Anyone familiar with Bronchial Thermoplasty?

[BookNut]

Has anyone had this procedure? I have been having a terrible experience with Cleveland Clinic which I have chronicled elsewhere on this forum. I am on my way home to NY, having accomplished almost nothing in spite of having been in Ohio for 3 MONTHS. Dr. Culver contacted me today. Not personally (I guess that would be too much to expect after what he has put me through), but through his secretary. His suggestion? I should stay longer and go to the ASTHMA doctor he has passed me off to. My recent CT did not reveal anything new. He thinks I have severe asthma so I need to be treated by the asthma center. There are several treatments such as Bronchial Termoplasty. I let him know that I am skeptical of BT for the following reasons:

My research about the procedure makes me wonder if it is even a possibility for me, as it requires that I be off prednisone for 2 weeks and that I not have had an asthma attack for 14 days. I have not had one single day without wheezing 24/7 for 3 full years so far. Even with DubNeb, singulair, and Symbicort daily, and even immediately after taking my medicine. Right now my peak flows are measuring between 180-225. I have never reached even a borderline normal range.

So - I would be very interested to hear from any of you who have had experience with this procedure.

Thanks for any ideas you can offer me!

[mrtmeo]

Is it possible that u could have silent reflux?
There is a huge link between acid reflux and asthma.
The pepsin enzyme gets into the tissues of the esophagus and even into the lungs and with an acidic environment, it attacks the tissues.
Pepsin belongs in the stomach.
There is a study that showed alkaline water with a ph of at least 8.8 can irreversibly inactivate the pepsin enzyme.
I thought this was happening to my mom, but the alkaline water wasn't helping her because hers is something related to the vasculitis.

[BookNut]

Is it possible that u could have silent reflux?
There is a huge link between acid reflux and asthma.
The pepsin enzyme gets into the tissues of the esophagus and even into the lungs and with an acidic environment, it attacks the tissues.
Pepsin belongs in the stomach.
There is a study that showed alkaline water with a ph of at least 8.8 can irreversibly inactivate the pepsin enzyme.
I thought this was happening to my mom, but the alkaline water wasn't helping her because hers is something related to the vasculitis.

thanks! Acid reflux and hiatal hernia have been ruled out.

[mrtmeo]

thanks! Acid reflux and hiatal hernia have been ruled out.

Have you had a HRCT scan of the lungs to see if there is any bronchial stenosis or nodules?
Do u know where the wheeze is coming from or if it is only on inhale or exhale?

[BookNut]

Mrtmeo, Thanks for your interest!! It is primarily on exhale. During exacerbations it is both. My peak flows are 150-180 prior to nebuliazation. I use DuoNeb 4 or 5 times a day, and symbicort twice a day. the ideal peak flow level level for my age is 319. after nebulization, it goes up to 200-250. I get so short of breath that cooking dinner is an incredible effort. I have the elephant on the chest feeling. At best, the elephant gets up for a week or two and I am only winded. Have been on pred tapers 8 times in the past year and am now classified as pre-diabetic. Lots of fun. I am sick of feeling exhausted all the time.

[mrtmeo]

Mrtmeo, Thanks for your interest!! It is primarily on exhale. During exacerbations it is both. My peak flows are 150-180 prior to nebuliazation. I use DuoNeb 4 or 5 times a day, and symbicort twice a day. the ideal peak flow level level for my age is 319. after nebulization, it goes up to 200-250. I get so short of breath that cooking dinner is an incredible effort. I have the elephant on the chest feeling. At best, the elephant gets up for a week or two and I am only winded. Have been on pred tapers 8 times in the past year and am now classified as pre-diabetic. Lots of fun. I am sick of feeling exhausted all the time.

It sure sounds like steroid tolerance.
Once someone is on a nebulizer with steroids, they get worse and worse because the steroids cause a rebound effect when u reach tolerance.
This causes anxiety and bronchial spasms.
I have seen this way too many times before and never knew anyone that was able to taper off.
This can happen with prednisone too.
It takes a long time for adrenals to come back and start producing cortisol.

