3 Reasons Why You Must Keep Your Own Health and Medical Records

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By CK Wilde for 3GenFamily Blog

Over the past 19 years since my first son was born, we have had a number of doctors care for us. Dr. G, our first pediatrician, was reassuring and supportive even when I was 2 hours late for the first baby check up.

When Dr. G accepted a partnership opportunity 80 miles away, we moved to Dr. H who gave my children friendly, practical care until it was our turn to move away.

Dr. H gave us a referral to Dr. B, a distinguished, elderly man trained in Europe. I really appreciated Dr. B’s concern and care when it came to treating my son’s asthma.

Unfortunately, our insurance carrier changed and I was forced to find a different doctor who was accepted by the plan. That’s how Dr. F entered our lives.

Every time we made a change, I dutifully requested that my sons’ medical records be sent to the new doctor. Dr. F inherited two files that were over 2 inches thick. The last time I saw a complete file was during an office visit for my youngest son two years ago.

(Here’s the Health Record organizer I recommend.)

Reason Number 1 – Medical Records Get Lost or Destroyed

Recently, it was time to changed doctors again. I requested copies from Dr. F’s staff and paid $50 for them photocopy the entire files.

What I got was only 10 pages for each son!

The doctors’ staff insists that I got everything they had.

So, what happened to all of those old records?

I can only suppose that someone was cleaning up the doctors files and moved ours to some unlabeled box in a storage facility. Or, perhaps they shredded them (California has enormous penalties for failing to destroy medical records properly).

HIPPA, the Health Insurance Portability and Accountability Act, requires information it defines as “protected health information” to be maintained by the physician for at least 6 years from the date of its creation or the date it was last in effect. The earliest date in the records I received was 1997. So Dr. F’s staff had actually kept records going back more than 10 years.

Isn’t that good enough?

Not always.

Reason Number 2 – Memory Fails & Doctors’ Notes are Impossible to Read

My oldest son recently came down with a sinus infection at college. He needed to tell Health Services if he had any reactions to medication. I recalled he had some issue with one antibiotic a long time ago. But which one was it?

I couldn’t remember the name so I searched the records I received. Dr. F’s scribbles were impossible to read. How I wish I had kept a set of records myself. The benefit claim forms that the insurance company sends don’t have any of these kinds of details.

So my son had to take the medication he was prescribed and hope for the best.

We lucked out. Number one son is recuperating nicely. But, there could have been a problem. All I had to do was make a legible note in a binder and put it in a safe place. But I didn’t because I thought I would remember.

My father tried to capture his key medical issues on pieces of note paper. I found a few of these notes in his tax paperwork for 2005. But, Dad didn’t have these papers with him the times he was hospitalized in the past two years.

My father wasn’t always able to tell the hospital doctors his medical history. It is clear from the records I have that they were in the dark about it. He ended up having multiple tests and x-rays over and over again because of it.

Reason Number 3 – Doctors Don’t Always Communicate With Each Other

In my post, Google Doesn’t Belong in the Health Records Business, I mentioned that my Dad’s family doctor did not always get records after my Dad’s hospitalizations because she was not affiliated with that hospital.

The hospital would assign a doctor to my father. Dad would protest that he had a doctor. They would explain that she couldn’t attend him that their hospital. My father would be angry and frustrated. The hospital staff would just call him difficult.

Eventually, I convinced my father to switch doctors so that he would have a family practitioner close to where he lived. With the help of the nurse at the retirement community, I arranged for my father to consult with two of the doctors who made visits to the community. He wasn’t sure which doctor he wanted as his primary care physician so we arranged for him to meet both doctors and then decide.

I requested my father’s medical records from his original doctor but her staff did not want to release them. The office manager said she would only release his medical records to another doctor. (Note: Each individual has a right to his/her own medical records.) They said they were afraid he would lose them and it would be too much work to copy them again.

Frustrated but unable to do much by long distance, I suggested to my father than I would give his old doctor one of the names of the new doctors, have the file sent, and then he could choose from the two new doctors. The nurse at the retirement community promised to get the file to the right doctor when it arrived.

