Are pa­tient por­tals se­cure?

The Palm Beach Post - - ACCENT - Dr. Keith Roach To Your Health Write to Dr. Keith Roach at King Fea­tures, 300 W. 57 Street, 15th floor, New York, NY 10019-5238 Write to Heloise in care of The Palm Beach Post, 2751 S. Dixie High­way, West Palm Beach, FL 33405-1233 or email Heloise@Heloise

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.

Dear Read­ers:

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

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