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)
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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.
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