Dad had a “meet and greet” with one of the doctors. Still no medical record for the new doctor to review. The other doctor had an emergency that day and canceled office visits.

Meanwhile, I continued to badger the office manager to release my father’s records.

Dad’s records eventually arrived, but not before he was hospitalized again. More tests, more x-rays.

You Need to Protect Yourself and Your Family

My family has had its share of doctors’ visits since the time my children were born. Most of those have been routine checkups. Never in all that time has any medical professional ever suggested I keep a binder to keep track of things.

My latest experiences tell me that I really need to get a binder together for my family. After doing some research, I settled on Jakoter Health Organizers.

Jakoter Health Organizer

The Jakoter Health Organizer includes a sturdy binder, 75 separate pages to record important information, pocket pages to hold instructions, notes and charts, even business card holder pages to keep all of your doctors’ business cards handy.

Click this link to see more information about the Jakoter Health Organizer.

Are you carrying around stacks of doctors’ business cards in your purse just in case you will need them? I was. The business card pages in this kit are a way to lighten your load and still be prepared.

This organizer was created by an enterprising mom, Laura Heuer, who needed a way to deal with the overload of details about her son who had severe reactions to antibiotics given for a strep throat. Her son eventually got better. Out of her struggle to stay organized and on top of issues, the Jakoter Health Organizer was born.

Please check it out. Having organized health records will make it easier to communicate with your doctors, prevent unnecessary procedures and help your doctor make better diagnoses.

Today is a great day to get started.

© 2008 CK Wilde. All Rights Reserved. Please feel free to link to this post but you must have prior written permission to reproduce this post either whole or in part. Please use the comments to request permission.

Does Your Parent Want To Sell Her Life Insurance To Speculators?

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By CK Wilde for 3GenFamily Blog

My father only had a couple thousand dollars of life insurance in force by the time he turned 83. He outlived the term of one policy, so the insurance company paid him the cash value and terminated the policy.

As someone who was deeply affected by the Depression, Dad would probably have jumped at the chance to sell a life insurance policy for more than the cash value. But, as someone in the early stages of dementia, he was vulnerable to being swindled. We had one close call with his investments.

I want to alert you to the booming business in life settlements that is still largely unregulated.

Help for the Terminally Ill

It started out as a compassionate way to help someone who has large medical bills to pay. It’s called a viatical settlement. It gives a person, typically with less than two years to live, who owns a large cash value life insurance policy but does not have a spouse or children, a way to get cash out of the policy.

Cash value insurance policies (also called whole life) have provisions for the owner to cancel the policy and receive the “surrender value”. But, this amount is usually very small compared to the total amount of insurance. The settlement company is usually willing to pay much more. The viatical settlement became popular during the 1980’s as a way to help terminally ill AIDS patients deal with the high cost of medical care.

A New Investment is Born

The purchased insurance policies from those early viatical settlements were sold to individual investors. Because this new investment was unregulated, it attracted some unscrupulous dealers. Salesmen were paid high commissions to sell the policies to investors who did not always understand what they were buying. The investment community soured on buying settlements.

In 2001, the National Association of Insurance Commissioners released the Viatical Settlements Model Act which established guidelines for ensuring sound business practices and avoiding fraud. It was about that same time that settlement dealers began purchasing policies using institutional capital. The demand for settlements as an investment began to increase.

Better Than Mortgages?

From an investor’s standpoint, buying insurance policies is even better than buying mortgages. Everyone dies! As long as the insurance policy was written by a company that is solid, the investor gets paid.

Investing in mortgages, once considered much safer than stocks or bonds, is not as predictable. People can get sick or disabled, lose there jobs, or have other life events that prevent them from paying the mortgage. US economic problems today were caused in part by defaults on mortgages — many made by unscrupulous brokers who bent the rules.

Most mortgages today are combined into packages that re-sold to large institutional investors. It wasn’t long before some enterprising folks figured out that they could package these purchased policies, now called life settlements, and sell them to institutional investors for generous commissions.

