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Power to the People: The EMR Revolution!

September 14, 2009

i_am_enabledI know that the more we inform people about their health, the more they will care about it.

Long gone are the days of secrecy of health care. We are encouraged to be responsible for our medical history. The American Heart Association encourages women to know your cholesterol number like you know your dress size. The mystery is gone and so should restricted health records.

Some doctors don’t agree. Some physicians think that there is a level of understanding and analysis that will cause more problems for patients.

How Much Access Should Patients Have to their Medical Record
http://www.kevinmd.com/blog/2009/06/how-much-access-should-patients-have-to-their-medical-record.html

I completely agree with the fact that doctors are critical to understanding your total health. They understand nuances and connections that I don’t even want to fathom. I also think that patients should have access to their medical record just for the sheer need to be portable.

The move to EMRs is truly a revolution. We have a lot of different competing factors in making it possible. We have a lot of fear and misunderstanding of the capabilities and possibilities of this new era in health care. It will not be easy but in the end it will be worth the effort.

I am Enabled, the social media campaign for Microsoft’s consumer-focused electronic medical record product HealthVault, is running a contest that will award the best ideas on how to use an electronic medical record for your family and how you’d share that story on camera.

So, here’s my idea….

I want a complete medical record from birth to now for my family.

I am a health care nomad. I’m 29 and have lived in two state and six cities and seen at least 20 different physician and specialists offices.  My husband has lived in 4 states, over 10 cities and seen countless PCPs, pediatricians and specialists.

As a millennial, we are a generation of ‘nomadic’ patients. Millennial move their health care to the most convenient practice based on coverage, costs and proximity to home or work. We don’t research doctors or put any extra effort into going to the same doctor. In fact, since I left for college I don’t think I’ve seen the same doctor for longer than two years.

Long gone are the days of seeing the same physician for your whole life. Long gone are the days when doctors have enough time to truly understand your whole health picture. Now is the time that we must take control of our own health information, bring it with us and understand it.

I want a complete medical history. There is no way that a physician office can do that for me. With increased demands for care, decreasing insurance payment rates, and a nursing/family physician shortage there is no way a physician office can track down and maintain my medical record. I am missing information that is important for my health including immunization records, test results, surgery details and childhood allergies.

I also want a clearer picture of health from our parents and extended family. My husband and I want to have little ones  soon, and I want to know my family’s medical history. I want to know about possible cancers and diseases. I want to know what we should be working to prevent to keep us as healthy as possible.

The thought of a complete medical record is also important to me, because I have a chronic illness. I  need to be able to quickly and easily give my health care providers a full picture of our health to help them make the best decisions for our care.

I was recently diagnosed with Hashimoto’s Disease which causes hypothyroidism. I know that I needlessly suffered because of my incomplete medical history. I remember as long as five years ago a nurse mentioning that my thyroid looked funny and that I should get tested. Being young ,naive and uninformed, I got tested and they said the results were “normal” so I just ignored trying to keep my record complete. As I hopped from practice to practice my medical record never came with me. My newest doctor never knew that I’d had a problem for that long of a time . As a “communications chick” who certainly does not have a medical degree, I never thought to put two and two together. I just thought that my stress and lifestyle was contribute to my fatigue and moodiness. I never had a complete picture of what my medical history and put the puzzle together.

With an medical record like HealthVault, I can track my own lab results, doctors visits and medications. I can have control to see patterns and ask questions of my physician. It also have the functionally to track other wellness markers like weight, blood pressure and glucose levels.

The way I would show my story  is to chronicle my journey of piecing together my care history. I’ll tell the story by not only chronically the numerous people I’ll have to be in contact with to complete my record, but I’ll interview medical professionals who deal with paper and electronic records to get their perspective on going digital, their struggles and successes. I also want to visually explore patients, physicians, insurance company’s resistance and embrace of medical records. It is the EMR revolution that I want to capture on film.

This is truly the power of the people. The more we understand the better we can take care of our health. Ownership is a huge part of responsibility. I am ready.

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14 Comments leave one →
  1. carpoolmom permalink
    September 15, 2009 1:00 am

    Dawn: I have Hashimoto’s too! How wild is that?? And yes, it’s not something that doctors test for as part of common protocol. Having it as part of a permanent record helps prompt a doctor to test for THS levels, which is an important test for Hashimoto’s so that you know if you need Synthroid or to increase the dosage for Synthroid. Loved your post, by the way!!

  2. Molly permalink
    September 16, 2009 12:33 am

    I think it’s essential that patients and doctors have the ability to view all medical files related to a patient’s history. How can a doctor do their job if they don’t have the big picture? I could also see how people would disagree with this idea because of privacy issues and, of course, some people would abuse this accessibility to medical documents for their own sordid use. For instance, identity theft. Hopefully, with the right format, a patient’s privacy could be retained, while also providing useful information to the doctor who is then more able to do their job well, without misdiagnosing or overlooking serious medical issues. Thanks, Dawn.

