The clinic that leases my NxStage has begun to request a ‘monthly’ thumbdrive in order to download the treatment information.
They will be able to know, when, how long, how often and how I treat in my own home.
The privacy that was inherent in dialysis at home for me will be greatly reduced.
They will say they have a right to this information, since they are renting the equipment and billing Medicare etc. for my treatments.
I am concerned about the loss of freedom that looks like a one-way street down which I do not wish to take the first step.
Let’s think about this and hear some well thought out responses …hopefully not REACTIONS…
Freedom is a commodity that once lost is very difficult to recapture.
[quote=A Traveler;13570]The clinic that leases my NxStage has begun to request a ‘monthly’ thumbdrive in order to download the treatment information.
They will be able to know, when, how long, how often and how I treat in my own home.
The privacy that was inherent in dialysis at home for me will be greatly reduced.
They will say they have a right to this information, since they are renting the equipment and billing Medicare etc. for my treatments.
I am concerned about the loss of freedom that looks like a one-way street down which I do not wish to take the first step.
Let’s think about this and hear some well thought out responses …hopefully not REACTIONS…
Freedom is a commodity that once lost is very difficult to recapture.
A Traveler[/quote]
It is ethical and perhaps controversial, but I think they already know alot about our health. They have our blood labs and more!
As for the thumbdrive, it may be source of information to troubleshoot tech problems the machine may be having or even help adjusting the patient’s therapy.
I even think a GPS installed on the cycler would even help us in situations where we get stranded somewhere in vacation.
In case it helps, I know that one reason for this is that many nephrologists don’t feel comfortable with their loss of control when patients go home. Without staff on site to supervise the treatment, they worry that folks will skip, shorten, etc.–so they don’t support home therapies. Giving the MDs back some ability to ensure that treatments really are being done is one way to enable more folks to do home dialysis.
Another consideration is on the billing side–without proof that the treatments actually occurred, centers that bill for home dialysis could be open to allegations of Medicare fraud if patients are not, in fact, doing their treatments.
Finally, memory chips etc. have been standard equipment on PD cyclers for probably almost as long as there have been PD cyclers. You have the ability to be “private” doing home dialysis in that there aren’t other patients and their families observing your treatments, but the parameters of the treatments themselves are medical information that is part of your chart that the staff need access to.
[quote=Dori Schatell;13573]In case it helps, I know that one reason for this is that many nephrologists don’t feel comfortable with their loss of control when patients go home. Without staff on site to supervise the treatment, they worry that folks will skip, shorten, etc.–so they don’t support home therapies. Giving the MDs back some ability to ensure that treatments really are being done is one way to enable more folks to do home dialysis.
Another consideration is on the billing side–without proof that the treatments actually occurred, centers that bill for home dialysis could be open to allegations of Medicare fraud if patients are not, in fact, doing their treatments.
Finally, memory chips etc. have been standard equipment on PD cyclers for probably almost as long as there have been PD cyclers. You have the ability to be “private” doing home dialysis in that there aren’t other patients and their families observing your treatments, but the parameters of the treatments themselves are medical information that is part of your chart that the staff need access to.[/quote]
I really think that’s where the future is. All is aiming toward paperless reporting. Just recently our clinic “WellBound” granted us the go ahead to Emailing billing. Basicly, we have an excel spreadsheet of billing which we can fill out in any manner, such as printed out and filled by hand then scanning it into computer then emailed or filled out directly with Microsoft Excel.
The emailing of private information is questionable too! Nothing is private over the net…it all goes through many mail web servers and leaves a copy of them scattered around. I wanted to suggest to my clinic to let us password our electronic medical files before emailing them.
Gus and Traveler,
We have had since day 1 a thumb drive attached to the cycler. Twice now I have called about a potential problem. They downloaded the information and called me back to let me know what I thought might be a problem is no and why.
I have no problem with using a thumb drive.
In fact, I am looking into the Medic Alert that uses a thumb drive you carry with you with all your information on it. Especiallly when you travel if something happens all you need to do is give the hospital etc the thumb drive an all your medical info is there including medications etc.
Just the other day we were at the gastroentorologist and talked to the nurse practioner.
She told us her nephew who is a graduate of RPI in Troy NY was working on a chip that is inserted under the skin with all your info that a hospital or doctors office only needs to put a hand held wond over it to get your information. It is already past the proto type.
Isn’t science wonderful!
Pat
I’m for privacy as much as the next guy, but one needs to define when keeping information “private” is in your best interests. I consider my nephrodoc, nurses nad NxStage as all part of my medical team, and I choose to let them have information regarding my treatments. That’s one of the reasons why I keep my System One hooked up to the modem. I want my info downloaded everynight. I’ve been meaning to hook it up to my home network so them could have the info instantly. I’ve called tech support in the past and have asked them to confirm an issue I was having and asked them to check the data. I believe it’s in my best interest for my entire team to have the info. Even if I dialyzed in my bedroom I wouldn’t think it was an intrusion upon my privacy.
Treatment information is very important to your providers. They can recognize trends and problems and use this info to provide better care to you. My PD pts use a cycler with an IQ card; when I download this info I can see alot of worthwhile information to assist them in providing self care. I don’t feel this is an unreasonable request and neither do they.
I say I on privacy I like to do longer tx then Rx and sometimes other thing that help me my labs are superb and that’s all that matter as far as I’m concerned.
I suspect that doing longer treatments would be just fine with your care team. What they’re worried about is not doing them at all, or cutting them short.
Just a recap on privacy, for those of you who are given the option to email your billing reports and/or charts, but don’t have or can’t afford Microsoft Office Excel you might want to look into the OpenSource community…the alternative is OpenOffice Applications that is free for everyone to use and can have many copies you wish, even on as many computers you want! Grab it at http://www.openoffice.org …already supports exporting of PDF format!
The most simplest and economical way to keep get your report ready is to use PDF format. Convert your excel reports to PDF and prepare them as fillable forms. Be sure to keep a master copy of it! Use any PDF reader/writer that supports saving your filled PDF forms and be sure to password the forms to prevent anyone else to edit it. Once you do that you password the PDF document to prevent anybody else to view it, but be sure your clinic has the password or else they won’t be able to view it!
Well It probably would be good to get the non compliant pts as you know we have to chart over time cost and if i did then Medicare would wonder why my Dr would wounder when all in all we are talking 1 gallon of bicarb and 4 oz of acid for all that. I would probably be told she doesn’t need that when we all know more is better. By only 400 dfr and bfr of 300 for a couple extra hours isnt hurting anyone I love to donate my time as a tech so that is not a issue since its my wife.
Another tip I give out is to get yourself an SLL Certificate for your email program. Having a an SLL Certificate further encrypts and digitally signs your email messages. This is very handy for those of us sending report through email. For this to work full your clinic should have their own certificate as well, that way the messages from both parties can encrypt/decrypt incoming and sent email messages. If only one side has a certifictae, you then only can digitally sign it, but cannot encrypt it, so its best bet to let your clinic know to get their own certificate…