Wednesday, February 18, 2009

Experiences on Medical Education networking

To share experiences on medical education networking I guess I won't have to go back further than when I was an undergrad medical student.

I always thought the best way to crack the assessments would be to know what our examiners knew. A bit of networking with them would have allowed me to know what was on their minds but then getting to get to know them was a major challenge in our college where even the internal examiners were actually from a different college (although from the same university).

So we had to restrict ourselves to knowing what was general knowledge ( I believe the MCI calls them "must know").

However a bit of networking with our hostel seniors did allow us a sneak peak into the previous assessment scenarios with interesting tit bits on the examiners as well.

Hostel life that way was a great place for networking.

I soon grew out of the assessment networking fever after having completed UG although I could never grow up from being a medical student: http://student.bmj.com/issues/03/02/reviews/41.php

In my clinical practice I realize that networking is essential to success and each and every new workplace offers its own challenges in setting up networks from scratch ( I have changed a good many places from Kolkata, Chandigarh, Nepal, Bangalore, Malaysia and finally Bhopal).

However online networking gives me an opportunity to maintain older networks with ease. My facebook contacts ( 250 and growing) are mostly people who I met on my previous institutions, many of them students sharing their life pictures ranging from holidaying in US or Borneo to getting married or having children etc etc.

Wish I could have kept in touch with my patients in the same manner.

Facebook gives me a hope that some day in the distant/near future we shall be able to network more meaningfully with our students and patients.

Saturday, February 7, 2009

Open health information management and user driven health care

What if we have user driven health records generated in the community by patients, relatives IT professionals (call them PHR, EMR whatever) and this was stored in an openly accessible platform (without patient identifying data) and this in turn was utilized effectively to upgrade stage 6 and 7 of Hospital records? (HIMSS says there are 7 stages of hospitals, most US hospitals on stage 3 and none on stage 7.The seven stages are : Stage1 Lab, Radiology and Pharmacy all networked, Stage 2 Clinical Data repository, Controlled medical Vocabulary, Clinical Data Support System, may have Document Imaging, Stage 3 Clinical Flow Sheets, CDSS, PACS, Stage 4 CPOE,CDSS , Stage 5 Closed Loop, Stage 6 Physician documentation complete, Stage 7 Medical record fully electronic)
.

http://www.igi-global.com/reference/details.asp?ID=33436&v=tableOfContents (chapter XVIII)

I know it sounds whacky but I feel this is actually what is happening today on paper (minus a lot of valuable data that goes unrecorded due to time and resource constraints thus making our present paper records useless...barring exceptions).

What is happening today is that the same PHR exists in an individual patient's and his/her relatives mind and a fracton of it is handed out to the busy clinician who records an even lesser fraction of it in his paper record. Thus a valuable opportunity to share patient and health professional driven experiential insights is lost.

openEHR platforms are changing for the better daily and the coming years will remain exciting for the clinical informatics community.