Easy To Be Taken In By Easy Money

It happened to Larry King, CNN’s famous talk show host. King alleges in a lawsuit filed recently that he was the victim of a scam to buy and sell life insurance on himself, also called “flipping” policies. While King made $1.4 million on the deals, he now realizes that he would have been better off if he had kept the policies. He feels that he was cheated.

An insurance company owns the $15 million in policies, a company by the name of Coventry Insurance. Coventry was sued last year by the State of New York for alleged predatory practices.

Yesterday, our local newspaper, the San Jose Mercury News, reported that flyers were circulating at a San Luis Obispo, California senior center telling seniors they could get as much as $50,000 from “investors that want to speculate on our life expectancy.”

Although the NAIC issued the Viatical Settlements Model Act in 2001 and amended it in 2007 to strengthen consumer protections for “Stranger- Originated Life Insurance” only 35 states have officially adopted the guidelines. California, where I live, has not yet adopted any guidelines.

What’s The Harm?

If Larry King, who is a reasonably intelligent 73 year old, could be duped, anyone could be. Particularly someone in the early stages of dementia.

Life insurance is just one part of a total financial plan. Selling a life insurance policy really needs to be evaluated in terms of the person’s overall needs and financial status. These life settlement companies are not doing that.

So we caregivers need to be alert to these issues. If your parent tells you about a wonderful opportunity to sell an old life insurance policy, get to the financial planner or attorney to have the deal reviewed right away. Who is buying the policy? Will it be sold to a third party? Who is that?

The Mercury News article quoted Jay Adkisson, an attorney who writes a blog about financial fraud, “You ought to know who you are selling to. You don’t want Tony Soprano buying your life insurance policy.”

Good advice.

Google Doesn’t Belong In The Health Records Business – Here’s A Better Idea

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By CK Wilde for 3GenFamily Blog

Sorry, Eric (Schmidt, CEO of Google).
Google doesn’t belong in the health records business.

For those of you who don’t follow Google’s business on a daily basis, here is a brief rundown of what has happened.

Last year, Microsoft announced a new service called Health Vault to help individuals manage health records online. This is not a revolutionary idea. There are already several smaller companies on the Internet offering individuals the convenience of storing health records online so that they are more available when they are needed. Several of the large players in the business of providing technology to doctors offices and medical clinics also have digital records initiatives.

But, no one company has been able to gain serious momentum in digital health records. It is a gargantuan task to coordinate doctors, labs, hospitals, pharmacies, insurance companies and individuals AND meet all of the requirements of HIPAA for privacy. Microsoft has already collected an impressive number of partners to work with Health Vault.

Google Announcement Starts Tsunami

In Orlando, Florida last week, Google announced Google Health, a platform for individuals to manage medical records such as medical test results and prescriptions. The announcement set off a wave of protests from consumer privacy advocates. Eric Schmidt is trying to soothe the uproar by saying that Google won’t sell ads on Google Health.

Oh really?
Here’s how one analyst sees the situation:

“Gene Munster, an analyst at Piper Jaffray, firmly believes ads will happen. ‘Advertisers would pay absurd amounts of money to be seen when someone wants to, say, refill a subscription online,’ he says.’ This is more lucrative than commerce-related search.” For the complete story, click here to see Jefferson Graham’s article in USA Today.

Digital Records Could Save Lives

I’m not a Luddite. I work for a company that develops mobile technology.

And, I have had to fight ferociously with doctor’s office administrators to obtain my Dad’s medical records as well as my own and my children’s records. In one case, I had to pay $100 for a file of poor photocopies that I could barely read. Forget about scanning to digitize them.

My father was caught in the bind between doctor and hospital. His regular family doctor had all of his records but she wasn’t admitted to practice at the hospital closest to my father’s home. The hospital would “assign” him a doctor while he was there. But the records never made it back to the family doctor.

