Letters: Better access to doctor’s notes comes with some caveats




, Letters: Better access to doctor’s notes comes with some caveats

Relating to the article “Extra U.S. sufferers to have straightforward, free entry to physician’s notes,” as a well being researcher and public well being advocate, I’m thrilled that suppliers can be required to share their notes with sufferers. When sufferers know what their medical doctors say about them, they’re extra engaged in and happy with their care.

To the extent these notes are ever made broadly accessible to researchers in a de-identified method, the probabilities are limitless. Researchers may use pure language processing and different analytic strategies to evaluate new dimensions of the affected person/clinician relationship and related medical outcomes.

However to be clear, there may be nothing straightforward about this modification. In as a lot as this growth may very well be a boon for affected person company and supply fascinating analysis pathways, there are lots of land mines. Within the analytics area we frequently see data-rich, information-poor environments, or eventualities the place organizations possess ample knowledge with out background, sense of accuracy or uniformity. With out cautious context and constant data-collection protocols, knowledge could be meaningless or, even worse, deceptive.

Every time we undertake a brand new analysis mission, we should develop a knowledge dictionary to know what we’re taking a look at and the way it was developed. As clinician notes turn into extra broadly accessible, it’s incumbent upon healthcare organizations to make sure that sufferers are usually not merely despatched an digital hyperlink to notes, however are armed with easy accessibility to knowledge dictionaries and, ideally, sources and contacts to ask questions.

Even higher, allow sufferers to file their very own observations within the notes. The work led by way of the Open Notes motion is a good place to start out to make sure that sufferers have data and knowledge, not simply knowledge.

Jessica Steier, DrPH
Important Statistics Consulting 
Maplewood, N.J.

“CMS approves Georgia’s reinsurance plan, exiting HealthCare.gov for 2023 protection” was useful and balanced. However having seen the scenario up shut, extra must be stated.

A complete of 38 states, pink and blue, have already expanded their Medicaid applications, bringing the U.S. fee of uninsured right down to 9.2%. However not Georgia, with the third-highest uninsured fee within the nation at 13.7%.

Georgia has 1.four million residents with out medical insurance. Why is the state so excessive in contrast with different states? As a result of the governor and Legislature have refused to just accept federal to increase the Medicaid program (which might have been 100% paid by the feds for the primary three years had we executed so a decade in the past). Estimates are that a further 567,000 low-income Georgians would get Medicaid protection if this system had been merely expanded now slightly than going by way of the waiver course of.

The ideological foundation for Georgia’s earlier 1115 waiver is that to acquire Medicaid protection an individual should be employed, even through the present depressed economic system, with the unemployment fee at excessive ranges not seen in over a decade. This goes towards each the spirit and wording of the Inexpensive Care Act, designed to enhance protection for low-income people and households.

Georgia’s just lately permitted 1332 waiver restructures the state’s medical insurance market. It erases the medical insurance market to acquire protection, which is able to inevitably result in client confusion and is predicted to considerably cut back the variety of individuals lined. Once more, that is towards the spirit and wording of the ACA.

Particularly, to seek out full ACA protection now, individuals merely have to go to HealthCare.gov. Gov. Brian Kemp’s plan units up a complicated Georgia-specific system, which might be pushed by for-profit insurance coverage corporations and brokers, containing substandard, noncompliant plans. Such plans usually don’t include the ACA’s legally mandated “important well being advantages,” failing to cowl pharmaceuticals, psychological well being companies, maternity care and different vital companies.

Jack Bernard
Peachtree Metropolis, Ga.