Lets not talk about the craven insurance industry or security or American healthcare for a moment. Lets let ourselves dream.
Most medical records don't capture enough information about a person longitudinally over time. I worked in a bank that had fantastic customer relationship management software that captured every interaction between the bank and customer and acted as a integration layer ontop of all services the bank provided. It was a stack based model where recent interactions went ontop and nothing could be deleted. You could find old scans of documents, letters the bank had sent and replies. The interaction between bank and customer over internet banking were all captured. I saw my own records from when I got my own account as a child and could see everything from then till now.
I've had a bunch of touch points with medical professionals relating to an eye injury in the last few years. From Emergency to Surgeons and specialists. A lot of information had to be repeated by my wife along the way whilst I a sat there blind.
I don't think special form support or really even business process support would be that useful. I just think having a single pile of client information that's in chronological order would really help doctors be able to stay on top of the issues at hand and then creating a culture of active documentation of actions by all staff so that patient records such as whats on the chart at the end of my bed get's onto my medical record by the end of shift or earlier each day.
I now keep a copy of the photos of my retina on a USB stick. It never fails - either I move and get a new ophthalmologist or they change systems and my old photos are lost/inaccessible. Having a history can be a big help to them in tracking my age-related vision issues, and so far every system is able to export a PNG/TIFF/JPG image.
Microsoft Health Vault was supposed to do something like this. The promotional materials said it was going to be a system that you and your medical professional could securely access, and be a central repository of your medical records, so you wouldn't have EMR vendor lock-in. It did OK for tracking immunizations (but I have a yellow WHO booklet for that..)
There have been several attempts at creating a personal health record system like Microsoft Health Vault. All have failed because providers have no incentive to cooperate. However it appears the Apple Health app is getting some traction and they have built interfaces to quite a few providers.
It’s the Carte Jaune (Yellow Card) which has a function of being a record of immunisations that is sometimes useful when travelling to or from regions with specific disease outbreaks (yellow fever, measles, polio etc). The US Government printing office may still print a version of this. https://en.m.wikipedia.org/wiki/Carte_Jaune
I told a doctor I'd received a few vaccinations but forgotten to bring the card, and they just added them with no other questions. I'm pretty sure that was true, but it's definitely not a very bulletproof set of credentials.
25 years ago when I was an intern, I worked for a healthcare software company on the interface team. Our job was to get records out of a hospital’s system and into a home care provider’s system. We were an early proponent of the HL7 standard and our customers were thrilled with not having to repeat information like you experienced.
But as you saw (pun intended), it hasn’t gone far. Every time I see my doctor I have to fill out the same forms and repeat the same information. Too bad my work didn’t go far.
Your doctor shouldn't be having you fill out the exact same information. Review of systems (like if you have a cough, etc) is fine, but all of your past history? It should just be what has changed or been added to your problem list since the last time they saw you.
It's like that in some places. Typically, the consequence is that you'll get a phonebook-sized file in no time, with so much cruft accumulated from prior encounters that the file will be next to useless.
This is a great point. As someone who receives a lot of medical records from various exports, I can just say that hundreds of pages for a healthy 11 YO only makes it easier to miss the important parts.
This just seems like lazy doctoring compounded by busy schedules. If you can't summarize what's going on succinctly, what was the point of all that training? God forbid you spend a little more time on patients.
Most medical records don't capture enough information about a person longitudinally over time. I worked in a bank that had fantastic customer relationship management software that captured every interaction between the bank and customer and acted as a integration layer ontop of all services the bank provided. It was a stack based model where recent interactions went ontop and nothing could be deleted. You could find old scans of documents, letters the bank had sent and replies. The interaction between bank and customer over internet banking were all captured. I saw my own records from when I got my own account as a child and could see everything from then till now.
I've had a bunch of touch points with medical professionals relating to an eye injury in the last few years. From Emergency to Surgeons and specialists. A lot of information had to be repeated by my wife along the way whilst I a sat there blind.
I don't think special form support or really even business process support would be that useful. I just think having a single pile of client information that's in chronological order would really help doctors be able to stay on top of the issues at hand and then creating a culture of active documentation of actions by all staff so that patient records such as whats on the chart at the end of my bed get's onto my medical record by the end of shift or earlier each day.
This seems like a good place for an ISO standard.