[lindseymysse]

Have we ever thought about going back to very manual processes as a matter of course? That maybe digital technology is great for immediate and ephemeral communication, but for long term secure communication perhaps pen and paper is best?

This means we keep fewer, more important records on paper.

This requires rethinking management which, lets be honest, needs to happen anyway.

I was having asthma and went to the doctor in Cassis France. To get a ventolin inhaler and a round of prednisone only took two forms -- one at the doctor and the prescription -- and about $70 dollars.

I look at the reams of documents Kaiser generates anyway, virtual and real even though I'm "paperless" and I wonder how much of the expense of my health care goes into schlepping all these documents around.

There is a book by Derrida called Archive Fever that I read when I was a temp and I always think about the quote in it: "the archivist generates more archive, and so the archive is never closed"

Maybe we need that big hack to finally take away the bottle. We don't have to record everything forever, and digital technology is bad at it, anyway.

[sofixa]

For medical records? Are you insane?

Every small little detail recorded by your doctor can be crucial to determine a timeline and help with treatment later. Or just to know your allergies and regular vital signs in case of a serious issue that requires emergency care, when you might not be able to give the information ( e.g. car crash, and you're allergic to penicillin or something in the usually used anesthetic or whatever). It can also be useful when you can just call a doctor to get a prescription, because they have your full medical records and know enough about you quickly.

Paper is extremely impractical.

[lindseymysse]

Why do I keep on having to give my allergies to the doctor every time I'm there?

My timeline is that it is too expensive and full of forms for me to go talk to my doctor. And I have to keep answering the same questions to my doctor about my allergies over and over and over anyway.

I think all this paper work helps a parasitic managerial class, but I've never seen it help me.

[Ovah]

I can only comment on why it's important for the physician to know about any allergies. Some people have a history or risk of severe allergy and anaphylactic reactions can be potentially fatal. I've had to managed such a reaction in a healthcare setting. Such a reaction is not only potentially fatal but is often very dramatic and sudden. After that I always err on the side of caution and ask for allergies regardless of what the patient's chart says. It's often a wise idea to confirm what's in the chart rather than to blindly trust what's already in there regardless.

It's the physicians job to weigh the benefits against risk of a drug. And potential allergic reactions is a part of that. If a patient with a known history of severe allergic reactions gets another one from a prescribed drug, and the physician hasn't done their due diligence, then the physician could be at fault. I can only imagine that it's even more prudent for US-based physicians to ask that question due to lawsuits and or personal liability.

Also a patients medical status is never static. While unlikely a patient could have had a reaction since the last visit. I guess a more realistic example of something non static is pregnancy status which can be equally important when prescribing drugs etc.

[lindseymysse]

Yes, why do we have to have reams of paperwork? It would be better if my doctor had time to get to know me. Instead, he fills out paper work, everyone around him fills out paper work.

[sofixa]

Because your doctor doesn't deal only with you. Having hundreds of patients it's impossible to remember everything about everyone, and they're not the only doctor that would need to know you(specialists). Hence, normalisation of data.

[lindseymysse]

Have you read a single one of my arguments? Less paper work, more doctors and nurses handling fewer patience.