For those of you interested in seeing your personal health records, we've been asked to share some basic guidelines. This info is from MedicalRecords.com and outlines how you can access your complete medical records -
Access Your Personal Medical Records
Access to personal medical records is guaranteed under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Under this law, patients may submit a medical records request, and the personal medical records must be provided within 30 days. Though originally designed to provide access to paper medical files, the law applies to accessing electronic medical records (EMR) as well.
Obtaining your personal health record is as simple as making a medical records request from your doctor. The exact procedure for accessing a personal health record differs from state to state, with some requiring a written medical records request and others accepting a verbal request for your patient medical records.
Ways to Access Your Personal Medical Records in Writing
Some advocacy groups recommend that a medical records request be made in writing so you and the health care provider have a record of the transaction. The Privacy Rights Clearinghouse, a pro-privacy group, has put together a sample request for medical records form letter to help you obtain your personal health record.
Release of Personal Health Records: Rights and Fees
Once received, you have the right to review your personal health record (PHR) and seek changes to information you think is wrong. However, if you want a hard copy of your personal medical records, doctors and hospitals may charge a “reasonable fee” to cover time and cost of materials.
You also have the option to send your personal health record directly to healthcare professionals. If you choose to go this route, most doctors say it is good to let them know ahead of time so they can know when to expect them.
Paperless Medical Records vs. Hard Copies
Proponents of transitioning to paperless medical records say that EMR / EHR systems will decrease the costs of maintaining patient medical records, making it faster and cheaper for doctors to gain access to medical records and thus for patients to submit a medical records request.
For doctors transitioning to paperless medical records, the most successful “were characterized by even more benefits and time savings per patient,” concluded a 2003 report compiled by the University of California on small medical practices that adopted EMR or EHR.
Sensitive Information
While most patients have no problem gaining access to medical records, there are times when accessing your personal medical records request may be rejected. These situations include any time when your physician or provider believes releasing the information to you could endanger you or someone else, or when special exemptions are provided under law, such as for mental health records, which are exempted from disclosure requirements.
Still have questions about how to get your files? Let us know!
We're thrilled to share our second video blog - all about caregivers. Check out Tina & Eric's Men's Liberty story and get our tips for minimizing the impact of incontinence on your life and the life of your loved one.
Most of us go to the doctor and year after year, build up a large file of medical records. From weigh ins to blood test results, there's an awful lot of personal data in those old paper files.
In recent years, with the introduction of electronic health records, HIPPA compliance and the growth in patient-centric care, more and more patients are interested in getting access to their records. But it's not an easy move, and many doctors oppose sharing full medical records with patients.
Check out the following article from Jeffrey Kopman at Everyday Health which outlines recent polls from healthcare professionals and patients and what they want to share!
According to a new Harris Poll survey, conducted on behalf of the management consulting firm Accenture, less than one-third of U.S. doctors think patients should have full access to their own electronic health records.
As a patient, you may literally trust your doctor with your life, and the doctor-patient relationship relies on this level of trust. The relationship should be one of give and take, even if the exchange is sometimes dominated by the professional.
So it may come as a surprise that 65 percent of docs believe their patients should have only limited access to their electronic health records, and 4 percent believe patients should have no access at all.
One thing is clear — patients believe electronic medical records improve their care. According to a 2011 survey, conducted by GfK Roper on behalf of Practice Fusion, a San Francisco-based electronic health record provider, 78 percent of patients whose doctors kept electronic medical records felt that their care improved.
"Patients want their healthcare to reflect the fact we're in the 21st century," said Ryan Howard, CEO of Practice Fusion. "They want to have prescriptions sent electronically, to receive email appointment reminders and to review past diagnoses and upcoming appointments online."
“Several US health systems have proven that the benefits outweigh the risks in allowing patients open access to their medical records, and we expect this trend to continue,” said Mark Knickrehm, senior global managing director of Accenture Health, of the poll’s results.
While a majority of doctors in the Accenture survey wouldn’t trust patients with full access to their records, 81 percent said they wanted their patients to keep the records up to date, which may seem like a disconnect.
Primarily, though, the doctors are referring to updating personal information, not medical information. Almost all doctors polled think patients should update their own demographic information (95 percent), family history (88 percent), medications (86 percent), allergies (85 percent), and even some medical information, like new symptoms and self-administered test results (81 percent).
There seem to be few disadvantages to giving patients access to records and some real advantages, according to experts and commentators. So why do many doctors feel that their patients should not have full access to their electronic medical records?
