Are patient portals secure?
Dear Dr. Roach: What are your thoughts about the security and integrity of patient portals? Almost all of the physicians we see offer them now; some of them pushing their patients to sign up. While we understand that they offer advantages for both the patient and the physician’s office, we have been very reluctant to use them. The main reason is the security of sensitive information and separation from other patients’ information. Several years ago, our previous doctor converted his patients’ records to electronic format. Shortly thereafter, at an appointment, the doctor reviewed my husband’s medical history with him and talked about a condition that had never been diagnosed previously. He maintained that since it was in my husband’s record, it had to be correct. We have since transferred to another doctor. — S.K.A.
Answer: I would try not to let your bad experience with the electronic medical record keep you from taking advantage of the benefits of patient portals. The issue with the mistaken diagnosis in the chart is one that was in existence long before the advent of the EMR. In the era of paper charts, I found mistaken diagnoses and, frankly, incorrect histories in a large number of patient charts. Most physicians have learned that when there is a discrepancy between the chart information and what the patient tells you, the patient is usually correct. We even have a term for it: “chart lore.” It is surprising and disconcerting that your husband’s former doctor apparently didn’t learn that lesson, and it’s good he found someone else, and good that the incorrect condition in the chart was identified. That’s a paradoxical good outcome from the bad event — the incorrect information probably was there in the old chart but not recognized as incorrect until your husband identified it.
As far as safety, patient portals are as safe as electronic information can be in the modern world. It is a legal disaster for a physician’s office, hospital or insurer to have a security breach, just as it is for a bank containing your financial information.
Dear Dr. Roach: I hope you can help me. I have had problems sleeping for many years, and I used diphenhydramine to get and stay asleep. Finally, last year I retired (I am 70) and stopped using it and started using two 10 mg melatonin pills to get to sleep. My problem is remembering. I forget almost everything I used to do. I can’t remember how to make dishes I would make at the drop of a hat. I can’t remember people’s names, and I will change things because I can’t remember what I was going to do. It is driving me crazy, and my husband is getting very angry with me when I can’t remember. Is there something I can do or a supplement I can take to help me get rid of the forgetfulness? — S.B.
Answer: Melatonin is a generally safe drug that many people use for sleep. Compared with diphenhydramine, it is probably safer, since diphenhydramine use is clearly associated with falls and motor vehicle accidents the day after using.
However, melatonin does have side effects, and the most common reported are headache, confusion and fractured sleep. These are more likely at higher doses, and the dose you are taking is very high. I recommend a dose of 0.5 mg to 1 mg; you are taking 40 times the recommended starting dose. I think it is likely the melatonin is the cause of your symptoms.
Today’s SOUND OFF is about people who choose to remain childless:
“Dear Heloise: Years ago, when my husband and I got married in our late 20s, we decided we weren’t going to have a family. No, we DON’T hate children. We’re simply not ‘childoriented.’ People with children keep saying, ‘Oh, you don’t know what you’re missing.’ That’s true, because you can’t miss what you never had.
“We applaud those who wanted a family and love their kids, but it just wasn’t for us. We’re not sorry we decided to skip having children, and we really wish family and friends would stop asking rude questions, such as ‘If you didn’t want kids, why did you get married?’ Parenting isn’t for everyone.” — Mike and Tara D., Nashville, Tenn.
Mike and Tara, you’re right: “Parenting isn’t for everyone.” Lately, more and more couples are remaining childless. — Heloise How can I clean my woodwork without breaking the bank? — Nina A., Jupiter, Fla.
Nina, mix 1 part white vinegar with 2 parts water. Using a clean sponge, dip into the water/vinegar solution, wring out the excess water and wipe the woodwork. Dry the woodwork, then polish with a clean cloth.
If you like this easy, effective method of cleaning, you’ll love my pamphlet Heloise’s Homemade Cleaning Solutions, which is full of household cleaning hints using everyday cleaners that you probably have at home and special formulas that are safe and inexpensive. Just send $5, along with a stamped (71 cents), self-addressed, long envelope, to: Heloise/
I read your informative articles in The Westfield News in Southwick, Mass.
There was a hint by Janet H., of Park City, Utah, asking for hostess gift ideas to take with her when she plays cards. Here are a few suggestions:
Homemade cookies stacked in a cellophane bag tied with a ribbon
A potted plant that blooms
Pretty napkins Notepaper
A good bottle of olive oil or balsamic vinegar
— Rachel T., Southwick, Mass.
A good ‘goo’ question Dear Heloise:
How can I get that sticky goo from plants off my pruners? — Irene M., Ionia, Mich.
Irene, spray your pruning shears with vegetable oil spray before use, and the goo will slide off. — Heloise