Frank Bernheisel: The View From Here
Frank Bernheisel
Frank Bernheisel
Posted 5.25.21
Just Outside Washington



As one gets older, it seems like we spend more time at the doctor's offices. Even when there is nothing specifically wrong, there are visits, periodic general practitioner checkups, lab visits for blood extraction, dental cleanings, dermatologist examinations, and more.

Then one can have something specific go wrong, say gall stones, which entails a trip to the emergency room, then a scheduled surgery, and follow up visits to the surgeon's office. This all seems endless.

OK, OK, I get it.

We have the best health care system in the world and without all the seemingly endless visits I am a living longer and healthier life. However, all these places that I must visit are run independently of each other. Surprise! They are almost all private businesses. So, every time I visit, I have to provide data; not just on symptoms.

It used to be that I would arrive at the office and a staff member would ask me a few questions to update their file. Then all these medical service providers decided to move into the 21st century, automate their record keeping, and go on-line.

Hooray! I was really encouraged. However, now, before I visit a medical service provider, I must go on-line, set up an ID, assign a password, verify the password and log in using secret codes, different for each practitioner. And then can I fill out on-line forms.

Now that I am doing the forms, instead of a staff member, they seem to be longer and more involved. Each provider wants entire my history entered each time, on one set of forms recently, I had to enter my name three times –- a tad redundant wouldn't you think.

Another time I had some surgery and went to the surgeon's office for follow up, the staff member wanted me to fill out the form. The surgeon's office was in the same building complex with the hospital, which had all my data, and where he did the surgery. One might think that the two would use the same data system or at least be able to access each other's data, not so.

No wonder the "best health care in the world" is so expensive.

A personal note: Recently, I needed a prescription refilled from a doctor of long standing and did not have an appointment scheduled. I thought, email. I went on the practice's website and there was no email address. However, there was the suggestion that I create an on-line account.

No way was I creating another.

My secret notebook with IDs and Passwords already has 52 accounts. No way was I adding one more. I wrote a letter with my request, put a stamp on it and placed it our mailbox. Low and behold, the letter was delivered, and my prescription renewed.

Historically, the medical data French system worked similarly to that of the U.S. with a combination of federal payment, personal insurance and out of pocket payments. However, the paper-based process has been streamlined and automated with the issue to registered individuals of a plastic photo identity health insurance card.

The card is called the Carte Vitale.

It is embedded with a microchip and contains your unique social security insurance number, gender, date of birth, birth registration, and security control numbers. The card does not include medical information, although the government has developed an on-line personal record system.

When a French citizen receives medical treatment, the card is presented to the doctor/pharmacist who places it into a card reader enabling obtain direct reimbursement from the insurance fund. Insurers for patients with supplemental health insurance policies are notified of their charges. Only the State-reimbursable part of the charge is paid directly by the Carte Vitale.

France also has developed and introduced an on-line centralized personal health record system called the Dossier Médical Partag&eacutre; (DMP). The purpose of the DMP is to provide health professionals with medical information on a shared database, which is stored on the Cloud. Thus, one's medical history, test results, imaging, ongoing treatments can be shared amongst health professionals, such as general practitioners, specialist consultants, nursing, or hospital staff.

The purpose of this centralized digital record is to improve patient care by ensuring all medical professionals were fully aware of the medical history and circumstances of their patient, particularly useful in the event of an emergency or when travelling away from home.

DMP was designed to create savings, elimination of unnecessary treatments, and avoid duplication of treatment.

A system in the U.S. similar to the Carte Vitale and the DMP would save us all time, effort, and money. We claim to be the most technically advanced country in the world, so let's apply this technology and solve our medical records mess.

"What about my privacy" you ask?

What privacy, that is long gone. We sold it to Facebook, Amazon, Instagram, Twitter, Tumblr, ebay, LinkedIn, YouTube, Etsy, WhatsApp, Google, Snapchat.... Did I mention the Chinese? Also, the federal government already has lots of our data, think of Social Security, the IRS, Medicare, and more. At least, government agencies have some standards concerning our data.

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