Stephen Baker, author of The Numerati blog, wrote that patient sensitivity may be to blame for doctors' unwillingness to share medical records.
“This would not be a problem if we, as a society, weren't so hypersensitive to 'hurtful' words, and eager to sue in cases of errors,” Baker stated on his blog.
He used an example of a doctor speculating about his or her patient being the victim of abuse. While the patient might be offended on reading this information in their electronic medical record, the doctor might feel that it's important to document their observations. Baker concluded, “if we want the data, we should be ready to see and accept it, even when offensive. This openness would pay off richly.”
Thomas J. Vento, MD, a family doctor in private practice in Reisterstown, Md., sees the benefits of open access to medical records, because patients can help prevent medical errors.
"It’s a great idea to give your family doctor a copy to keep in his file, but it’s also very important to have your own copy of the health journal in case of a medical emergency," Dr. Vento said. "Being an active voice in health care is an integral part of getting the best care you can for yourself and your children."
After a 2012 study found that doctors failed to read many test results when patients were discharged from hospitals, experts claimed that electronic records could help "prevent important information from falling through cracks."
"[This] problem could be solved with electronic medical records that keep track of test results and alert doctors when the results have not been reviewed," said Gordon Schiff, MD, associate director of the Brigham Center for Patient Safety Research and Practice, at the time. "Patients also can play a role by keeping track of their tests and asking their doctor about the results."
As doctors and medical institutions continue to switch to electronic medical records, and patients demand more access, the debate will continue: How much information should patients have access to?
We're thrilled to share a post from Tracy Sher, MPT, CSCS. - Pelvic Physical Therapist, Faculty for Herman and Wallace Pelvic Rehabilitation Institute, and founder of the awesome Pelvic Guru Blog. She posted this late last year and I recently found it once again and was inspired to share.
She has some great advice that we're keen to share with all of you!
Parents can relate to the fact that we spend a lot of time potty training children. However, that’s likely the only time we experience “toilet talk”. When I provide basic bowel and bladder tips to my adult patients, I am always surprised when they say “why didn’t anyone tell me that?”. So, here’s a list of of some of the best tips that every person should know about toilet talk.
- Don’t force your children to go to the bathroom “just in case” or just out of convenience too often. This presents two challenges: 1. The bladder and nervous system are very sensitive. If your child goes to the toilet without an urge regularly, the bladder will become sensitive to that threshold; and they will feel the urge to go more often. 2. This behavior is easily carried with them into adult years with potentially unnecessary episodes of urinary urge, frequency, and hassle. * There are obviously times when the decision to use the toilet early is advisable.
- Did you know that the average healthy adult should be able to wait 2-4 hours to urinate? Can you wait that long? The most common thing I hear “but you don’t understand, MY bladder is so small. I have to go every 30 minutes…”. Generally, there are easy ways to train your bladder to wait longer. As indicated in the prior point, you may have had habits for many years that predisposed you to believe your bladder was small and unruly. Remember, don’t go to the bathroom just in case (NO JICs). Your bladder is constantly storing urine. So, if you go early, you will likely urinate, but this does not mean it was time to go yet.
- Urinate when you wake up in the morning. Your bladder needs to get “flushed” out. The rule of waiting 2-3 hours to urinate does not apply here.
- Don’t sit on the toilet for greater than 10-15 minutes at a time. This increases risk for hemorrhoids, worsening of pelvic organ prolapse, and more pelvic floor issues! On a related note, NO STRAINING with bowel movements. When you strain, there’s a significant amount of pressure placed on the pelvic floor and surrounding structures. So, sitting for greater than 10-15 minutes + straining = unhappy and unhealthy pelvic floor.
- Women- remember to always wipe front to back (after urinating or having a bowel movement). This reduces the risk of introducing bacteria and other bad elements into the vagina and urethra.
- If you feel a bulge or a “golf ball” at/near your vagina or rectum or you need to use your hand to help with bowel movements, you possibly have some form of a pelvic organ prolapse. Other symptoms can include increased urinary or bowel urge, constipation, and a pressure feeling worst with standing up or straining. You can discuss this with your gynecologist, family physician, or pelvic physical therapist. You are NOT alone. This is common, but patients feel very embarrassed to share. But there is help for this.
- Do you like to wear Spanx, shapewear, girdles, or pantyhose? They are totally slimming, right? Guess what? They can also impede your pelvic floor muscles from fully relaxing when you urinate or have a bowel movement. When you sit down on the toilet with your slimming designer fashion, make sure to slide them all the way down as close to your ankles as possible. This way you can relax your pelvic floor and allow for best chance of fully emptying your bladder or bowels.