The cardiologist at the hospital might not have put my father on Plavix if the doctor knew my father had a history of gastrointestinal bleeding. At one point, the docs who did not talk to each other had my father on DOUBLE doses of 4 different medications. It only got corrected because he could feel that the medications were not working right. He went to the family doctor who reduced all the doses and got rid of the duplicate medications.

That was a close call! And, it is a safe bet that this happens to thousands of Americans everyday.

If you have experienced anything like this, you may think I am crazy to oppose help from the two tech companies that have the best chance of making digital records happen. Pam Dixon, executive director of the non-profit World Privacy Forum, said it best,”A publicly traded company is supposed to have shareholders (my emphasis) in mind first.” (As quoted in an Associated Press article by Travis Reed.)

The Push for Quarterly Profits

Wall Street, institutional and individual shareholders are illogically relentless in their push for quarterly profits from publicly traded companies. Every employee knows what ROSHE (Return on Shareholder Equity) its company is trying to achieve. The focus may be making customers happy so they buy more product or service but the goal is always ROSHE.

The bulk of Google’s revenue comes from selling ads. Microsoft sells software and services. These companies are locked in a battle to gain your attention for its products and partners’ products. Each is working to dominate the marketplace.

So, it is easy to envision a scenario in which our personal privacy gets compromised.

But, it doesn’t have to be that way.

Microsoft has the platforms to connect little devices like a glucose monitor to your home computer but its web sites infrastructure is not as strong as Google’s. (Full disclosure– my company is a Microsoft Partner. I have many good things to say about Microsoft but not when it comes to its web sites.)

Google has the digital infrastructure to power web-based communications around our planet. If you use Google to search the Internet, you are tapping into an amazing, gigantic, distributed network that gives you search results after it has filtered out over 3 million malicious or problematic web sites in a small fraction of a second. But, even Google admits that its first version of a G-Phone is buggy beyond belief.

I admire both companies for what they have achieved and the vision they espouse. But both companies have the compelling need to make ROSHE. Right now Google has advertisers that are willing to pay $25, $50 or more when a person visits the advertiser’s web site. The possibilities for enormous revenue for delivering pharmaceutical ads, for example, to consumers are easy to imagine. Google has all of the technology from Double Click to track every purchase you make. It’s only a short step to your entire medical file.

Microsoft has slightly different, yet just has huge revenue possibilities. It’s making the Wall Street analysts giddy with thoughts of double digit quarterly profits.

The Third Alternative — A Consortium

It’s hard to get things done by committee. Compromises can result in gazelles that look more like camels. But sometimes a non-profit organization or a governmental entity is the only way to protect citizens from the fallout of the giant corporate gladiators.

From my vantage point, the only way to assure that digital health care information does not become another series of battles like Blu-Ray versus HD-DVD (or Betamax vs. VHS for those who have long memories) is to have a non-profit consortium responsible to citizens to safeguard privacy and set standards for interoperability.

Think of the headaches if you want to change doctors but the new doctor doesn’t use the same medical records system. If you choose to go with the new doctor, you have to figure out a way to get all of the pertinent data into the new system. That’s more time out of your week, more money out of your pocket, and another point where your information could be corrupted or misused.

Now is the time for Microsoft and Google to call a truce and become part of a non-profit consortium for health care records. It won’t be perfect, but when consumers trust that their information is safe, they will sign up to buy in droves. And that would make Wall Street happy, too.

It’s Valentine’s Day – Take Your Parent For a Walk and Salmon Dinner

And, Make Sure to Have Pudding for Dessert

What?!

A popular nutrition newsletter arrived in my email today talking about Vitamin D deficiency in the US. I was surprised to read that Vitamin D deficiency is very common in the US. A recent study in the American Journal of Clinical Nutrition (January 2008) found that a low blood concentration of Vitamin D was associated with higher blood pressure in Caucasians (but not African Americans.)

It seems that researchers are finding all sorts of health issues that a little bit more vitamin D would lessen or prevent. Most important for seniors — Vitamin D helps your body use calcium to build stronger bones.

Hip or other bone fractures are often the beginning of a grindingly slow downward spiral for many seniors. Less mobility leads to even less mobility. The end of the line is the nursing home.

