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This seems pretty dumb and an excuse for doctors to have expensive systems to retrieve and disburse records.

It should be near zero to deliver these records. Or at least marginally zero.

I’d rather records be free electronically and let healthcare providers plan for this.

Having costs discourages information sharing, I think.

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Living in Germany, I can state that the costs are very low: 10 EUR for a DVD/CD/other media are the typical ballpark. You are essentially just paying a fee for an administrative assistant to pull your files and give them to you.

Same in UK. There is a fee but it's like £20, it's minimal.

£20 is not a minimal fee (meaning, would pay without a second thought) for most people in the UK.

What makes you think so?

Perhaps the fact that some need to use food banks or even disconnect from electricity providers

https://www.theguardian.com/society/2022/may/15/watchdog-urg...

Sure, of course those people exist. I mean specifically what makes you say that for "most" of people in the UK £20 is not a minimal expense.

Imagine I have a heart attack. I do an ECG, some CT, X-RAY, MRI. Suddenly its £200 just for the DVDs.

Really? Where did you get that quote? That's not how it's meant to work, not with NHS anyway. When I did that recently I rang my GP surgery, and they got EVERYTHING from my medical history. You don't pay £20 per result - it's £20 to get hundreds of pages of medical history(if you have that much) all at once.

This thread is a good example of a law of internet communication: when different people are responding consecutively to a single person in a thread, each person will subtly change the subject and misunderstand the foregoing argument, so the end of the thread will be discussing a completely different topic than the beginning.

Do you get paper copies or PDFs?

They sent me an email with a link to an encrypted archive with everything in it.

This is out of date information. The fee was scrapped. The fee should only be charged where the request is manifestly unfounded or excessive.

I would guess the argument goes that very few people want or need their records so the cost of building and maintaining an online system that won’t leak medical information to hackers is very high. If you want it, paying a small amount and proving you are who you say you are isn’t that much of a burden.

In the ever expensive US health care system, I was able to get a free cd of my CT scan. Took 15 seconds to burn.

Don’t know andix’s country, but for France for instance sharing data with patient is widely accepted and I got by default a copy of most of my check ups without having to ask, and I don’t even noticed the price if there was any. For longer care history, it can be a bit more paperwork, but nothing complicated.

One aspect to this is you are usually the one bridging the doctors dealing with your health, and might be hand handling the relevant data to whoever needs it (e.g. your family doctor can request an X-ray, but after taking you need to switch doctors for any reasons. As you have the actual X-rays, you can hand it to anyone else competent for the case)

> an excuse for doctors to have expensive systems to retrieve and disburse records.

They are free in Italy, if you go through the National healthcare.

to answer the question: the images are of the patient, the National health care (SSN) can use them for research purpose only by authorized personel, the distribution must be authorized by the patient.

In some regions the patient can de-authorize them through a web app, but it's not very common yet.

If you go to a private medical center, the scans are included in the price and are yours.

It's due to a lack of incentive ($$) to provide a service to easily deliver your electronic records. The standards and protocols exist, but no one yet has created a good one that has been widely adopted.

We could vote with our feet, and only use providers that have electronic delivery available. Then they would feel the need to provide it.

The insurance anyway pays the doctor only the minimal amount of money for taking X-rays, I understand that they charge you for doing extra effort. If you get your X-rays done privately, it is included for sure.

Yeah who owns a CD drive anymore. It should be a free web-based viewer that lets you login securely, manage temporary links to other providers, and download for offline use. It’s not that hard to build and the government could provide it but instead we’re stuck with expensive third party vendors.

Which is several orders of a magnitude more expensive than just adding a CD-burner. Or use the pre-existing USB interface to write the files to a 5€ small memory stick (new as mentioned earlier)

Ditto for the complexity regarding the security.

What about the marginal cost of each CD, a technicians time to burn it and the extra time for a patient to receive their images in a CD before they can share it with other providers? I went through this problem trying to get the X-rays for my grandma that got COVID.

I'd rather prefer my data not be available on the web.

It already would be, they have to transfer the data between hospitals somehow. The only difference is that you will have access to it, not just the doctors.

The security depends entirely on the implementation though. I'm guessing that's why your concerned about it.

How long did it take for your government to have a site with an up to date list of all the places doing co-vid tests ?

For me it took months to have a site, and it’s been stale and broken every time I checked.

Why should we trust it more to host such a critical service ?

It took a few weeks, it work perfectly and I could book time for test. We also got a national EU Covid pass service where Covid tests and vaccines are show.

It takes me a couple of minutes to do my tax return and I can deliver every form to any government organization from one single portal. All my health information is stored on another single portal (same one where I find the Covid pass).

I don’t think the rule that all government software is bad is universally applicable.

Our country has that.

Not impressed with their security.

There are supposed to be no intrusions, but honestly the systems is so bad/old(1), that I am not sure they'd even notice.

1 It futures latest and greatest security practices ... from year 2000. Better than nothing, but inadequate nowadays.

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