Thursday, February 25, 2010

The Ultimate Guide to Taking Control of Your Health Records | NOEDb

Managing your personal health records has become the latest buzz. By utilizing an online service, you can record, store, update, and share all your information. Having all of your information in one place promises to provide better treatment for routine medical care, and in cases of chronic illness or emergencies, having the most up-to-date information on your health can make the difference between life and death. The following resources will help you learn about managing your health records, tell you where to go for the best services to help you, and offers a peek into what medical providers can implement.

Gathering Information about Electronic Health Records (EHR)

Before you start managing your health records, it's best to get the facts relating to how and why it's done. The following resources will help you find out the basics about EHR.

  • The International Council on Medical & Care Compunetics. This international site posts articles, studies, and more to help inform or raise discussion questions about EHR. Read articles that touch on topics such as the security of Google and Microsoft for medical records to social networking and patient portals. Because this site is international, not all articles are in English.
  • HIPAA. Health Insurance Portability and Accountability Act was established in 1996 to set rules for electronic medical records. Visit this site to learn all the latest on health information, background information, regulations and standards, and compliance and enforcement.
  • This personal health record resource is sponsored by the American Health Information Management Association, a non-profit devoted to managing health records. At this site, you will learn why it's important to manage your records and how to go about doing so by accessing their resource library. You can also research various types of record management systems that are on paper, software-based, or on the Internet, ranging from free services to those with cost.
  • emrupdate. Get the latest news, read blogs, and join in forums all discussing the EMR issue. This site is an unbiased site, but it does allow Google ads, which will flash names of various EMR providers across the top of the page.
  • Personal Health Record (PHR) Systems: An Evolving Challenge to EHR Systems. Read about PHRs and learn speculation on how they may evolve over the next several years in this helpful primer.
  • RPMS EHR Website. While designed for health care management of American Indians and Alaska Natives, this website offers an informative view of electronic health record management in action through articles, presentations, training, and a forum.

Free Services and Tools

All of these resources are free of charge and will help you set up a personal health record management system. Many of these services work in conjunction with the first two--Google Health and Microsoft HealthVault.

  • Google Health. With Google Health, you can organize all your health records in one place. Once you sign up, you can import medical records, choose conditions about which you would like to receive more information, and find out how your medications might interact. You can even search for doctors by specialty or location and receive a Google Map with each result.
  • Microsoft HealthVault. Collect, store, and share your health information with this free service. It also connects to a variety of sites, programs, and devices that utilize your information to enhance your health record management.
  • iHealthRecord. Now merged with Google Health, this free service is easy to use, secure, and used on over 100,000 physician websites. You can sign up for a free account, link it to your information in Google Health, and be able to manage everything from one spot. You can even print a handy wallet card to carry important health information with you always.
  • MediKeeper. Create your own health page with this service that works in collaboration with Microsoft HealthVault. You can track your health risks, get personalized alerts, and receive health news.
  • myHealthfolio. Manage your health records with this service that includes health calendars, health cost management, medication management, health education, and more. This service works along with Microsoft HealthVault.
  • Based in the U.K., this service provides support and information on conditions ranging from asthma to diabetes to stroke and their treatments.
  • Dr. I-Net. Manage your medical records, lab results, and medical billing with this resource. You also have access to a wide range of information on a variety of health topics.
  • Health Butler. This preventative health website helps you manage your care and records through such preventative measures as cancer screening, immunizations, and more. You can even receive email reminders for your personal preventative healthcare tasks.
  • TouchNetworks. Patients can store their health information, make it available to their physicians, and communicate with their physicians through this free service.
  • WorldMedcard. Store your health information here, then print out a card that you carry in your wallet. Any time you need medical attention, whether routine or emergency, your information card allows access to your full, up-to-date medical records. With participating providers in over 36 countries, you can feel comfortable that no matter where you are, your medical provider will be able to help you with a more personalized treatment.
  • ZebraHealth. Manage your health history, medications, allergies, physicians, and more with this service. You also have access to a physician locater, health forums, and health news updates.
  • WebMD Health Manager. Use this service to manage your health records, get health assessments and a personalized health plan, and more. You can even share your information with your health care provider with this service.