[BookNut]

It sure sounds like steroid tolerance.
Once someone is on a nebulizer with steroids, they get worse and worse because the steroids cause a rebound effect when u reach tolerance.
This causes anxiety and bronchial spasms.
I have seen this way too many times before and never knew anyone that was able to taper off.
This can happen with prednisone too.
It takes a long time for adrenals to come back and start producing cortisol.

Hmmm... the symbicort inhaler is a steroid I believe. DuoNeb is what I use in the nebulizer and it is NOT a steroid. I will ask about that at my appt on Thursday. Thanks again.

[annekat]

I'm always interested in your updates, Jacquie. My mother had severe asthma toward the end of her life and I'm not sure we ever knew what caused it or that she was being properly treated for it. She did use a nebulizer and some inhalers and I'm not sure what. Yes, I'm pretty sure Symbicort is a steroid inhaler. My heart aches when I hear of you having trouble preparing dinner or having an elephant on your chest. FWIW, I think you are probably in better physical shape, aside from the asthma, than my mother was. Some interesting ideas have been discussed here, and I have nothing to add but that I'm thinking of you. I've had some severe enough asthma in my life, though not currently, to know that "elephant" feeling and how scary it is, and how helpless one can feel.

[BookNut]

Thanks so much Anne! It is always good to talk to you and get your ideas, perspective and sympathy. I am feeling a bit better this am. We are at our son's house in PA and I am looking forward to going to the Daniel Boone homestead today... A nice outing which should give me a chance to get some exercise, without too much strain and evaluate where I am.

I have started to use a peak flow meter and am hoping that the graph will help my doctors understand where my breathing really is. I am using an awesome phone app to chart the levels, which fall into the categories of Well, Worse, and Critical. I am in the critical level half the day and the worse level half the day. This might help them understand that when I am comfortably settled in their office resting, that is probably not the best way of judging how I am doing.

I get to see my asthma specialist at home on Thursday. Her office staff was able to squeeze me into the schedule. I sent her a detailed update via the MyChart system. Hopefully she will have time to review it before she ses me and that willsave time. By next thursday I will be more than half way through a pred taper....so I will be glad to have the peak flow chart to show her that my breathing has not been as good as it sounds.

when did your Mom develop asthma?? I am always surprised to have gotten this so late in life. Did she have COPD as well? Did she smoke or work in an environment that might have irritants?

Thanks again!!

[annekat]

My mom did not smoke or have COPD, that I know of. She definitely worked in an environment with irritants, chiefly the typesetting ink that they used at the newspaper where she worked as an editor. So the story was that from that she had developed a chemical sensitivity and would react to all kinds of things. At one point she had pneumonia for awhile, though I'm not sure whether it was viral or how she got it, but she was in the hospital for a few days. Anyway, we just thought of her as having severe asthma from the chemical sensitivity, and there didn't seem to be much to do but for her to use the nebulizer and other meds. She used prednisone for awhile after having pneumonia but got temporarily diabetic from it. I think she got off of it and was doing without it between then and when she died. She had just been up here in Olympia visiting and a day or two after she got back, she collapsed and died, and we thought it was an asthma attack, but it turned out to be a heart attack. We'd never heard about anything to do with her heart. She had been overweight but had slimmed down a lot since having a new male companion in her life for a few years. I wonder if the asthma had taken a toll on her heart. She was only 68 when she died. So I hope you are getting thoroughly checked out in all ways, including your heart. I think they are better about checking women's hearts these days, as heart disease is no longer thought of as a men's disease. My dad, who was a doctor, read the autopsy report and I know he said there was heart disease, I'm not sure if it was hardening of the arteries, excessive plaque, or what, and he's gone now too, so I can't ask him. Obviously I need to keep better tabs on my heart, as well. But I know I'm in better physical shape than my mom was, despite having Wegs, and I'm sure you are, too, when you are getting a respite from your asthma. I'm glad you feel better today and will get out and about, and also that Bob is there in your life.... and I hope he's doing well.

