Pogonip, noun: A dense winter fog having ice particles.

[conuly]

I've never experienced such a thing, but when I do, I'll be ready.

******************

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Comments

[greghousesgf]

Shame on American Airlines!

[siderea]

More US patients to have easy, free access to doctor's notes

Psychotherapy notes don’t need to be shared with patients.

AHAHAHAHAH, no. Psychotherapy notes are effectively being broken into the sharable and the not-sharable parts. Or rather, as we psychotherapists currently understand it, if you don't break your notes into two parts – stored separately – the entire note is considered sharable.

There are some unobvious reasons this is terrible, but the obvious reason this is terrible is now a whole lot of psychotherapists have a... whole lot of work ahead of them.

[ETA: I asked a consultant if this is retroactive, and while I haven't yet read his response, I see no reason not to expect it is. That means therapists, who are legally responsible to be able to produce records up to 7 years old, who see, say, 26 patients a week (see my previous posts on the topic to explain where that number comes from) and work 48 weeks a year, now have to manually separate 8,736 notes. Or just give up and treat their notes as wholly sharable.]

One of the unobvious reasons is that a lot of them are using therapist-specific note-keeping software that doesn't support this.

Good times, good times.

BTW, when I joined the field, keeping "double notes" was considered a massive ethical violation and in some places a crime. Now, it's becoming industry standard, creeping on towards mandatory.

This is literally what I plan on spending part of my day today figuring out how I want to handle.

[conuly]

Sounds like a shit-ton of work.

[siderea]

Fortunately, there's an exemption to the Open Notes law.

It doesn't apply if you keep paper notes.

\o/ So I'm exempt.

And it turns out the therapy-technology-law experts who are the industry leading consultants on this sort of thing have confessed that they also keep paper notes.

So right now, it's sure looking like the right solution is for the entire field to walk away from technology for notes.

FORWARD INTO THE PAST, BABY! IF IT WAS GOOD ENOUGH FOR FREUD, IT'S GOOD ENOUGH FOR US.

ETA: also, for the record, yes: every edict from the Feds about medical record keeping has generally come with astronomical costs for providers. The Feds extorted hospitals – anyone who accepts medicare or medicaid – into adopting electronic health records, at staggering cost. Cost for the software, cost for the hardware to run it, cost for customization (enterprise class software is simply not runable out of the box), cost for training every single employee, cost for increased IT head count on an ongoing basis, and massive, massive, massive cost for lost labor in the transition. And while we were promised these systems would make medical recordkeeping faster and better, the truth is they slow doctors down and waste more of their time.

AMERICA, THIS IS WHERE YOUR HEALTHCARE DOLLARS ARE ACTUALLY GOING.