Patient control of medical data raises questions for ethics, policy

Guest post courtesy of Steve Hinnefeld, who normally writes at the Policy Briefings blog.

Should patients have control of their own medical records? For most patients, the question sounds like a no-brainer: They’re our records. Of course we should!

But for health care providers, the answer is more complicated. Should patients be able to conceal pertinent medical information from their doctors? What if doing so compromises the quality of care that doctors can provide? Who’s responsible when something goes wrong as a result of missing information?

William Tierney

William Tierney

A new study by the Regenstrief Institute, Indiana University School of Medicine and Eskenazi Health raises those questions and more. Described as the first real-world trial of the impact of patient-controlled access to electronic medical records, the six-month study involved 150 patients in an Indianapolis primary-care clinic.

Among the findings: Nearly half of the subjects withheld information in their medical records from some or all of their health care providers. And that’s cause for concern, according to Regenstrief President and CEO William Tierney, the principal investigator for the study.

“Without an understanding of how medicine is practiced, a patient may not appreciate why access to their health information is needed by medical team members other than their physician or nurse — for example, a specialist or a clinical lab or unit clerk,” he says in an IU School of Medicine news release. “While understandably concerned about privacy, they may not realize how important it is for their medical team to have access to the complete medical record.” Read more…

Suicide: A local and national problem

Guest post courtesy of the Indiana Prevention Resource Center:


As suicide becomes a growing issue, know that there are steps you can take to help someone at risk.

As International Survivors of Suicide Loss Day approaches on Nov. 22, the Indiana Prevention Resource Center at the School of Public Health-Bloomington is calling attention to the problem of suicide among young adults in Indiana and nationally and amassing a collection of online resources related to suicide to help educate the public about this growing problem.

“Suicide is the ultimate consequence,” says center Deputy Director Barbara Seitz de Martinez. “Indiana is well above the national average for suicide, so it’s important that we learn as much as we can about how depression, substance abuse, and other risk factors contribute to suicide.”

As is the case nationally, suicide is the second leading cause of death in Indiana for young adults ages 15-34, outnumbering homicides. Suicide is also a growing problem on college campuses. The Indiana College Substance Abuse Survey found that one in seven students had at some point thought they would be “better off dead” or had thought of “hurting themselves in some way.”

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Lesson from addiction: ‘Every moment in time that we are alive and well is a miracle’

Indiana University student Jacob Desmond discusses his recovery from addiction to help draw attention to the toll addiction levies on people of all ages. Young and enthusiastic college students are not immune.

A candlelight vigil is scheduled for 6 p.m. tonight at IU Bloomington’s Whittenberger Auditorium in remembrance of people who died or whose lives have been affected by “alcohol- and drug-related poisonings, injury, overdose or addiction.”

Sponsored by OASIS, Amethyst House, Centerstone’s Recovery Engagement Center and Stepping Stones, the vigil represents a coming together of community and campus organizations to help students and non-students alike deal with consequences of addiction. More information is available at OASIS.

Jacob Desmond

Jacob Desmond

Jacob Desmond

I have been sober since July 1, 2013; I was 19 years old at that time. My life in recovery did not start until I was about 90 days sober. Being that young, being sober, and knowing nothing about a sober lifestyle had me thoroughly confused each day of my new sober life.

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Number of moles could mean increased risk for breast cancer, not just skin cancer

Guest post courtesy of IU colleague Michael Schug

Beauty marks. They make you unique.

Woman drying off after showre

Research points to connection between number of moles and breast cancer.

And no doubt, you know where most are on your body. Women especially are familiar with their bodies and are aware of their moles. Now there’s new research that suggests that the more moles on a woman’s body, the greater chance of her developing breast cancer.

If a woman has 15 or more moles on her body, she is 35 percent more likely to be diagnosed with breast cancer than women with no moles, according to new research findings by Jiali Han, the Rachel Cecile Efroymson Professor in Cancer Research at the Indiana University Melvin and Bren Simon Cancer Center and professor and inaugural chair of the Department of Epidemiology at the IU Richard M. Fairbanks School of Public Health, and colleagues.