The crying shame is that Vitamin D is so easy to get through our diet, supplements and sunlight. Eggs, tuna, salmon, mackerel and sardines are good sources of Vitamin D along with fortified milk products.

Your daily vitamin probably contains it, but not enough. The recommended daily allowance is 400 IUs. Many all in one supplements contain less than half that amount.

More Is Better

Dr. Andrew Weil, (click here) highly respected for his approach to combining nutrition with traditional medicine, recommends 1000 IUs per day and even more if you don’t get out in the sun at all. His recommendation comes after extensive research into the latest studies on Vitamin D.

His conclusion: More is Better!

Love the One You’re With

Here’s an easy way to show your Valentine you care. Take your parent (or loved one) out for a walk in the sunshine, weather permitting. Just 15-20 minutes of sun on your hands and face is enough. But, don’t put on sunscreen. It blocks your body’s ability to make Vitamin D. Take the sunscreen with you to apply after you get a bit of sun if you’ll be out more than 20 minutes.

Then, have a lovely salmon dinner. Tuna sandwiches are ok, too (go light on the mayo.)

And, top it off with pudding made with fortified milk (nondairy, if milk is a problem). Sorry, milk chocolate truffles don’t count.

Both People Benefit

Spending time with someone to celebrate has benefits for your parent, loved one and you. Mind, body and spirit. Don’t miss out.

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Five Easy Steps to Shrink Your Risk of Age Related Macular Degeneration (AMD)

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By CK Wilde for 3GenFamily Blog

A Good Friend Remembered

A good friend of ours died the third week of December. We just received a note from his daughter responding to our holiday card. Unfortunately, it never reached him.

We sent cards every year even though we were never quite sure our friend could read the card. AG, now in his 60’s, had worked with my husband some years ago. Macular degeneration wiped out his sight, and his ability to make a living as a computer programmer.

His vision problems were already underway when he attended our wedding 20 years ago. He soldiered on, working from home and adapting his life to his condition.

When his vision decreased to the point that he could not drive, he rode his bicycle for shopping and errands. AG amazed me with insistence on doing things for himself. He was determined to maintain his independence. Eventually, even bicycle riding became impossible.

Women Are More At Risk

While it’s true that women are more at risk of developing macular degeneration than men, AG had two other high risk factors working against him: smoking and high blood pressure. And, based on what we know about his cooking and eating habits, nutritional deficiency was a distinct possibility.

You are also more likely to develop AMD if you are over 60, have a family member who has it, are seriously overweight, have other cardiovasular problems, have light eyes and spend a lot of time in bright sunlight. Whew! We fit in several of those categories. That’s scary.

Five Easy Steps to Healthy Eyes

Fortunately, there are some very easy things you can do right now, no matter what your age is, to prevent Age Related Macular Degeneration from happening to you.

