Medical Record Management on MaidSafe... what if patient is unconscious?


#1

I think this application is a natural fit for the SafeNetwork, all patients data controlled by the patient, the whole history following the patient whenever they go, and inviolable to hackers or third parties, except to those who are already explicitly authorized by the patient to access and add new records (presumably his primary care doctor and a few other specialists).
That is dandy, but what if the patient arrives unconscious to the emergency room to an unknown hospital? How can the ER doctor access to this patient’s records to initiate treatment ASAP?

What do you guys think? What could be a nice workaround?


#2

I’m an epileptic. So this isn’t inconceivable for me. But consider I could give a family member or whoever else who might be taking care of me whist I was seizuring access (akin to the ICE numbers of one’s cell phone). Or consider the usefulness of a medicare bracelet that could have limited access or information on the actual bracelet (or an RFID chip on said bracelet either or) that would release temporary access to the files and contact information to authorized access holders. think of it like “What happens if your account is breached?” Or “What happens if you want to share access to your wallet?” Same difference only in this case it’s the human body.


#3

Well giving access to family is sensible, but I wonder what if you are by yourself.
There should be an efficient way of enabling the ER doctor.

In my head I was imagining like having a fingerprint and other biometric record in the patient’s medical records (it could be useful for remains identification in case of a catastrophe).
But doctors who don’t have the permission by the patient can query these biometrical information (lets say by scanning their fingerprint, iris or dental records) and instead of getting the patient’s full records, they get a list of authorized members (might be primary care doctor and emergency contact) to whom they can contact to ask temporary access to them.

Now the question is, how does the system know that the one requesting such access is an actual doctor, and not an impersonator on the phone?

Uhm… I am thinking about maybe having two main attributes, one specific for patients, another for doctors.
The account for doctors can’t be activated without two vouches from department heads of hospitals, or even better, signed by the medical board itself!
Maybe a system like linkedin for doctors should also be in place in this part of the system, with feedbacks from coworkers, bosses and feedback from patients.

So when a doctor gets a request to see one’s patient’s record, the primary care can check out the requester’s profile, confirm that it is a doctor, that he is in activity (some basic stats on his performance could also be added), and even check the degrees of separation from him from all the doctors they know in common.
And once they see the guy is legit, authorizes a temporary access to the records. The only one that can set up permanent access to the records is the patient himself.

The records can’t be deleted and are permanently written, and there must have logged and displayed the authorship and time of each entry. Logs should indicate entry and access to records. If there is a mistake, an amendment can be made, but it will be an extra record indicating this, never overwriting over existing records.

Patient accounts can’t never ever query biometric data about anyone, there shouldn’t even have an option for that.

Uhm, I think this could work pretty fine!


#4

This of course assumes that the patient in question trusts doctors. It’s entirely possible the patient wouldn’t and would therefore severely limit access to the permissions granted to doctors. Also I wouldn’t feel comfortable having my biometric data in the medical records unless they were using the SAFE network. And if that was the case aren’t we back to the original connundrum? Doctor requests biometric data to scan my fingerprints in order access my records but needs to prove I’m actually there in medical distress. or something of that caliber.


#5

The point is to build this on the Safenetwork. Otherwise what’s the point of posting it here?
In fact those biometrical records could be completely compartmentalized, and only those you as patient and owner of the information handpick who gets access to it, it could be nobody or your primary care or someone else.
But even if it is inaccessible (no read permission), it could be used by other doctors to query identity. In fact, not even identity, it would only list the authorized persons who have the power to authorize temporary access to the patient’s records.

And you know that because it is on the SafeNetwork, if you choose to not give read permission to nobody, it is perfectly safe and it is yours.


#6

Okay fair enough just so long as the security is taken care of and people are granted their medical freedom.


#7

My only idea is having a pre-approved list of your local doctors who can access it in an emergency


#8

Or the crazy idea that the x-prize tri-corder works and medical records plus hospitals etc. become history?

I am being tongue in cheek but only a little, if tricorders can analyse any issue, genomics/proteomics etc. can provide the “fix” then it could really impact the requirement for doctors, hospitals (apart from trauma (initially) and quick fix, bandage, plaster, stitch etc.) and very much look at altering the pharma industry (at last).

I believe it’s interesting to look at the problem we fix here, maybe it’s not securing medical records, maybe tech will just remove them? I realise I am very much a left field thinker, but I find this potentially feasible and perhaps even way simpler to “fix”.


#9

Even if tricorders were possible to create, it would still need to have a longitudinal record of the detected sympthoms.
Some complex diagnoses can only be detected from a historical analysis and also it is the only way to follow up the effectiveness of treatments, besides the need of storing previous studies.

My bet is that the star trek tricorders were using SafeNetwork to store every species’ physiological profiles, and the converged historical medical record of everyone who used any tricorder on the same patient.


#10

After looking at this from every possible angle for the last few years I have come to that conclusion. SAFEnetwork has to give patients the power to control their own PHI and they should be the only caretakers. They will have to be the ones to demand change and having a simple secure way to do it, makes it possible. Here in the US everyone in the medical IT industry is making ridiculous amounts of money and have way too much power by controlling patient health information. HIPPA rules alone make it impossible to build a non-patient controlled EMR…they require a written log book (seriously) for “HIPPA compliant servers.” So the only way through the legislative monopoly on our personal info is by taking it back.

The unique heart beat (electrophysiological signal) authentication is the absolute best biometric for all patients…including unconscious ones.

Building this is on my roadmap, but it is pretty far down.


#11

How about one of those thin USB drives that you can carry in your wallet with details of how to access Safenet and the password for your medical details. Not as secure as keeping it in your head, but if it only accesses your medical records, then not really a lot of incentive for your average thief.


#12

The nice thing about your heart beat is you don’t leave it behind and it is almost impossible to get a decent read without consent. The ED would have something like this https://nymi.com/product_overview that would unlock pre-chosen medical info to be shared with ED personnel.


#13

Lets make it happen @MrAnderson, I think this project will benefit everybody: the society, our lives and even become an excellent study case and the good kind of publicity that MaidSafe’s SafeNetwork needs to launch it to the mainstream.

I just joined 42, an experimental coding university, and we all got our first exposure to programming with C. Once I become proficient enough and pass the first stages of the study program, I think they will allow us to switch to whichever language we desire and I will choose Rust.


#14

What about identifying remains from a fatal accident, it would be useful to also be able to identifying through dental records and fingerprints, besides heartbeat. This system would be faster than what the police have, and the greatest advantage is that your biometrical data is yours.