any kind of an
argument is, you know, you hadyour gall bladder out and that's
not in there, then it needs tobe. The other thing I think of
(10:00):
that is one of the big benefitsof this is that there are
programs that will translate ifEnglish is not your first
language and that's probably thelanguage your chart is going to
be in. There are translationapps that can translate all of
that for you. There should bethings in there that deal with
the preventative measures,things like, what's your
(10:20):
vaccination status? Are youcurrent? Are you up to date?
Have you gotten all the vaccinesthat you should at your age? And
almost anything in there isrelevant, and you just want to
make sure that it's complete andthat it's accurate, and then
you're in a position to helpshare in decision making. You
(10:40):
will have a better understandingof your health status. You
should have a betterunderstanding of what your
provider has talked to you aboutin terms of treatment and and
there should be a note that yourshared decision making is to do
this or do that do the otherthing.
Beth Brown (10:56):
So you talked about notes. Let's build on that a
little bit because, yeah, a lotof times now, when we go in to
see a doctor, they're on alaptop, or they're on a tablet
or something, and they're takingnotes, or they have someone in
there with them that's helpingthem take those notes. So what
can you tell us about thoseappointment notes? I guess
sometimes they're also calledoffice visit summaries. What is
(11:17):
happening there, and how canthat help improve what we're
doing as patients and whatproviders are doing?
Dr. Doug Kuntzweiler (11:24):
Yeah, you have a provider sitting down
with somebody who has some kindof a problem, and you got to
look them in the eye. You haveto touch them and let them know
that you're there and that youcare about their health. Now
there are different ways than totake notes. You can have a
scribe who watches theinteraction, and they have
training, and they learn thelanguage, and they can take
(11:47):
notes, and then after that, youcan go and meet your notes. I
used to just jot down littlenotes to jog my memory, but I
did it very sparingly, and mostof the time I was engaged face
to face with the patient, but Iwould turn and make a little
note on paper. You could do thesame thing with a laptop, but
I've had providers who were juststaring at their laptop the
(12:07):
whole time and hardly everlooked at me. And frankly, it's
it's not a good experience. Now,what's in the notes the
electronic medical record shouldhave all of that historical
stuff that we talked about, yourpast medical history, to your
family history, all those suchthings. Your medication must
blah, blah, blah, theappointment note, or what we
(12:28):
always refer to as a progressnote, then, is a record of what
is happening during thisparticular visit, and it might
be a follow up for a chronicproblem. Maybe you've been
switched to a new medication,and the provider was to check
in, see how you're getting alongwith that, see if it's working,
see if you're having any sideeffects. So it's it's more
(12:50):
focused on today's problems, andthere are various formats that
are used, but it's a way torecord in some sort of routine
fashion. What's going on withyou today?
Beth Brown (13:03):
I have had providers that have headsets, too, that
they just talk into those sothat could be a little bit
better than having your nose ina laptop.
Dr. Doug Kuntzweiler (13:10):
Yeah, one thing I do like I have a
cardiologist who dictates theprogress note, and he does that
in front of me at the end of ourvisit. And I like that because
it gives me an opportunity. Ifthere was something I didn't
understand, or if he sayssomething that it actually is
inaccurate, then I can, I cancorrect him right there. And it
shows a level of confidencebetween the two. I trust him and
(13:34):
he trusts me and and there'ssome interesting research as to
how all of this electronic stuffaffects patients. One of the
studies I read shows that if thepatient has access to his notes,
there's about a 60% increase inadherence to their
recommendations. You're morelikely to keep follow up
(13:56):
appointments, you're more likelyto fill your prescription,
you're more likely to take themedications or to do whatever
therapies exactly the way theywere prescribed to you. So it
really is important.
Beth Brown (14:10):
That's awesome, yeah, because sometimes we don't
catch all those details whenwe're just having a conversation
with our provider, but if we cango back and look at what was
written down, then it sinks inand we understand it better. So
that makes a lot of sense. Sowe're going to talk about
telehealth a little bit, youknow, speaking of digitalizing
healthcare and some of thesethings that are becoming more
(14:30):
electronic, we're even gettingsome of our health care via
digital means. But before wereally jump into that, let's
talk about a term that peoplemay be hearing called electronic
prescribing, or e-prescribing.
What is that? Does that tie intotelehealth? Is that something
different?
Dr. Doug Kuntzweiler (14:46):
So what used to happen if a medication
was going to be prescribed is,towards the end of the visit,
the provider pulls out aprescription pad and writes
generally, allegiably themedication. And the dose and how
it's to be taken, and how muchmedications to be given, whether
or not to be refills. And theyhand that to the patient, who
(15:08):
then has to keep the dog fromeating it, take it to the
pharmacy, hand it to thepharmacist, who has to try and
decipher the handwriting.
