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Tuesday, 16 August 2011

Electronic health records - information is power AND possibly lifesaving

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We are all individuals.  Our genetic make-up varies.  What we eat and drink forms part of what we are.   What we are exposed to can affect our bodies.   It should not be surprising that when a battery of “tests” are done, that unlike machines that operate in a specific fashion, that each of us ‘operates’ differently.  Thank goodness for physicians and others that interpret these differences, determine when we are operating incorrectly and recommending ways to function better.
All that takes information.  What is happening today is important. What has changed is often the most critical information when something goes wrong.   The Star Trek tricorder concept of a quick scan misses that the story is usually about the change.  How can a physician who doesn’t know you, figure out what you need if they don’t know your information?  
Health system users expect that their information is readily available to anyone working in the health system.   A small minority are concerned that their “privacy” is compromised.  In our often libertarian driven policy environment, the privacy concerns have won out.  This perception is likely fuelled by health care workers that recognize that information is power,  and to not share information, means keeping control.
Unlike Facebook where nearly half of Canadians are willing to post intimate details of their personal life,  your medical information is usually so tightly wrapped up that hospitals do not have information from your family doctor. Even you would be challenged to amass all the health information into a single location if you tried. You have the right to access your medical records, but you are not the owner of the record.  It is this problem that contributed to the demise to Google Health. How can you populate your record, if there are barriers to you collecting the information (physicians may charge for copies, hospitals may require written requests and can charge to review the record for sensitive information before you can look at it, and can charge for anything that is copied)  
While there are attempts being made to integrate health information together, the inadequacy of the efforts should scare us all.  Our bodies and mind tell an important story.  Time to share it with those that are involved in helping us care for it.   This won’t happen until the public demands it – and that is more often something critical in an emergency, not when we are well.   In the meantime, propagating the information inefficiency requires more workers, and at risk is your wellbeing.

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