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5 questions with Russ Siadatian about IU fraternities taking a stand against sexual violence

Sexual violence has become a national conversation in part because of attention the White House has focused on the subject. This week, it became clear that a number of fraternities at Indiana University have joined the conversation.

“Overall, this has been an initiative that started as a conversation between a few students a few years ago, and has grown into something exponentially greater, said Russ Siadatian, president of the Interfraternity Council at IU Bloomington.

It has grown to forceful statements from 21 fraternities denouncing sexual violence and pledging to work to eradicate it on the Bloomington campus. The statements have received media coverage from The Huffington Post, WTHR and Fox 59.

Siadatian is quick to say that many students were involved and they worked closely with the university’s Sexual Assault Crisis Service, which is part of the IU Health Center. SACS works with a wide range of student groups to educate men and women about sexual assault. Ann Skirvin, a licensed mental health counselor with SACS, said they also are “proud to promote positive character development on the Bloomington campus.”

“The pledges and other initiatives undertaken by the Interfraternity Council and MARS (Men Against Rape and Sexual Assault) are examples of our work engaging men in forming positive ideals of masculinity and creating safer environments in our Greek system,” she said. “Twenty-one fraternities have created clear and powerful mission statements regarding sexual assault and we anticipate more fraternities will create statements as well.

“The men created these statements to connect their fraternal ideals to this issue and demonstrate their commitment to improving the climate on our campus. We anticipate these men will live up to their words and ideals, and the campus community looks forward to providing them guidance and support as they address this important issue on our campus.”

Siadatian took time to answer some questions about the initiative and what he and the others involved think it can accomplish.

This Btown Banter post discusses other efforts to reduce sexual assaults.

Health & Vitality: How did this come about?

Russ Siadatian: Sexual assault programming has been something Sean Ndebele, our VP for membership development, has worked on through the MARS program all year. MARS was started by a previous IFC group, and started the sexual assault conversation within our community. Since its start, it has grown to a 300-person program. In a Presidents Council meeting discussion earlier this semester, we concluded that we needed to do more to fight sexual abuse. This was reinforced by a Sexual Assault Summit we all attended earlier this semester. Read more…

The healing power of art?

Cloud Busting tile piece by ceramics Associate Professor Malcolm Mobutu Smith

‘Cloud Busting tile piece by IU ceramics Associate Professor Malcolm Mobutu Smith

The therapeutic benefits of making artwork doesn’t surprise me. Art and medical experts quoted in this NBC News article say that just looking at art can have a physiological effect on the body, justifying investments by hospitals in art installations throughout their facilities.

From the NBC article:

For every day a patient lies in a hospital bed, it takes roughly three days to achieve his or her previous level of functioning, according to Dr. Lisa Harris, an internist and chief executive of Eskenazi Health, affiliated with the Indiana University School of Medicine.

“If an art installation gets a patient out of his room or paintings take a person’s mind off their pain and lower their stress levels, the art isn’t just decorative anymore. It’s part of the entire model of care,” said Harris, who oversees a $1.5 million art program, funded entirely by philanthropic donors, that launched last December.

Read more…

If sitting is the new smoking, this may be an easier fix

The IU Newsroom office space

The IU Newsroom

I walked through shady Dunn Woods on my way to a meeting yesterday and reveled in each peaceful step. IUPUI researcher Steve McKenzie makes a case in this Indianapolis Star article for how bouts of exercise can improve work performance. A new IU study finds, however, that slow, hourly 5-minute walks can do a world of good.

Growing concerns about sitting have launched the phrase “sitting is the new smoking.” Prolonged sitting is associated with risk factors such as higher cholesterol levels and greater waist circumference that can lead to cardiovascular and metabolic disease.