I guess the upshot of all that was that although we had an explanation for my mom's asthma, provided by her, the chemical sensitivity from the typesetting ink, I wonder if there could have been some other things going on that we or she or her doctors didn't know about and if they hadn't thoroughly investigated all the possibilities.

[mrtmeo]

My mom did not smoke or have COPD, that I know of. She definitely worked in an environment with irritants, chiefly the typesetting ink that they used at the newspaper where she worked as an editor. So the story was that from that she had developed a chemical sensitivity and would react to all kinds of things. At one point she had pneumonia for awhile, though I'm not sure whether it was viral or how she got it, but she was in the hospital for a few days. Anyway, we just thought of her as having severe asthma from the chemical sensitivity, and there didn't seem to be much to do but for her to use the nebulizer and other meds. She used prednisone for awhile after having pneumonia but got temporarily diabetic from it. I think she got off of it and was doing without it between then and when she died. She had just been up here in Olympia visiting and a day or two after she got back, she collapsed and died, and we thought it was an asthma attack, but it turned out to be a heart attack. We'd never heard about anything to do with her heart. She had been overweight but had slimmed down a lot since having a new male companion in her life for a few years. I wonder if the asthma had taken a toll on her heart. She was only 68 when she died. So I hope you are getting thoroughly checked out in all ways, including your heart. I think they are better about checking women's hearts these days, as heart disease is no longer thought of as a men's disease. My dad, who was a doctor, read the autopsy report and I know he said there was heart disease, I'm not sure if it was hardening of the arteries, excessive plaque, or what, and he's gone now too, so I can't ask him. Obviously I need to keep better tabs on my heart, as well. But I know I'm in better physical shape than my mom was, despite having Wegs, and I'm sure you are, too, when you are getting a respite from your asthma. I'm glad you feel better today and will get out and about, and also that Bob is there in your life.... and I hope he's doing well.

I guess the upshot of all that was that although we had an explanation for my mom's asthma, provided by her, the chemical sensitivity from the typesetting ink, I wonder if there could have been some other things going on that we or she or her doctors didn't know about and if they hadn't thoroughly investigated all the possibilities.

Hi Anne,
That is so sad that you lost your mom.
I had a friend that had asthma and she died at 31 yrs old because she couldn't get off the prednisone.
When she died, her heart was 4 times the normal size and she died due to a pulmonary blood clot.
All was due to the prednisone and nebulizing treatments.
Prednisone is more toxic than cytoxan or rituxan.
Inhalers cause tremors, anxiety/panic attacks and rebound brochospasms.
My mom has emphysema and had all this until I got her D levels up and got her on some supplements that allowed her to ween down on the inhalers.
Before I got involved, her oxygen was always 91% and a couple of months after supplements, her oxygen went up to 98%.
She also, had the ground-glass opacities and vasculitis nodules in her lungs.

[annekat]

Thanks. It was in 1995, so it's been awhile. But it was too soon; I'm sure she was expecting a longer life.

[mrtmeo]

Thanks. It was in 1995, so it's been awhile. But it was too soon; I'm sure she was expecting a longer life.

There were tons of asthmatics dying due to the inhalers and this is why they have combined certain drugs and avoid prescribing ones like advair.
Way too many people died that shouldn't have due to inhaler overuse.
The buteyko method seems to be a helpful technique for those that have asthma.
There is nothing worse than feeling like u can't breath.

[annekat]

There is nothing worse than feeling like u can't breath. Yep, I've been there and know how it feels. Luckily, asthma hasn't been much of a problem in recent years, with the exception of Wegs feeling like asthma sometimes when mucus collects in my windpipe. But not the elephant on the chest thing. If it becomes a problem again, I'll hope to have docs prescribe the best and least harmful treatments.

