On Fri, 22 Oct 2004 09:35:44 -0700, Tim Cook <[EMAIL PROTECTED]> wrote: ... > 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.
Tim, I agree. However, also having a portable copy of your records in your pocket (in addition) can still be useful. > 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> The portable copy can be synchronized with the doctor's-office-copy in various ways: at the next office visit, from home via Internet, etc. > 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. Right - of course, we still need a reliable way to transfer/synchronize records between different doctors' offices, hospitals, etc. MPI is exactly designed to serve that function - but there are other ways to do it. > 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. What ends up happening in the absence of a "master" patient index (MPI) is that we use record-location, date of birth, SSN, + name to serve the record matching function. This is the current state of the field. It has advantages and disadvantages - but adopting electronic medical records systems (EMR) does not mean we have to adopt MPI. Best regards, Andrew -- Andrew P. Ho, M.D. OIO: Open Infrastructure for Outcomes www.TxOutcome.Org
