Mcard offers patients more control of records
Fax on demand of health information
Consumer backlash toward the constraints on treatment imposed by managed care is causing many people to fight back by taking their health care into their own hands. Increasingly, that includes not only participating in decisions about their treatment but gaining access to their own medical records and the information they contain.
Now a California company is capitalizing on this trend for patients to gain more control over their own medical records and decide who has access to them and when. Mcard, based in Sunnyvale, offers patients the ability to authorize fax-on-demand access by health care personnel to a central database containing their health information.
One Mcard scenario: An injured man is wheeled into an emergency department. The usual investigative process begins - find out the extent of the injuries and hope that the treatment doesn't cause adverse or allergic reactions. If the injuries are severe enough, resuscitate or maintain on life support in the absence of information indicating otherwise until next of kin can provide further information.
Tiny card holds key to patient's file
But this patient carries a credit-card size Mcard in his wallet, which instructs health care personnel to call a toll-free number for medical information.
A 16-digit patient identification code authorizes release of his medical information. (Patients also can opt for a four-digit personal access code as added security.) The call is made. The emergency department's fax number is given, and within two to three minutes, a fax of the patient's medical record is printing out. History of heart problems, EKG results, allergies, even a living will are in the hands of emergency department doctors and nurses within minutes.
Mcard, launched in 1995, is an arrangement made solely with the patient, and all information is provided by the patient.
"One of the things we're kind of grappling with is how do we get the doctor to provide the information," says Rama Jager, Mcard co- chairman and co-CEO.
"The incentive is if the patient is ever in an emergency department he or she can have the records immediately faxed over. The patient can provide those medical records. There is really no incentive for the doctor to provide us with that medical information. Doctors are already burdened with paperwork."
The company charges a fee - $19 for individual membership and $49 for up to four members of a family. Members are sent a detailed Mcard medical record form on which they are asked to supply the following information:
· emergency contacts;
· family or personal physician;
· medications currently being taken;
· allergies;
· previous surgeries or use of medical devices;
· past or current illnesses;
· family medical history;
· obstetric and gynecological history for women;
· details of last hospitalization;
· health insurance coverage;
· immunization history;
· social history, occupation, and tobacco and alcohol consumption;
· any other comments they wish to include.
In addition, members can include an electrocardiogram and three additional pages of information, such as lab reports, a do-not-resuscitate order or a living will. The form can be updated as often as necessary.
Information is complete and secure
The information on the form is digitally downloaded into Mcard's computer database for storage. The form is then shredded. Once the information is downloaded, a printout is sent back to members for verification. They are advised to check with their doctors if they are unsure of any information they have given.
Mcard insists that the information contained in its database is secure, and the optional personal access code insures confidentiality. The code can be used to block out certain information contained in the medical record, such as HIV status or genetic test results.
Mcard keeps a log of all phone calls made to obtain information. When the record is accessed, patients are notified by mail.
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