[mrtmeo]

Yep, I've been there and know how it feels. Luckily, asthma hasn't been much of a problem in recent years, with the exception of Wegs feeling like asthma sometimes when mucus collects in my windpipe. But not the elephant on the chest thing. If it becomes a problem again, I'll hope to have docs prescribe the best and least harmful treatments.

I pray you don't have any breathing issues and stay in remission.
This disease is far worse than cancer.

[mrtmeo]

Has anyone had this procedure? I have been having a terrible experience with Cleveland Clinic which I have chronicled elsewhere on this forum. I am on my way home to NY, having accomplished almost nothing in spite of having been in Ohio for 3 MONTHS. Dr. Culver contacted me today. Not personally (I guess that would be too much to expect after what he has put me through), but through his secretary. His suggestion? I should stay longer and go to the ASTHMA doctor he has passed me off to. My recent CT did not reveal anything new. He thinks I have severe asthma so I need to be treated by the asthma center. There are several treatments such as Bronchial Termoplasty. I let him know that I am skeptical of BT for the following reasons:

My research about the procedure makes me wonder if it is even a possibility for me, as it requires that I be off prednisone for 2 weeks and that I not have had an asthma attack for 14 days. I have not had one single day without wheezing 24/7 for 3 full years so far. Even with DubNeb, singulair, and Symbicort daily, and even immediately after taking my medicine. Right now my peak flows are measuring between 180-225. I have never reached even a borderline normal range.

So - I would be very interested to hear from any of you who have had experience with this procedure.

Thanks for any ideas you can offer me!

Hi Jacquie,
Have you ever been tested for c or p anca or mpo or pr3 antibodies?
Do u ever have high eosinophils?

[BookNut]

Anne...so sorry to hear about your mom. She was only a year older than me. I guess we all need to keep in mind how quickly thongs can change...spending less time working and more time enjoying our loved ones while we have them.

I am SO looking forward to going home tomorrow. I am feeling quite a bit better, so the trip will not be too bad.

[BookNut]

Hi Jacquie,
Have you ever been tested for c or p anca or mpo or pr3 antibodies?
Do u ever have high eosinophils?

I was briefly diagnosed with "mild wegeners" based on a slightly elevated reading of one of the ancas.. I believe it was the p anca? i would have to look it up. And I have had slightly elevated eosinophils. I am interested in the possibility of igg2 deficiency based on a few labs.

[annekat]

Anne...so sorry to hear about your mom. She was only a year older than me. I guess we all need to keep in mind how quickly thongs can change...spending less time working and more time enjoying our loved ones while we have them.

I am SO looking forward to going home tomorrow. I am feeling quite a bit better, so the trip will not be too bad. I hesitated to mention her because I know you aren't much younger than she was when she passed, but I don't see a lot of similarities except in the troublesome breathing problems. I think you are more active, when you can be, for one thing. I just wonder about the breathing problems and why they have so much trouble figuring out how to treat them sometimes, along with knowing what their cause is. That was 19 years ago, and no doubt there are better meds and more advanced systems of treatment now. I hope.

I look forward to hearing from you when you get home! That will feel good.

[mrtmeo]

I was briefly diagnosed with "mild wegeners" based on a slightly elevated reading of one of the ancas.. I believe it was the p anca? i would have to look it up. And I have had slightly elevated eosinophils. I am interested in the possibility of igg2 deficiency based on a few labs.

Have any of your drs looked into possible churg-strauss?