Probably can't. Has to call theprovider. Says, What on earth
did you write here? I'mexaggerating some, but this
stuff really does happen. Youknow, when you write 30 or 40
prescriptions a day, yourhandwriting gets worse and worse
(15:28):
as time goes by and soe-prescribing is doing this
electronically, and mostcommonly, what happens is you,
you make a decision about whatyou're going to prescribe, which
medication it should be a jointdecision along with the patient.
And then you go to the pharmacythat is going to supply it, and
(15:48):
from a list, you pick themedication, and you click on
that, and then it will give youoptions for you know, are you
taking it twice a day or once aday, or how are you taking it.
And so you click on the correctoption for that, and then the
number and refills. So it takesthe whole handwriting thing out
of it. It takes the wholepassing the prescription from
(16:10):
provider to patient who has tokeep track of it and get it to a
pharmacy, because thingslegitimately did get lost
occasionally, or ringing down orwho knows what. So it takes that
out, as long as the prescriberhas done his clicks accurately,
and this is where mistakes canhappen, but no system is mistake
free, but as long as they arecareful in their clicks, then
(16:32):
you get the correct dosage andthe correct instructions on how
to take it, and there's a recordright of the way the pharmacist
doesn't have to remember or fileit, or, you know, do something
else to record that you got it.
It's it's right there in theircomputer banks, and so it
automatically reconciles yourprescription list. And most of
(16:54):
these programs also incorporatethings like alerts, like if
you're prescribing twomedications that might interact
adversely with each other,you'll get an alert if the
patient happens to be allergic,say, to a particular type of
antibiotic, and that's what wasprescribed, an alert will sound.
And so it's it's much better atdoing that than human beings
are. So it really is a betterway to prescribe medications.
(17:19):
Now there, there are somecontrolled substances that, in
order to make sure there isn'tany any fraud or abuse, that you
still have to have a writtenprescription for it. But in
general, most everything at thistime is electronic.
Beth Brown (17:35):
Okay, so that's when, you know, my doctor asks
where my pharmacy is, and thenthey're just sending that
prescription right over, thatwould be another reason why
having one pharmacy is good tojust simplify that whole
process, even though it's beensimplified so much already by
the electronic process.
Dr. Doug Kuntzweiler (17:52):
Yeah, one thing we haven't talked about in
all of this is that there's alot of proprietary stuff, and
like electronic health records,it would be nice if they all
transferred to each other. Andso if you are in hospital, a
that uses Meditech as their EHRsystem, and you're traveling and
you go to a different hospital,and they use Epic as their
(18:14):
electronic health record, it'sit's not guaranteed that
Meditech is going to send yourrecord to Epic, and they're very
proprietary. They're veryworried about people stealing
their trade secrets and whatnot.
It's getting better, and thereare government offices that are
working on this. Legislation hasbeen passed to try and make
these all more uniformlyavailable, and we're getting
(18:36):
there, but it's been slow, and alot of it is because, you know,
corporations are worried abouttheir secrets being stolen.
Beth Brown (18:46):
Sure, yeah, I think that's where health information
exchanges come into and stateshave been trying to work on that
as well, by creating a higherlevel system that helps those
specific hospital systemscommunicate to one another
better. So I know healthinformation exchanges have come
into play there too to supportsome improvement there. That
might be for a differentepisode. That's an explaining
(19:09):
what a health informationexchange does. But okay, so
let's talk about telemedicine alittle bit. In about two years,
from 2019 to 2021, the use oftelemedicine exploded from just
about 15% of patients usingtelemedicine to 86%, so almost
nine in every 10 people wereusing telemedicine to go see
(19:31):
their doctor. And of course, wehad a pandemic in the middle of
that, and so that really helpedpeople lean into using that
telemedicine. But now it's here,doesn't appear to be going
anywhere, but there are timeswhen using that telehealth or
telemedicine appointment makessense, and there are times when
you really should go see adoctor in person. So first,
(19:52):
let's talk about, if someone hasnever done a telehealth
appointment, what does that looklike? And then secondly, let's
talk about when should you usethose type of appointments
versus when should you reallytry to get in to see a doctor in
Dr. Doug Kuntzweiler (20:05):
Well, the appointment looks very much like
person?
a Zoom meeting. If you've everbeen in a Zoom meeting or a
Teams meeting, or used FaceTimeon your telephone when you're
talking, so it should be twopeople looking at each other on
a screen. You need to be able tohear and language needs to not
(20:27):
be a barrier. If there is alanguage barrier, then, as I
said, there are lots of appsaround that can do translation
for you, but that's what itlooks like. It's like watching
your provider on a TV screen inreal time. And that's good, you
Beth Brown (20:43):
Yeah, it seems like those sorts of follow up
know, you get some bodylanguage, you get some facial
expression, you might get betterunderstanding of what they're
saying. So it works pretty wellfor some things. Not so well for
others. It works pretty well forthings like psychiatry, which in
large part involves talking topeople and watching their
reactions. It can work prettywell for dermatology, if you
(21:05):
have a good camera. I knowdermatologists who love looking
at things through telehealth andmaking a diagnosis. It's pretty
good for managing chronicdisease, if somebody's not
having an acute problem rightnow, but let's say they're
diabetic and maybe their sugarsare a little bit out of control.
