Summary:
We have been using this term in our local networks loosely over a decade and thought it was time we formalized it in this preprint.The horcrux EHR to optimise clinical complexity is a case report that exists as a sole EHR, originally belonging to an individual, later deidentified (akin to stripping it off it's soul) and subsequently it's split into multiple EMRs that accommodates the individual's multiple comorbidities in different project platforms separately analysing those comorbidities as different projects.
The article below illustrates this with a single patient's EHR case report that has been horcruxed into multiple case report EMRs addressing an aspect of his multiple problems (comorbidities) that are also linked to a case based reasoning engine under construction, which houses thousands of case reports thematically analysed in terms of outcomes focusing on a single topical problem.
UDLCO keywords glossary:https://
Introduction:
Epilogue:
Ron: "Isn’t there any way of putting yourself back together?"
Hermione: "Yes, but it would be excruciatingly painful."
Harry: "Why? How do you do it?"
Hermione: "Remorse. You’ve got to really feel what you’ve done. There’s a footnote. Apparently the pain of it can destroy you. I can’t see Voldemort attempting it somehow, can you?"
— Ron Weasley, Harry Potter and Hermione on reconciling the fragments of a broken soul[src]
What's a horcrux EHR?
It's a single EHR individual soul case report story, deidentified (stripped of it's soul) and merged into a colony of similar individual EHR case stories that are pivoted around each of the multiple comorbidities in the same patient.
Well the above is a loaded definition and it has been demonstrated further in this horcrux EHR case report of a 75 year old man that begins with a focus on the patient's immediate requirement of altered sensorium and tachypnoea.
Demo:
The patient's horcruxes linked and shared here below is that of a 75 year old man who presented to us recently on 27/06/2024 with:
Altered sensorium and rapid breathing since 2 days
HISTORY OF PRESENT ILLNESS:
Patient was apparently asymptomatic 2 days ago then he developed loose stools 4 episodes , large quantity ,watery in consistency , non mucoid, non blood tinged , non foul smelling.
Then he developed altered sensorium.
Horcrux EHR case report 1 is focused on the patient's immediate requirement of altered sensorium and tachypnoea:
Images of the patient's clinical phenotype showing the factors responsible for his metabolic syn as
1) abdominal obesity and sarcopenia
2) Vitals chart and graphical timeline
3) chest X-ray, ECG
4) cardiac echo showing posterior pericardial effusion at one point, thought to be inflammatory, due to a bread and butter appearance
DAY - 1
A 75 Yr Old Male With History Of Hypertension And Diabetes Mellitus Since 5 Years , Came To Casualty With Complaints Of 4 Epsiodes Of Loose Stools, Altered Sensorium Since 2 Days .
On Initial Evaluation
Ecg Showed - Atrial Fibrillation With Fast Ventricular Rate For Which 1mg Metoprolol Iv/Stat Was Given And Rate Was Controlled.
Ryles Tube Was Placed And Started On RT Feeds - 100ml Milk 4th Hrly , 100 Ml Water 2nd Hrly.
Serum Electrolytes Showed - Sodium-126,potassium-4.2, chlo
Hemogram showed- Hb-12, TLC-15,400 ,(N/L/E/M/B-87/06/00/07/00) , Plt-1.69.patient was started on INJ CEFTRIAXONE 1GM IV/BD
DAY 2
Ecg Showed - Atrial Fibrillation With Fast Ventricular Rate For Which 1mg Metoprolol Iv/Stat Was Given And Rate Was Controlled.
Ryles Tube Was Placed And Started On RT Feeds - 100ml Milk 4th Hrly , 100 Ml Water 2nd Hrly.
Serum Electrolytes Showed - Sodium-126,potassium-4.2, chlo
Hemogram showed- Hb-12, TLC-15,400 ,(N/L/E/M/B-87/06/00/07/00) , Plt-1.69.patient was started on INJ CEFTRIAXONE 1GM IV/BD
DAY 2
GCS was E3V3M5,
0.9 % NS infusion continued as serum electrolytes report showed Na:126meq/L , K: 4.2meq/L , Cl : 83meq/L.
2D ECHO SHOWED RWMA , LAD TERRITORY Hypokinesia , EF= 51%, Fair LV systolic function.
ECG changes of ATRIAL FIBRILLATION WITH FAST VENTRICULAR RATE Was Persistent And Was Started On AMIODARONE INFUSION 1mg/min for 6hrs followed by 0.5mg/min for 18 hrs AND ANTI COAGULANTS.
I/v/o Hypotension patient was started on INOTROPE support .
Repeat serum electrolytes showed : Na:117 meq/l , K : 4.3meq/l , Cl: 91meq/l was started on 3% NS INFUSION .
Past history:
C/O HYPERTENSION since 5 years and on tab TELMISARTAN 40 mg, tab METOPROLOL 50 mg .
K/C/O DIABETES MELLITUS since 5 years and on tab GLIMEPIRIDE 2mg , tab METFORMIN 500 mg
K/C/O DIABETES MELLITUS since 5 years and on tab GLIMEPIRIDE 2mg , tab METFORMIN 500 mg
More about the patient here collated and initially logged by Dr Narasimha Reddy in the case report horcrux link below:
Subsequently redone with more image data here: https://www.facebook.
The above horcrux of this 75M as in the above case report EHR links would be hidden in an assortment or colony of cases matching one of it's multiple comorbidity themes such as a colony of similar souls with:
1) Cardiac and renal failure with clinical complexity as processed with a colony of 50 similar cases in the link below:
2) Anemia and clinical complexity as processed with a colony of 50 similar cases in the link below:
3) Altered sensorium and clinical complexity as processed with a colony of 50 similar cases in the link below:
4) Metabolic syndrome, arthropathy and clinical complexity as collated in the link here:
5) Organismal and organ systems complexity as collated for acinetobacter (as in this patient) here:
And in many more here: https://
Organismal complexity in general here:
6) Cardiac arrhythmia and clinical complexity as collated here:
7) Diabetes
If the reader dares to click on the above links and examine the colonies of similar cases by the time he or she is done, she may have forgotten what was the original horcrux case story and may not be able to locate the exact story of the 75 year old there!
Well that's why it's a horcrux who's sole aim as a fragmented soul of an individual is to merge within an unfragmented, singular, universal soul! This universal soul is a large global system that is made up of individual organismal systems that thrive on optimizing organisational and organ systems complexity. More here: https://pubmed.ncbi.nlm.
https://commons.m.wikimedia.org/wiki/File:Tom_Riddle%27s_Diary.jpg#mw-jump-to-license
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