[BookNut]

I will ask...but there are a lot of symptoms that I do not have. I definitely have malaise, but I do not have weight loss or fevers for instance. No skin manifestations etc. I think I have severe asthma that does not respond well to standard asthma meds. There are a couple of non-standard meds that I might consider. Theophylline is actually an old stand-by that is not prescribed as often these days. I would like to try that. The other one is Xolair. I am not crazy about that because of the side effects. It involves an injection ... once a month I think. Patients are required to remain in the office after the shot to monitor for anaphylactic shot. That requirement is eventually suspended, but the anaphylactic shock can occur at any time...even months after the med is started. It is extremely expensive and is tricky to get insurance approval. I also think I will push my ENT on sinus surgery. He is never very enthusiastic about it...but I feel I need to do anything that might help.

My sister-in-law has COPD. She just had a minor fall...but her skin is so thin from prednisone that the skin on her arm and leg pretty much just rolled back. Urgent care was unable to stitch the lacerations so had to use another method. I REALLY do not want to be on prednisone long term. Not to mention the elevated blood sugar levels. On the other hand, I would like to be active again.

[mrtmeo]

Could there be a mold or food that you are allergic too?

[Velma]

I think I would agree with Mrtmeo who thought maybe it was stenosis. I have had broncial airway scar tissue forming and we tried all of the same thing you have had and nothing helped. For two years they thought it was asthma and I have the same wheeze on exhale. You really sound like I was and a simple bronch will tell the tale. With a bronchoscopy they discovered stenosis forming in the main airway and then tried to place a stent (done in Pittsburgh and wrongly by a thoracic surgeon) to open up my airway. I am now seeing Dr. Michael Machuzak at the Cleveland Clinic and he is trying to fix the mess I am in because of the stent. However, I would advise you to see if they can do a bronchoscopy on you to determine if it is scar tissue because sometimes a CT scan does not show exactly what is going on. Steroids will not help matters much because it is not inflammation causing the breathing issues but scar tissue. Make sense?
Hope this helps.
v.

[BookNut]

Could there be a mold or food that you are allergic too?

I have been tested for allergies and not much showed up. Grasses and some weeds. I am also allergic to artificial colors. Red dye 40 will turn my entire body bright red from head to toe. In the past three times, I have had exacerbationswhile spending weeks in different locations.....home in small rural village in NY, rural Maine, suburban Ohio and urban area in PA. Pets and no pets in the atmosphere. We have no pets at home.

Saw my allergy/asthma doctor today. She is recommending Xolair injections. I am hoping that I can get insurance coverage for it. Many who have intransigent asthma have had success with this.

[BookNut]

Thanks Velma. I HAVE had a bronchoscopy. It showed very littlle. I am not sure if that is how my brochiectasis was diagnosed. I think not. I think that was one of my CT scans. I don't really remember what came out of the bronchoscopy...other than that it was relatively unremarkable.

I saw my doctor at home today. she was appalled by what went on in Cleveland. She was also shocked when I showed her my Fev1 reading of .9 that the technician wrote down for me my last clinic appt.

Have my doctors received any reports from Cleveland Clinic? Of course not. That would require that the people there actually do their jobs. I requested that a release form be sent to me asap. Two weeks later...still no form. Had to call AGAIN. I have never had them do one single thing they said they would do without calling them back to remind them to do what they said they would do in the first place. I am SO angry with them. Once I actually get the records in my hands on the records, I plan to let the doctor and the hospital just what I think of how I was treated.

Right now I am on my 8th round of prednisone in little over a year, and. so I am feeling pretty well. That should last for another two weeks, and then down I will go again. My poor husband is so patient. He does one art show a year with his photography. We have arranged to pay a nephew to help us with set up, since we never know how I will be. If I am bad..which is most likely the case, i simply cannot help set up the display walls and hang pictures. Very frustrating for someone who just three years ago was walking 5 miles a day.

Oh well. Fingers crossed that the Xolair works out for me! At $800 a shot and between 2 and 4 shots a wekk (sorry a month NOT a week!.)....it had better be covered by insurance!

[mrtmeo]

Hi Jacquie,
You sure had the ordeal with cc.
Bronchiectasis can cause mucus plugs in the lungs that are like glue.
Could this be happening?
If so, I wonder if brochoalveolar lavage would work to clear that out?

