> ------------Original Message------------ > From: Andrew Ho <[EMAIL PROTECTED]> > To: [EMAIL PROTECTED] > Cc: "OpenHealth List" <[EMAIL PROTECTED]> > Date: Fri, Oct-22-2004 11:18 AM > Subject: Re: Medical Record Location(s) was: Virtual Privacy Machine - reprise > > 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.
Absolutely. > > > 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 agree. > > > 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. More than an MPI is needed. Tags as to the origin of the data need to be provided in some way so that data duplicates can be handled. These are distinct from the process of identifying the patient. > > > 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. Well if every location or system uses a different identification mechanism it makes the patient identification even harder, in my opinion. You are effectively adopting an MPI process. Having a relatively more uniform process and separating out the service explicitly would make it all much easier. Dave > > Best regards, > > Andrew > -- > Andrew P. Ho, M.D. > OIO: Open Infrastructure for Outcomes > www.TxOutcome.Org > >