Saurabh Thosar, a postdoctoral researcher at Oregon Health & Science University, led the new study as a doctoral candidate at IU’s School of Public Health-Bloomington. From our news release:

The researchers were able to demonstrate that during a three-hour period, the flow-mediated dilation, or the expansion of the arteries as a result of increased blood flow, of the main artery in the legs was impaired by as much as 50 percent after just one hour. The study participants who walked for five minutes for each hour of sitting saw their arterial function stay the same — it did not drop throughout the three-hour period. Thosar says it is likely that the increase in muscle activity and blood flow accounts for this.

“American adults sit for approximately eight hours a day,” he said. “The impairment in endothelial function is significant after just one hour of sitting. It is interesting to see that light physical activity can help in preventing this impairment.”

Saurabh Thosar

Saurabh Thosar

I’m not the only one who likes Thosar’s findings — reports about his findings have appeared this week in the Washington Post, U.S. News & World Report, New York Daily News, Shape Magazine and in other major outlets.

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Wake up — time for school!

A new recommendation by the American Academy of Pediatrics that encourages middle and high schools to push back start times for the benefit of the students has been receiving a lot of attention this week in social and traditional media.


The author uses a bullhorn sometimes to wake up one of her sleepy teens for school.

In Indiana Public Media:

Dr. Vaughn Rickert, professor of adolescent medicine with the IU School of Medicine says teenagers especially thrive from getting extra sleep because they’re at a point in their lives when the brain develops at an incredible rate.

“Clearly kids who are deprived of sleep are not going to be coping with stress, and certainly they’re going to be at risk for other [things],” such as depression, anxiety, and psychiatric disorders, Rickert says.

“There’s really no reason not to have later school start dates except many people who are working on the other side of the classroom are not particularly thrilled about starting later,” Rickert adds. “It disrupts their day.”

I was encouraged to see that 15 percent of high schools already begin at 8:30 a.m. or later. My middle child’s private middle school begins at 9 a.m. My oldest child’s public high school begins at 7:40 a.m., with many athletes, like Peter, practicing or participating in weight training before school. Part of me wonders if later start times would result in more before-school activities.

Last year Peter’s first period teacher let her bleary-eyed students make hot chocolate, which I thought was brilliant.

In lieu of a later starting time, maybe administrators could schedule in nap times for students … nahhh.

Study IDs influence of gender in gene-environment interactions and health

I’ve often marveled at the complexity of the human body, mine specifically, and how it can be so challenging to ID the root of aches, pains and ailments. A new study by Indiana University medical sociologist Brea Perry reinforces the idea of complexity by showing that gender can interact with individuals’ genes and environments to produce very different health outcomes.

Brea Perry

Brea Perry

Her study, discussed on Monday during the American Sociological Association’s annual meeting, discussed how men and women struggling with substance abuse reacted differently when enveloped in close, supportive social environments if they had a genetic sensitivity to stressful situations. For men, the environment helped keep them sober. Not so, for the women.

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Fighting Ebola: Passion for her country and love for public health helps IU alum conquer fears

Tiawanlyn Gongloe, a graduate of Indiana University and its School of Public Health-Bloomington, lives in Monrovia, Liberia, where she works for the Ministry of Health and Social Welfare as a member of the National Task Force, which was created to eliminate the Ebola virus from the country. Overwhelmed by the work involved in fighting the outbreak, which has led to more than 200 deaths in her country, she found time to answer some questions about her life in the midst of such tragedy and her experiences in Bloomington.

Tiawanlyn Gongloe at her graduation ceremony in May

Tiawanlyn Gongloe at her graduation ceremony in May

Born in Grand Bassa, Liberia, in West Africa at the beginning of a civil war that lasted “for 14 years of my life,” she fled to the United States with her family in 2002, when she was only 12 years old. She grew up in Bloomington, Ind., and received multiple degrees from Indiana University’s School of Public Health-Bloomington: a bachelor’s degree in community health and a Master of Public Health and Master of Science in School and College Health Education.

I asked her if she is afraid for her own health and safety. The short answer is “Yes, but … ”

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