Services and Tools Available for a Fee

While there are many services you can get for free, others cost a bit of money. It might be worth it to you if you feel the security is better or the services far outweigh what you can get for free. Some services are highly specialized and charge a fee because of their tight focus.

  • HealthRecords Online. Manage your emergency contact information, medical records, obstetric records, get newsletters and health reminders, and have your physician notes all in one place with this service out of Canada. This service requires a paid subscription, and is directly connected with participating physicians around the world for a seamless medical record management system.
  • ActivePHR. Receive 90 days free before signing up for a subscription with this service that stores health information, tracks test results and health goals, and makes information available to physicians, family members, and emergency personnel. This service works with Microsoft HealthVault.
  • icePHR. Working in conjunction with Microsoft HealthVault, you can organize and track up to ten family members' health profiles with this service. Some of the information you can manage includes personal contact information, allergies, conditions, emergency contacts, immunizations, and medical devices.
  • GeneMedRX. Manage both prescription and non-prescription drugs through this service to reduce the risk of an adverse drug reaction. There is an annual fee for this service, and additional family members can sign up for a reduced fee.
  • PureWellness. With health risk assessments, diet and exercise tools, incentive tracking, online coaching and mentoring, and a resource library, this service will help keep you healthy.
  • MyVitalData. Keep all your most important information here. You choose what you want to share, making it available to hospitals, first responders, and disaster response teams. There is a fee to maintain this service, but the cost is very low.
  • This service takes information from your health profile, your available workout resources, and the music on your MP3 player to create a customized fitness program designed by top fitness trainers. You will end up working out to your favorite songs without needing to buy any additional equipment and know that your exercise program is custom tailored for you.
  • TrainingPeaks. If you are in training, this service will help you manage your fitness with a virtual coach and training plans, help you make healthy food choices, and allow you to analyze your performance. There is an annual fee for this service, but it is probably less expensive than that gym membership and a lot more personalized.
  • MySelfHelp. Help yourself with this behavior-management service that will assist you in making positive changes in areas such as depression, stress, insomnia, eating disorders, grief, guilt, low self-esteem, and compulsive shopping. This service is available for a monthly fee.
  • Store your health records, print a personalized emergency card, track prescriptions, and communicate with your physician with this Swiss-based company. Children under five are free with adult memberships.
  • FullCircle Registry. Manage your living will and emergency contact information with this service. In case of a health emergency, medical staff will know your wishes and your family members will be contacted right away. There is a fee associated with this service, but the annual cost is low.
  • ElderIssues. Elder care can require many different medical needs. Whether you are currently caring for a parent, planning to care for a parent soon, or are planning for your own care, you can manage all the necessary medical records here for a small monthly fee.
  • Keep your entire family's records together with this service. You can even print out the records or have a basic version sent to select physicians prior to your appointment. These services are free of charge, but for a fee, you can upgrade to a better subscription, which includes a service that uploads your information and sends it to your physician on the forms used at that specific office.

Services and Tools for Specialized Groups

From veterans to those with chronic illness to the parents, the following resources are all designed for a niche market. Whether you are looking for a fitness program or a way to monitor your weight, you are sure to find something useful among this list.

  • VistA. Veterans Administration health care system is one of the largest integrated systems in the world. Patients have access to Personal Health Journals through MyHealheVet in this system.
  • Heart Profilers. Sponsored by the American Heart Association, you can manage your heart health care with this free service that works with Microsoft HealthVault.
  • DPS Weight Management. A part of Microsoft HealthVault, this service helps you make healthy lifestyle choices with behavior planning and tracking as well as weekly lessons to help you manage your weight.
  • MSN Route Tracker. Manage your exercise goals with this creative service. Select your destination, then log and track your exercise progress as you learn about where your virtual hike is taking you. Your fitness goal will take on a whole new life.
  • LifeMasters. Managing care for patients with chronic disorders, this service connects physicians, patients, and payors to ensure the best treatment and reduced financial costs through better management of the patient's health care. They offer support on a wide range of disorders such as asthma, cancer, congestive heart failure, and low back pain management.
  • MiVIA. Originally launched as a personal health record resource for migrant and seasonal workers in California, this service is now available for many populations with special needs such as those living with chronic illnesses or the uninsured. MiVIA is used by many clinics, mobile clinics, and rural hospitals.
  • SugarStats. For people managing diabetes, this free service will come in handy. Track and monitor your blood sugar levels and even share them with your family or physician. This service is free, but they do offer a premium service with more enhanced features for a fee.
  • Trixie Tracker. Parents who want to keep a record of their baby's daily patterns can do so with this service. Track your baby's sleep, diaper changes, bottles or breastfeeding, medicine doses, and more; then share with family and friends if you want. There is a monthly fee for this service, but buying in bulk saves you money.