[annekat]

Jacquie, this is reminding me, I keep having to ask the nurse at my ENT, whom I like very much, to send my reports from there to my pulmonologist, who is treating my Wegs. She may do it, but then doesn't follow through and keep doing it. So the pulmy gripes that he hasn't gotten any recent reports from the ENT, and the implication is that it's somehow my fault. Why doesn't he just ask his nurse to call the ENT and ask for all my records? That's what my PA ended up doing and they sent them all over. What is wrong with doctors and nurses these days, anyway?

I hope the Xolair is covered and will work. That price is astronomical! I wonder why this terrible asthma started 3 years ago for you.

[BookNut]

Hi Jacquie,
You sure had the ordeal with cc.
Bronchiectasis can cause mucus plugs in the lungs that are like glue.
Could this be happening?
If so, I wonder if brochoalveolar lavage would work to clear that out?

That is an idea I have not heard of yet. I will definitely run that past my doctors. I DO have post nasal drip. When I take pred, it dries up and gets gluey. Maybe that is happening in my lungs. Thanks!!

[BookNut]

Jacquie, this is reminding me, I keep having to ask the nurse at my ENT, whom I like very much, to send my reports from there to my pulmonologist, who is treating my Wegs. She may do it, but then doesn't follow through and keep doing it. So the pulmy gripes that he hasn't gotten any recent reports from the ENT, and the implication is that it's somehow my fault. Why doesn't he just ask his nurse to call the ENT and ask for all my records? That's what my PA ended up doing and they sent them all over. What is wrong with doctors and nurses these days, anyway?

I hope the Xolair is covered and will work. That price is astronomical! I wonder why this terrible asthma started 3 years ago for you.


Not quite as expensive as I originally posted. I corrected it. It is only twice a month not twice a week! Still...it will be between $800 and $1600 a month!

It just seems that with so much now on computer systems, that we should be able to give a blanket release for our doctors and then they can easily log in to the records online whenever they want to.

[annekat]

It just seems that with so much now on computer systems, that we should be able to give a blanket release for our doctors and then they can easily log in to the records online whenever they want to. True, in fact, I ran into someone online who was telling me that with the new health care law, everything was recorded online and docs have access to everything (which I doubt, unless people have signed a release). There was a name for it and I looked it up and found it... but this person was extremely paranoid and thought that docs would use it against her and already had, like they'd see something another doc had said and use it as a reason not to treat her, or some such. So I had sort of dismissed it and hadn't thought of it much. But it does seem like a good idea in many ways, as long as it is used in positive ways.

[annekat]

Hi Jacquie,
You sure had the ordeal with cc.
Bronchiectasis can cause mucus plugs in the lungs that are like glue.
Could this be happening?
If so, I wonder if brochoalveolar lavage would work to clear that out? Remember, Phil had bronchiectasis, and that was a lot of his breathing problem. Nothing seemed to help him much. I don't remember him mentioning this procedure, so I don't know if it was tried on him. I do remember him mentioning a possible lung transplant someday, previous to his incurring the collapsed lung that put him in the hospital. I'm not sure if with a lung transplant the bronchii are also replaced, but I'm sort of assuming so. It does seem reasonable to think that the bronchiectasis is a big part of your breathing problem, Jacquie. But then, your docs know about it and I'd expect them to know more than we do.

[drz]

True, in fact, I ran into someone online who was telling me that with the new health care law, everything was recorded online and docs have access to everything (which I doubt, unless people have signed a release). There was a name for it and I looked it up and found it... but this person was extremely paranoid and thought that docs would use it against her and already had, like they'd see something another doc had said and use it as a reason not to treat her, or some such. So I had sort of dismissed it and hadn't thought of it much. But it does seem like a good idea in many ways, as long as it is used in positive ways.