You're right there with theprovider at the screen, and they
(21:27):
can ask you about what yourdiet, what your activity level,
that you're doing with yourmedications. So it's it's good
for those kinds of things,stable, chronic and mild kinds
of problems. If, on the otherhand, you are genuinely sick,
maybe you have a new conditionthat hasn't been diagnosed yet.
(21:48):
Maybe you have symptoms that areworrisome to you more than
minor, then it's it's not sogreat. You shouldn't be trying
to diagnose people remotely,when what you really need is, as
I said earlier, to sit down faceto face and to touch them. That
touch is a huge component. Youget so much information when
(22:11):
you're face to face, watchingthe patient breathe, watching
them move. You know, you getmore subtle facial expressions
when you're really face to face,and then you can touch them. You
can see if their skin is sweatyor dry. You can feel if they're
warm or cold. You can pressaround, we call it palpation,
but press around and find tenderspots. You can feel masses.
(22:33):
Pretty difficult to do thatthrough a tele medicine console,
so you have to be a littlecareful how you use it. And I
think for the most part,providers love it because it
means better follow up withtheir patients, especially in
rural areas like Montana,Wyoming, Alaska, Hawaii, the
states that we are most activein, it's difficult, like if you
(22:53):
live in Jordan, Montana, it's ahell of a long way to anywhere
where you can see a providerface to face. And so it fills in
for that, but it has definitelimitations too.
appointments were sort ofmanagement of your conditions.
That's also where thosetechnologies come in handy, too.
(23:14):
If you do have something thatyou're using at home to monitor
either your glucose levels oryour blood pressure, or, you
know, those kind of things thatsend data right to your phone,
and then you can share thatinformation with your doctor.
Dr. Doug Kuntzweiler (23:28):
Right. And there are new technology, of
course, is advancing like crazy.
There are stethoscopes that youcan have in the home, and you
hold it up your chest, andprovider remotely can listen to
your heart, do you want the sameway blood pressures can be taken
that way? When I was in the ER,we had an agreement with
University of Utah Burn Unit,and they gave us a television
(23:48):
camera, really high quality,high resolution television
camera. And when we got burnpatients, we would call
University of Utah, and the burnresident would be there, and we
would move the camera around,show them where all the areas
were that were burned. And fromtaking that information, they
could advise us whether or notwe could take care of the
patient locally, or whether theyshould be transferred to the
(24:10):
burn unit. So it's prettyamazing, especially when I think
back on how things were when Istarted in medicine. It's it's
completely technological now,
Beth Brown (24:22):
Yeah, it is amazing, and that's a way for other
providers to connect withspecialists, like you said, for
those people to look at burns,that's just amazing. And you
mentioned the psychiatry thingtoo. So that's getting people
access to health care where,again, if they live in those
remote areas, they might nothave a psychologist or a
counselor of some kind, rightthere in their little town of
(24:44):
200 but they can talk tosomebody on FaceTime or on Zoom
or Teams and get the care thatthey need. So that's super cool,
and it's really breaking down alot of barriers. Are there other
ways that you can think ofthose? Are some great examples,
but how else is this healthinformation technology really
just improving our access tohealth care?
Dr. Doug Kuntzweiler (25:06):
Well, one of the things that when I talk
to people about this, one of thethings they're most exciting
about, is self scheduling. A lotof clinics and offices now are
allowing patients to selfschedule. And that is, is huge.
You're not sitting on the phoneforever, you know, waiting for
the front desk person to finallyget finished and get to you. And
(25:29):
there isn't a lot of trying tomash your schedule into there,
as you can see what's available,and you can pick out the time
that works for you, the timewhen you know you have
transportation, because thatsometimes is an issue,
especially in rural areas. Sothat's, that's something that
people don't often think about.
The technology this made itavailable, and that's, that's
really quite good, and that alsohas sped up follow up
(25:52):
appointments and has improvedpeople keeping those
appointments far fewer no shows.
So even though I'm an oldcurmudgeon, I have to say that,
on the whole, this technologyhas really made health care
better and the more involved thepatient is, the better it's
going to work.
Beth Brown (26:12):
So speaking of being a curmudgeon, there are people
out there who are a littleintimidated by but also
concerned by technology, andthat's not being a curmudgeon.