  3. September 16, 2009 6:28 am

    I am also a “nomad “, three states in five years and chronically ill ESRD (End Stage Renal Disease” and I understand the need for my complete medical records to be available to my doctors. I believe it is the patients right and responsibility to have access to the medical records they need to keep them healthy or to get the best care possible.

  4. Dana permalink
    September 16, 2009 9:38 am

    As one who recently had emergency gallbladder surgery, it would have been so nice to not tell my history the multiple times I had to each time I was transitioned from phase to phase – Urgent Care, Ambulance, Hospital. I am sure that I missed things that might have been helpful. Also, as one who had just changed dosage on one of my meds, it would have been nice to be able to remember the exact amount so I wouldn’t have had to go 3 days without. I do have concerns about the crazies who will do weird things if they can hack into it and employers who can also misuse information. But overall this is a much needed system.

  5. September 16, 2009 9:40 am

    I absolutely agree that it is necessary to provide doctors with a complete picture. There are somethings in my family history that I am sure that I am unaware of. When I need to provide my family history, I am sure that I am not painting the complete picture and I may be putting myself at risk. Electronic records from birth will allow parents to provide a complete picture at birth. Moreover, generations from now EMR’s could be used to track family history and allow for doctor’s to watch for and hopefully prevent possible health problems.

  6. September 16, 2009 11:48 am

    This is a huge emerging issue, of course. Your timing is excellent.

  7. Gary Davisson permalink
    September 16, 2009 2:39 pm

    Being a disabled vet and in the VA system I am encouraged that the VA is trying to open up their system to us. Right now it is at its infancy, but they do have myhealthyvet that I can start.

    Beyond that they have begun merging patients that go to the dif medical centers in dif states. It’s really nice knowing that my doc here can see my records from CA. I many ways the VA is ahead of the curve.

  8. roxitarian permalink
    September 17, 2009 8:48 am

    I think that having our health records accessible to us as patients should be a given right. We pay for our coverage and it’s only right that we should be able to see the progression of our bodies over the years. This also would make it a lot easier when switching doctors or getting a second opinion. A lot of what slows the process up so much is simply getting the paperwork transferred. I think a lot more people could be helped in a much more timely manner if we didn’t have to wait on the dr’s office to do everything for us.

  9. September 17, 2009 12:38 pm

    I don’t believe that I’ve had a regular doctor since my pediatrician. Even before I started moving all over the place most visits were as needed with emergency rooms and urgent care centers.

    On a technical side, I think I’d rather see the records in a format not controlled by one entity. There are security pluses and minuses to each approach.

    (Looks like a typo in the 10th paragraph: “move their health care to the most convent practice”… convenient?)

  10. Heather permalink
    September 17, 2009 1:05 pm

    The thought of a full medical history (including family history) following a person from doctor’s office to emergency room and on, is exciting. I recently started seeing a new doctor and had to give a “full” medical history at my first visit. Things like when my last tetanus shot was are way beyond things I can keep in my memory. I have not flipping idea… when I have been treated, tested or checked for what. I am just trying to get in an out and not spend my life’s savings in the process. Electronic medical records that are accessible by patients and doctors would not only be convenient, but it is desperately needed. Having my new physician be able to remind me that it has been 15 years since my last tetanus shot and that I was in need of a booster would be great, but more importantly preventative medicine due to clear and concise communication among patient and various doctors will reduce cost (both to insurance and to the end user) and is long over due.

  11. September 17, 2009 6:33 pm

    Love your “health care nomad” descriptor. As people grow up and become more mobile, it’s inevitable they’ll encounter many health care providers along the way. Your ideas make us better stewards of our own health care.

  12. Crash permalink
    September 18, 2009 12:41 pm

    Great story. I am also somewhat of a “healthcare nomad”. I have moved around constantly and cannot even remember the last time I had a primary care physician. The only doc I can remember seeing on a regular basis was my pediatrician. I dread doctor visits and only go get a routine physical when it is absolutely necessary, which may be the results of moving a lot, leading somewhat of a “disposable lifestyle”, and not ever sticking around someplace long enough to have a regular doctor. Nowadays, it becomes exhausting even thinking about going to a doctor and giving them your information and filling out your family’s medical history that has been passed down from word of mouth, most of which can be variable based on what you remember at any given day. The doctors can never really fully understand their patient’s needs without a complete picture. The process is out of date and needs to be streamlined. The thought of a complete medical history is exciting.

    I have been hospitalized numerous times for an eating disorder heart problems associated with that. Too say the least, I have had quite a sketchy medical past. When I was younger I did not really care if I had high cholesterol or blood pressure, or a low heart rate. I did not care how those issues would affect me as an adult, because I did not look that far into the future. But as you get older and the notion of life becomes more precious, and you begin thinking about starting a family, the importance of a complete medical record become increasingly important, as you do not want the health risks you have taken in the past to affect your future. More importantly, you do not want a serious health issue with you or a loved one to go un-noticed until it is too late.

  13. Catherine permalink
    September 19, 2009 12:03 am

    Wow…it really is important for us to take care of understanding our own medical history! I can’t believe how quickly these technological advancements are changing our lives…especially in healthcare.

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