- Have you ever read a magazine that told you to try to stop your flow of urine to check to see if your pelvic floor muscles are strong? Well, it’s technically one way to check, but it’s not good for you! Some of my patients thought they were supposed to do this every day on the toilet as part of a Kegel exercise program. No, no, no. This can cause all sorts of issues.
- If you experience bowel or bladder issues- such as constipation, irritable bowel, painful bladder syndrome/interstitial cystitis, urinary urge or frequency- there’s hope! There’s a high likelihood that you can modify your diet or fluid intake and make significant changes. For example, did you know that caffeine and alcohol can increase urinary urge? I have also seen many cases of constipation drastically improve with proper diet modifications. Take this seriously!
- As a general rule, adults should not need to get up in the middle of the night to urinate. As we age and get to 60+, urinating one time during the night is normal. Oh, and pregnancy is also an exception. Two easy tips: 1. Limit fluid intake to little or nothing 2 hours before bedtime. 2. If you feel an urge to go in the middle of the night, see if you can fall back asleep and resist that urge to get up. On a safety note, if you do wake up to go to the bathroom in the middle of the night, please make sure you have a well-lit, clear path without furniture, uneven rugs, or toy soldiers in your path.
If you found these tips helpful or want to share more, please leave a comment and sign up to follow us. Pelvic Guru also welcomes and receives great comments and updates on the
Facebook page.
Blog post by:
Tracy Sher, MPT, CSCS. - Pelvic Physical Therapist, Faculty for
Herman and Wallace Pelvic Rehabilitation Institute, Founder of Pelvic Guru, Consultant and National Speaker.
* From www.pelvicguru.com
Join us as Wendy LaTorre discusses her involvement in Men's Liberty in the first video blog.
I'm officially appalled. This has to be the WORST advice for dealing with incontinence ever - “live with it. It’s just a little bit of water. Get help. And be brave."
Check out the full article here. I know the British are stereotyped as having a 'stiff upper lip' about problems (not inaccurately, I lived there) but still. No one should ever be relegated to just living with incontinence. There are so many treatment and management options that can help reduce or eliminate incontinence. At absolute minimum, there are ways to manage incontinence so that it has less of an impact on your daily life.
So, inspired by a heapful of dismay at such poor advice, I've copied Maggie's original question below and provided my own answer!
Dear Virginia,
I’m 35 and I’ve had radiation therapy for cancer and the resulting scarring means that I find it very difficult to stop leaking urine at times during the day. I really need to be near a loo all the time and as a result my life has been severely hampered. I’ve tried pads, but I’m always worried about the smell. Because I can’t go out very far my kids have to stay indoors all the time and it’s not good for them. I’ve tried every doctor, but no one can help and they just say I must “live with it”. But I can’t. Do you have any suggestions?
Yours sincerely,
Maggie
Dear Maggie,
First, let me apologize for the poor advice you received from Virginia. You absolutely do not have to just "live with" incontinence, much less explain your bladder issues to friends and family to excuse having accidents on their furniture! Fortunately, several other ladies emailed in with much better advice. Still, I deal with this all the time, admittedly mainly from men, so I wanted to throw my own two cents in.
First, since your incontinence is the result of radiation, go back to that doctor. There are prescription options that can reduce the frequency and intensity of your incontinence. If they can't or won't provide better options, consider a physical therapist who can help you with Kegel exercises (to improve muscle control) or a urogynocologist who specialized in disorders of the pelvic floor and reproductive organs. You also shouldn't rule out surgical options which may be appropriate, depending on the exact causes and your doctor's recommendation.
Second, consider changing your diet to reduce or eliminate foods that irriate your bladder and increase incontinence. This includes spicy foods and caffeine. Do NOT drastically reduce your fluid intake. Your urine should be a pale yellow, anything darker and you're dehydrating your body which can do more harm than good.
Third, do regular Kegel exercises and scheduled toiletting to improve muscle control and to help train your bladder to go at controlled intervals. Maybe you need to go to the bathroom every few hours, on a schedule so your bladder gets used to the idea of holding it and builds up muscle strength.
Fourth, depending on the amount you leak, don't be afraid of pads. They're not glamorous but unfortunately they are a ubiquitous option that will give you a sense of security. You can also bring spare ones in your purse and change them every two/three hours. Great strides have been made in capturing or eliminating odor, so you can reduce the embarassment. The truth is, you're probably the only one that knows you have them on. Sadly, there aren't a lot of great alternatives out there for women (though I know we're working on it). Due to their anatomical variations, men have more options like condom catheters and our product, Men's Liberty. When we get the market with one for women, we'll definately let you know.