  1. Stop smoking. Not only will you reduce your risk of AMD, you will reduce your risk for a long, long list of health issues. If you still smoke, you know what I am talking about. My annual bout of bronchitis mysteriously disappeared after I quit smoking.
  2. Eat a colorful, balanced diet. Leafy greens, bright colored fruits and vegetables, eggs, lamb, poultry, fish, nuts and seeds and whole grains contain antioxidants, vitamins and minerals that nourish our eyes. The key nutrients are Vitamins A, C, E, Zinc, Selenium, Lycopene, Beta-Carotene, Lutein and its cousin, Zeaxanthin. A recent study found that one egg a day substantially increased the amount of lutein in the bloodstream of post menopausal women in the study with only a very modest increase in cholesterol. Can’t eat that much? Supplements can help, too. Here is a link to the Mayo Clinic’s complete list of supplements for the eyes.
  3. Stop eating processed baked goods. Put down that danish and slowly back away from the table! Ditto for cookies, cakes, crackers and chips. There is evidence that hydrogenated fats double your risk of progressing to advanced stages of AMD. And they are terrible for your cardiovascular system. As an added bonus, you may find that you have an easier time with your weight and more stable blood sugar. My sugar highs and lows are gone. (Yes, I do miss a gooey cinnamon bun every now and then.)
  4. Wear sunglasses that block UVA, UVB and blue light. Do you remember the “BluBlocker” sunglasses ads on TV a few years back? I thought it was just slick marketing. It turns out that yellow or amber tinted glasses block blue light and really do reduce glare so that you see more clearly. Blue light is believed to react with the pigments in the retina to produce free radicals causing waste products to build up in the retina if not cleared out by antioxidants. The studies are mixed on whether blue light causes macular degeneration. It may be that people with light eyes have less protection because there is less pigment in their eyes to block those wavelengths. It makes sense to me to wear UV/Blue blocking sunglasses while out in bright sunlight since UV has been associated with the development of cataracts. Not long ago I bought a pair of sunglasses that were gray instead of amber. I really notice the increased glare compared to my old pair of amber sunglasses. I’m switching back to amber.
  5. Get regular eye exams. If you are over the age of 40, seeing your eye doctor every two to four years is recommended. Over 60 years old, the recommendation for eye doctor visits is every one or two years. (More if you have problems.) There are several tests that the doctor can use to check the health of your retina and the macula (the small part of the retina responsible for clear vision.) If your doctor offers Optomap, make sure to get it. The Optomap is a computerized camera that takes a wide angle picture of the retina. It allows your doctor to get a really good view. It doesn’t require dilating your eyes with drops so that you have trouble seeing for several hours. Because the digital image of your retina is stored in the eye doctor’s computer, he can compare older images with the newest ones to look for changes – much better than working from notes in your chart. With early detection, you can take steps to stop the progression of AMD . . . and keep your sight.

Does Your Parent Need A Cell Phone For Emergencies? Here’s The One.

3GenFamily Blog has moved to a new location on the web.

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By CK Wilde for 3GenFamily Blog

Dad rarely travelled outside of a 10 mile radius of his home. The one or two times each year that he needed to go farther, he would enlist someone to drive with him. So, I never pressed the issue of getting a cell phone for emergencies.

When I showed him my newest phone, he dismissed it saying,” The buttons are too small. I can’t read that screen. I’m hard of hearing, you know!”

Then came the accident.

Dad was driving back from the car dealership, took a wrong turn onto the New Jersey Turnpike, got lost and tried to find his way back through a neighborhood he had never seen before. Peering sideways to read the street signs, he veered into a parked car. Crash!!

My father was a very lucky man. The owners of the parked car were looking out their kitchen window when it happened. They rushed to help him.

He climbed out of his car, shaken, but not injured. At first, the police thought he was drunk. When my father told the police he was a diabetic and could not drink, they worried that his blood sugar was too low.

Eventually, Dad convinced them that he didn’t need an ambulance, just someone to take care of his car and give him a ride home. Those good samaritans who witnessed the accident called someone to take care of the car. The car repairman took my Dad home.

My father waited for several days before telling me about the accident. He knew before I said a word that I would urge him to give up driving. He did stop driving shortly after that incident. It had scared him that much!

It scared me, too. What if nobody had been around to help?

I wish that my Dad had had a Jitterbug phone.

Jitterbug cell phones are designed to be easy to use with big, back-lit buttons, large text, and a powerful speaker for loud, clear conversations.

What makes the Jitterbug phone perfect for seniors is the live, 24 hour operator service. The operators will make calls for you, assist you with finding a phone number from a directory or add names to your phone list. (5 minutes are deducted from your minutes for each operator assist.)

The best part is there are no contracts and no long distance roaming fees. You choose the plan that’s right for you (as low as $10 per month.) You can even share minutes with another family member.

If your parent likes to go out and about but you worry, get your parent this phone for the holidays or any gift giving occasion. The price of the phone is very modest — $147. The peace of mind for a caregiver is priceless.

To learn more about the Jitterbug phone and service plans, click here.

Jitterbug Phones with Feature List

photo courtesy of GreatCall, Inc.