> ------------Original Message------------ > From: Tim Cook <[EMAIL PROTECTED]> > To: "OpenHealth List" <[EMAIL PROTECTED]> > Date: Fri, Oct-22-2004 10:39 AM > Subject: Medical Record Location(s) was: Virtual Privacy Machine - reprise > > > 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 agree. The ability to have the medical record carried with the patient doesn't change the fact that it must be available in other locations at other times, too. This simply indicates that the record to be carried around needs to be reconciled with a higher level medical record. In the DoD case, they would care basic information in the portable medical record as well as triage results associated with some medical event, the results of which would be reconciled at the higher level at a later time. > > 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. I disagree. Your medical record can be created over a variety of locations each of which may have its own id. This can occur even within a single hospital system. Thus an MPI of some sort is required to "stitch" the medical record together. > > 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. Exactly, but the records from both locations may need to be combined. Thus the need for an MPI. Dave > > Cheers, > Tim > > > >