Last but certainly not least, take every opportunity to talk to people who are also in your situation. There may be support groups (online or in person) with people dealing with your same treatment, diagnosis or even dealing with incontinence. They're an amazing resource of truly sympathetic people who are looking for options just like you. They can turn you on to all sorts of other options that most people (including doctors) may not know about.
I hope this helps a bit. Incontinence isn't inevitable and its not something you just have the learn to live with. There are ways of minimizing its impact on your life so that you and your kids can go out and about without constantly looking our for a bathroom.
Anyone else have questions about managing their incontinence? Let us know!
Medical diagnosis can be tricky – particularly when it’s your very own health we’re talking about. So who cares if you want a second opinion?
Well the doctor’s ego might… 
And no one wants to hurt a caregiver, even your doctor. In our polite society, we often put other people’s feelings ahead of our own. Some people believe it may be considered “insulting” to your doctor, or at the very least “awkward”. And it shouldn’t be – really!
So here are some “nice” ways to do it and what to incorporate:
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Be Upfront – Don’t go behind your doctor’s back. Your doctor will appreciate your honesty. Those health records are your records, and the law requires doctors to give you access.
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Say It Straight – Medicine is complicated, so try saying “I understand there are tons of studies, some contradictory, and doctors have different ways of interpreting them. I wonder if you think I should get another doctor’s position on my situation?”
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Be Nice – It goes a long way. Add the nice statement, “I appreciate the time you’ve spent examining me. I know this was a difficult diagnosis for you to call. Seeing an additional doctor is just so I don’t sit up all night forever wondering.
What might be some of the clues or situations in which you might ask for a second opinion?
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Being bounced around between doctors is one scenario. Determining your exact diagnosis will ultimately assist in developing the most effective treatment. It is SO VERY IMPORTANT!
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Any type of diagnosis that is severe warrants asking for a second opinion - particularly diseases such as cancer. Especially, if you have a nagging feeling that the diagnosis isn’t sitting well with you. Trust your intuition.
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Another reason to ask for a second opinion is trying to determine a course of action when there is more than one treatment option. This is close to the saying “two heads are better than one.” A reassuring opinion is worth its’ weight in gold!
Okay - so what if no diagnosis is being made? You don’t want to lose faith in your caregiver, particularly if they are a specialist. So a graceful request for a second opinion can potentially move you closer to further answers, and subsequent solutions.
We highly recommend that you get a copy of your records. That way, you know what is currently recorded about you. Write your questions and concerns down prior to visiting with the new doctor. Having the critical information and your misgivings or concerns recorded will help the second opinion doctor focus on you.
Who to go to? Ask your doctor - they know who’s reputable in their field, and more than likely, they want the best for you. Or, do some research yourself.
A little known research tool is Google Scholar (http://scholar.google.com/). With Google Scholar, you can search published books, abstracts and articles across many disciplines and sources. This is very helpful when trying to identify a person that is active in the field that is specific to your case.
You are actively putting your health first. Congratulations! In addition, you are standing on the shoulders of giants when you’re able to view relevant works from academic publishers and professional societies.
One final special note: Don’t give up any appointments with your first doctor, just in case the second opinion doctor doesn’t work out for whatever reason. Makes sense, right?!
We wish you the best! Know that we’re here for you, and we’re interested in you having the best health possible!
And don’t forget… We want to hear from you! Tell us your “Second Opinion” stories, and let’s all share your ideas!
To your best health!
Just a short note today, we wanted to mark the one year anniversary of the Men's Liberty blog! It's hard to believe our first post went live 365 days ago! Check it out here!
To everyone whose been here since the beginning and everyone whose joined in along the way - thank you!!! You're comments, emails and questions have made us better and we've learned so much from you along the way.
We're looking forward to continuing to grow in year 2! We've even outlined a couple of new areas we're hoping to explore. We'd love to have our readers contribute, provide guest posts and share your experiences and make the blog even better!
New Topics for Year 2:
- Stem Cell Research & New Medical Technology
- Daily Living Challenges with Spinal Cord Injuries
- PSA Screening, Prostate Cancer Diagnoses & Incontinence
- Direct from the Doctor, views from healthcare professionals
- Your RN and You - nursing & home care to increase independence
We're also launched a new video blog so you can get a bird's eye view, behind the scenes at Men's Liberty!
Are there new areas you'd like to see us explore?
Let us know!!