Services for Medical Professionals

Whether you are a physician who wants information on setting up an electronic records system or a patient who wants to find out more about what is out there and what institutions are using to manage your records, the following list covers different types of systems available as well as information such as how and why to implement a system and an assessment of some of the open source systems available.

  • Indivio. This personally controlled health record allows patients to have full copies of their medical records in a secure format. Because this technology is open source, it is available to all developers at no cost to implement.
  • Centricity EMR. This GE product promises a virtually paperless office with their system. Subscribers to this service receive free webinars, case studies, and white papers as a part of the service.
  • e-MDs. Using Microsoft technology, this system is designed to be easy to use and implement. It also offers handwriting recognition and automatic ICD-9 coding for medical professionals using the system.
  • CapMed. Having been around for over ten years, this company is the "leading provider of interactive personal health management solutions for the healthcare and pharmaceutical industries." Find all you need about setting up this system that provides quality and security for its clients and their patients.
  • Open-Source EHR Systems for Ambulatory Care: A Market Assessment. Find out what these researchers have to say about several open source systems and whether or not they are suitable for professional use.
  • HiMSS Electronic Health Record. Find out why you should implement an EHR system, get legislation, the latest news, tools, and more from this informative site that lets the medical professional become an informed user of EHRs.
  • Eclipsys Sunrise Patient Portal. Provide important medical information to your patients about their health care via this portal. Patients can connect with their Microsoft HealthVault account.
  • CureMD. Both an electronic medical record management and practice management system, physicians can get connected with this service. Among the features are browser-based medical records, front office management, patient portal, mobile access, and more.

The Ultimate Guide to Taking Control of Your Health Records | NOEDb

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Jury finds mother guilty of murder in girl’s drug death - The Boston Globe

A South Shore mother was found guilty yesterday of second-degree murder in the death of her 4-year-old daughter, Rebecca, who went to sleep one night after being given toxic levels of psychotropic drugs and never woke up. Carolyn Riley, 35, showed no visible emotion when the 12-member jury returned the verdict after 19 hours of deliberations in Plymouth Superior Court. Riley, her upper chest displaying a “Rebecca 12-13-06’’ tattoo that reflected her daughter’s date of death, was handcuffed as soon as the word guilty was uttered by the jury forewoman.

Before sentencing, Judge Charles Hely permitted the reading of a letter from Ashley Davidson, 17, Riley’s first biological daughter, who as a toddler was removed from her mother’s care, placed in a foster home, and eventually adopted. The teenager condemned her mother for the cruel fate she delivered Rebecca, as well as the tormenting memories left for her and Rebecca’s two other siblings, ages 14 and 9, now both in foster homes. “When I think that you are my biological mother, I sometimes wonder if it is in my blood. Will I grow up to be a mother like you?’’ said the letter, read by her adoptive father, Bob Davidson.

Riley, who has an additional tattoo on her arm with the name Ashley, listened and stared at the floor.

The judge sentenced her to life imprisonment, with the possibility of parole after 15 years, the mandatory punishment for a second-degree murder conviction. It was one of the lesser offenses that the jury of eight women and four men was allowed to consider in this first-degree murder case.

As officers led Riley out of the courtroom, she looked at her mother, Valerie Berio, a constant presence in the 3 1/2-week trial who was sobbing among the spectators. Riley quietly wept as she was taken our to be transported to MCI-Framingham.