Insurance carriers including Medicare would have access to all of your medical contacts which would include billing info on all services provided including a diagnosis for treatment received. I don't know how much extra detail this would include but suspect if they knew you recently saw several doctors recently for same problem this could impact the decisions of a medical provider. Or they might be inclined to assume the previous doctors diagnosed you correctly even if they didn't.

[annekat]

Insurance carriers including Medicare would have access to all of your medical contacts which would include billing info on all services provided including a diagnosis for treatment received. I don't know how much extra detail this would include but suspect if they knew you recently saw several doctors recently for same problem this could impact the decisions of a medical provider. Or they might be inclined to assume the previous doctors diagnosed you correctly even if they didn't. Good explanation, and I think the woman I spoke of had been to a lot of doctors and argued with them because they wouldn't diagnose her with something she thought she had, and may have been something of a "problem patient", or that's how she implied she'd been treated... I will look back at some messages and try to find the name of whatever it was she was telling me about... she made it sound more like a government thing than just insurance company records.

[drz]

Good explanation, and I think the woman I spoke of had been to a lot of doctors and argued with them because they wouldn't diagnose her with something she thought she had, and may have been something of a "problem patient", or that's how she implied she'd been treated... I will look back at some messages and try to find the name of whatever it was she was telling me about... she made it sound more like a government thing than just insurance company records.

Medicare would be a "government thing" and they might share documentation notes too. Maybe some one who works in a medical facility can shed some light on this. Maybe sharing electronic records is somethng that is included under Obamacare, who knows?

[annekat]

Medicare would be a "government thing" and they might share documentation notes too. Maybe some one who works in a medical facility can shed some light on this. Maybe sharing electronic records is somethng that is included under Obamacare, who knows? I started on this last night but was too tired to decide what to share. I googled "ehr affordable care act" and found evidence that there is some sort of "mandate" under this act for medical professionals to incorporate electronic health records (ehr) into their systems by 2015 or lose a percentage of their medicare and medicaid disbursements. Already, in 2014, part of this penalty is in effect in order for them to maintain their current level of disbursements. This site covered it fairly well: Federal Mandate for Electronic Medical Records | USF Health News (http://www.usfhealthonline.com/news/healthcare/electronic-medical-records-mandate-january-2014/#.VEpcsN1qoRg) but there are other sites to look at as well.

So this would affect all doctors who take Medicare and Medicaid patients and electronic records would presumably be kept for everyone including those on private insurance plans. So under this mandate, it would appear that doctors could access each others' records on a patient. There was some mention of patient privacy protections but I did not delve in enough to try to find out how that would work. It was also pointed out that there are new job opportunities for IT specialists with some medical knowledge in implementing this system.

[drz]

I started on this last night but was too tired to decide what to share. I googled "ehr affordable care act" and found evidence that there is some sort of "mandate" under this act for medical professionals to incorporate electronic health records (ehr) into their systems by 2015 or lose a percentage of their medicare and medicaid disbursements. Already, in 2014, part of this penalty is in effect in order for them to maintain their current level of disbursements. This site covered it fairly well: Federal Mandate for Electronic Medical Records | USF Health News (http://www.usfhealthonline.com/news/healthcare/electronic-medical-records-mandate-january-2014/#.VEpcsN1qoRg) but there are other sites to look at as well.

So this would affect all doctors who take Medicare and Medicaid patients and electronic records would presumably be kept for everyone including those on private insurance plans. So under this mandate, it would appear that doctors could access each others' records on a patient. There was some mention of patient privacy protections but I did not delve in enough to try to find out how that would work. It was also pointed out that there are new job opportunities for IT specialists with some medical knowledge in implementing this system.


I have experienced this already when I went to a clinic and they inquired about the service i recently had at another clinic. I had not requested any exchange of info to inform the second clinic about the first clinic. I asked how they knew about the the other visit and they said it was on my Medicare record which they accessed.