Side effects of prostate cancer treatment are nothing new, but a new survey published by American Medical Systems, sheds new light on how many survivors are suffering from side effects like erectile dysfunction and incontinence that are detrimentally affecting their sex lives and self image.
We wanted to share these important results, as so many of the men we talk to have told similar stories. They've survived the cancer but didn't expect the side effects. They're eager to get back to a normal lifestyle and love that Men's Liberty allows them to do just that!
Here are some key excerpts from the survey results, provided by MediResource.
More than half of prostate cancer survivors say side-effects, including erectile dysfunction, affects their sex lives, a new survey has found.
The survey of 502 randomly selected prostate cancer survivors found 80% experienced erectile dysfunction and 54% said it significantly affected their sex lives.
Of those polled, 27% reported their side-effects were worse than expected, especially when it came to being intimate.
The men also reported experiencing urinary incontinence in 43% of cases, with 23% of survivors needing to wear adult diapers.
The number of men who suffer side-effects may be surprising to other survivors, but Dr. Tim Davies says surgeons know just how many men go through it, often silently.
Davies, who is an assistant professor in the department of urology at McMaster University in Hamilton, Ont., was not part of the survey, but said he hopes the results will get men talking.
"The more we talk about these things, the more we can hope men will talk about them," Davies said in a phone interview Saturday.
"A lot of them feel very guilty about not being able to perform for their partner," he said. "That's a huge blow to a guy's ego."
The side-effects for both erectile dysfunction and urinary incontinence can range from mild to severe, and Davies noted treatments can range from medication to surgery.
He said the focus of patients is often to get through the cancer and when they do, they are not expecting the side-effects, especially if they're severe. But in his experience, he has been able to help most patients who have spoken to him about concerns and, in turn, survivors are able to return to a normal lifestyle.
"Unless patients speak up and say, 'I'm having a problem with X and Y,' they're not going to get treatment," Davies said. "When you get the opportunity, before the doctor walks out the door, speak up."
At Men’s Liberty, we’re really looking forward to the Wheelchair Games! They’ll be right here in Tampa Bay this summer on July 13-18th. Everyone on our team is excited about all the different venues and sports that will be occurring, and many of them are volunteering their time to help out.
That made me start thinking about the benefits of volunteering…
Many organizations have a seemingly endless stream of volunteers. Now here’s some great news: According to statistics, volunteerism is on the rise.
From 2010 to 2011, the number of volunteers reached its’ highest level in five years. It increased to an all-time high of 64.3 million Americans volunteering through organizations! This equates to 8 billion hours with an estimated economic value of $171 billion dollars’ worth. That’s phenomenal!
Both civic and school volunteerism is up. Just look at the response to Hurricane Sandy! Many individuals came from all over the country in response to a natural disaster. And they are still there with an increased commitment to solve the problems of that area, as well as connect with the residents.
Ask most anyone that volunteers – they’ll tell you that it creates a deep sense of satisfaction! Think about it… When you help someone, how does it make you feel? Great, right?! Same with volunteering – you benefit personally by incorporating service and making a difference in other people’s lives, throughout your communities and your country.
All types of individuals volunteer. Parents are one of the largest groups to volunteer. Many parents work tirelessly as volunteers in schools or with youth organizations. This aids in the development of our young people and helps our youth succeed. They work to raise funds, mentor, tutor and teach our youth.
Another large group of volunteers do neighborhood projects, assisting their less-capable neighbors with projects they themselves can’t accomplish. There best part of volunteering are the wonderful intangible benefits - an increase in pride, satisfaction and accomplishment.
Veterans are a very large source of volunteers in our country. Their commitment to serve continues well beyond their service of duty. According to “Volunteering in America”, an average of 26% of all veterans continue to volunteer in their communities.
So - are there any health benefits to volunteering?
The simple answer is yes!
The Corporation for National and Community Service examined this relationship. Their review of health benefits showed that volunteers had lower mortality rates, greater functional ability, and lower rates of depression.
Among older volunteers, it’s reported that volunteering provides them with both a physical and social activity. There seems to be a definite sense of purpose among this group. Older individuals and most of their peers are facing changing social roles and potentially questioning their place in society. Volunteering keeps them going. And longitudinal studies show they have lower mortality rates and live longer.
So volunteerism can enhance the overall health of our population, as well as foster a culture of citizenship, service and responsibility in our world.
And if you’re in the Tampa Bay area this July, come on down and volunteer. You know we’ll be there, and we’d love to meet you! So come on down - you’ll make a difference - and feel great about it!
If not Tampa Bay, then ask yourself: Where can I volunteer? The payoff will be tremendous!