While Plymouth District Attorney Timothy J. Cruz praised the verdict as “a small measure of justice for Rebecca,’’ the mother’s defense lawyer, Michael Bourbeau, said the decision, which he plans to appeal, reflects the jury’s judgment of “what kind of a mother she was,’’ as opposed to the evidence in the case.

He had argued to jurors that medical evidence showed that Rebecca died of fast-acting pneumonia, not drugs, and that the mother gave medications based on the sometimes-flexible instructions of her child’s psychiatrist.

Riley’s husband - Michael Riley, 37 - will be tried separately on the same charges, and his case is scheduled to go to trial next month unless yesterday’s result leads to a plea bargain.

Rebecca’s case attracted national attention to the expanding use and potential abuse of giving psychotropic drugs to very young children. When Rebecca died, she and her two older siblings, Gerard and Kaitlynne Riley, were each on three potent psychiatric medications for bipolar and hyperactivity disorders. Each of them went on the drugs at age 2.

Prosecutors say Carolyn and Michael Riley, Weymouth High School graduates who had been living briefly in Hull when Rebecca died, deliberately sought the psychiatric drugs for their three children to scam their local Social Security office into approving disability benefits.

But behind the twists of the case is the all-too-familiar tale of a deeply troubled, financially strapped couple whose capacity to harm their children became catastrophically evident - to their many doctors, psychiatrists, teachers, and social workers - only when it was too late.

The prosecutors, Frank J. Middleton Jr. and Heather Bradley, depicted Carolyn Riley as an unusual form of child abuser, a woman who used three sedating medications, including Depakote, Seroquel, and clonidine, to control her energetic toddlers and induce sleep.

Remarkably, prosecutors said, Carolyn Riley managed to obtain the drugs routinely through prescriptions from Dr. Kayoko Kifuji, a Tufts Medical Center psychiatrist who faces a medical malpractice lawsuit in the death and agreed to testify only after being granted immunity from prosecution.

On the night Rebecca received her fatal overdose, her father, who had been prone to violent outbursts, became irate about the child’s pleas to be with her mother. Rebecca had been battling a respiratory illness for days, and that night, according to housemates, Rebecca kept trying to enter her parents’ bedroom, moaning, “Mommy, Mommy.’’

Prosecutors said that the mother, whom they portrayed as routinely putting her husband’s needs above her children’s, went to the pill dispensers in their Hull home. That night, the state said, Carolyn Riley gave the coughing and feverish child as much as twice the girl’s daily dosages of clonidine at once, the equivalent of seven tablets of .1 milligram each.

Rebecca’s lifeless body, clad only in a pull-up diaper with a teddy bear beneath her head, was discovered by her mother around 6 a.m. on Dec. 13, 2006, next to her parents’ bed.

Her defense lawyers, however, portrayed Carolyn Riley as an overwhelmed mother deserving of sympathy, a former foster child who was doing her best to raise a family in which the adults and children all had mental health problems.

If the mother had some lapses, her lawyers said, they had to be viewed in light of the difficult choices of a woman struggling with poverty and a domineering husband.

In the year before Rebecca died, Michael Riley saw the children sporadically. He was barred from living with the family in a Weymouth housing development because he had been charged with trying to sexually assault and show pornographic pictures to Ashley during one of her visits with the family.

The father, who was convicted of only the pornography charge and served a 2 1/2-year prison term that ended this year, remains behind bars awaiting his trial in the death of Rebecca.

The attachment of Carolyn Riley to her husband was a recurring theme in the lengthy trial. As the mother waited over three days for a verdict, sitting on a bench reading a romance novel and playing games on her cellphone, she responded readily to reporters’ questions.

When asked about the prosecutor’s argument that she and her husband wanted only to maximize their disability benefits, the mother, who speaks with a soft, girlish voice, disputed that point. She said that Social Security awards more money in total to a couple who file as unmarried singles.

But, she said that she and Michael, together for more than 15 years, chose to remain true to their status as a wedded couple.

“We would have gotten more money if we weren’t married,’’ she said.

Jury finds mother guilty of murder in girl’s drug death - The Boston Globe