Thanks to Tim Churches for doing a great analysis of this issue and then following it up with real world testing and a report on his results. These things (see Tim Flewelling's article reference as well) can be very important if you have information that is very private and you want to keep it to yourself.
In the real world though my medical record needs to be accessed fairly often when I'm not there. One example is when lab test results come back to the ordering physician. These results could sit and wait in an electronic holding bin until I come back in with my record in hand but they are relatively useless from a clinical standpoint without the context of the complete (or significant parts) medical record. So if I carry it around with me I may have to come in to see if the doctor needs to see me again......There might be a workflow issue or two with this scenario. <g> I still contend that my primary health record should be at my primary care provider's location where ancillary data can be pushed into it. Be this a radiology report, lab report, hospital discharge letter or cardiologist results. Using this approach there is no need for huge MPI's (that invariably contain errors) and there are no socio-political concerns about unique patient identifiers and their abuse. At any one point in time I have a unique patient identifier. Because my records are on file in Dr. Smith's office on Broadway in MyTown and the file number is 12345 I can have any pertinent information sent to my record. When I decide to switch to Dr. Jones on Main Street in AnotherTown I can do so and still have a unique patient (record) identifier.....just not the same one I had before. Cheers, Tim