There are some legitimateconcerns there about I don't
want everyone to know about myhealth information. I don't want
(26:32):
that information to just get outover the internet. And so when
people have those real concernsabout the security risks of
sharing that kind of informationvia technology. What should they
know about that? Are therethings in place to help put
their minds at ease a littlebit? Or what do we have to tell
people about that concern, Dr K?
Dr. Doug Kuntzweiler (26:52):
Yeah, it really is a concern. And if you
followed the news at all, youknow that in the last few years
there have been a couple ofbreaches in some big health care
systems of people's medicalinformation. There's federal law
that all providers have tofollow the HIPAA Act, Health
Information Portability andAccountability Act that
(27:15):
guarantees that everybody thatgets federal dollars, which is
essentially every health careprovider, has to follow those
rules, and they have to havesafeguards to keep patients
healthcare information safe. Andthere are significant fines,
including even jail time,especially if you release
(27:39):
information maliciously. Butsignificant financial fines for
companies that allow sloppinessand somebody hacks into their
system, or, you know, theyinadvertently give information
out, because it's not just yourhealthcare information, usually,
there's access to your socialsecurity numbers, sometimes even
(28:00):
things like your credit cards,your bank accounts. So it's,
it's no laughing matter. Whereit's, it's very serious. And I
think it's fair game to ask yourprovider how they are ensuring
that HIPAA is followed in theiroffice.
Beth Brown (28:16):
That's great. And so I do think that we have
providers who do try very hardto follow those guidelines and
regulations. But like you said,there are breaches that happen
even when people have tried totake those steps. And so when
that does happen to a person,where their hospital or their
provider notifies them thatthere has been a breach, and of
course, they're working on it,what should the individual do in
(28:37):
that case?
Dr. Doug Kuntzweiler (28:39):
Well, I would first check and make sure
that they have reported theHIPAA violation, because that's
part of the law. They have afairly short time frame that
they have to report that they'velost some data, that there's
been a violation, and so thefirst thing I would do is call
the provider's office and seewhat they're doing about it,
make sure that they havereported it, because they are
(29:00):
mandated to report it. Healthand Human Services as an Office
of Civil Rights, you can callthem, they have ombudsman who
can help you follow through andfollow up on your reports and
make sure that you knoweverything is done. No way it
should be done.
Beth Brown (29:17):
So there are other risks, but I think what we
really want to say today istechnology is sort of taking
over health care in a lot ofways, and it's good to get
involved and understand thoseways better so that you can
again have those tools to bemore active in your own health
care.
Dr. Doug Kuntzweiler (29:35):
Yeah, absolutely. And I would say to
folks who are in my generation,you know, it really is going to
help you if you're not verycomputer savvy. You know, find a
niece, find a nephew, find aneighbor kid, somebody who is
very savvy with computers, andhave them help you navigate. I I
(29:55):
use about three differenthospital portals now, and I find
it challenging at times, but itreally is rewarding too, when
you'll get a much better pictureof what's going on and and I
think it will give you someassurance too, that, you know,
you see how much people care andhow much time and effort they're
putting into the care for you.
And so I think it's reassuringas well.
Beth Brown (30:19):
That's great. Yeah, so if you need the help, ask for
it. Especially young peopletoday, seem to have been born
with smartphones in their hands.
So they they get all that.
Dr. Doug Kuntzweiler (30:28):
Some of them, almost literally, were.
They can't speak yet, andthey're playing with mom's
iPhone.
Beth Brown (30:35):
That's so true.
Yeah, all right, any closingthoughts that you want to leave
us with today, Dr. K?
Dr. Doug Kuntzweiler (30:40):
No, there are lots of other places you
know, you can go to getinformation. As always, if
you're going to go to the weband learn about these things,
make sure you're on a reliablesite. But even places like Mayo
Clinic, Cleveland Clinic, JohnsHopkins, they will have a lot of
information on medicaltechnology, and there's a lot of
good information in the CDC toWorld Health Organization. If
(31:02):
you're concerned about security,you know, look up the HIPAA Act
and see exactly what it says.
Beth Brown (31:09):
That's perfect. And we'll include some of those more
reliable, top resources when wepost this about this topic today
with our podcast episode. And sothat's our show for today, and
that ends our series on helpingyou feel more confident about
getting your health care andtaking an active role in your
health. If you have anyquestions about that, or any
(31:30):
other questions for Dr K, he'salways here to answer them,
please email us at Q and A withDr k@mpqhf.org and we'll have
that email address with thisepisode as well, you can submit
your question, and we will keepit anonymous, but get you the
information you need. Thanks, DrK.
Dr. Doug Kuntzweiler (31:48):
Thank you.
Beth Brown (31:49):
Thanks everybody for listening. Have a great day.
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