The simple form that could save your life
Medicine is a data processing business. Doctors measure, notice and inspect, and based on the data they collect, make decisions and take action.
Alas, despite years of promises, online data storage in medicine is a mess. Whenever I visit a new doctor, I have to start over, from the beginning, to the best of my recollection. And I hate forms, so I leave stuff out, or forget things, or my handwriting is a mess.
Perhaps we shouldn’t wait for a universal solution.
This simple Word doc (Download file) (Google doc) will take you a few minutes to fill out. And, as you get older, you can keep it up to date. Every time you go to a doctor’s office, print it out and bring it with you. Keep one where you can find it. Make sure your kids or parents have a copy as well. (And, while you’re at it, forward a blank one or this post to people who will benefit from having one.)
Engage! Will patient engagement achieve “warp speed” this year?
A fascinating HIMSS LinkedIn thread started by Brad Tritle (@BTritle) on January 9, 2013, with 100 posts through January 23, 2013 by 46 Individuals (31 single post, 15 multiple posts) – 18 pages. The full thread can be found here. I had great difficulty categorizing and summarizing. I started trying to use the National eHealth Collaborative, Patient Engagement Framework: Inform Me, Engage Me, Empower Me, Partner with Me, Support My e-Community. The exchange was more: Culture/lifestyle, Experience/literacy/diversity/education, Reimbursement/incentives/cost, Community/coordination, Clinician engagement, and Access/technology/interoperability/portals. The thread included 24 links. They are compiled here. The extract can be found below. Here are some pearls: Read More
- As a clinician myself, having read tens of thousands of notes, it’s hard work finding relevant information in those notes. Clinicians don’t all write in an informative manner. Abbreviations abound. It will be interesting to see how note writing evolves as Open Notes proliferate.
- Can I challenge an error? This is no different than errors in my medication lists or vaccinations. I have tried to correct something in my record with no affect. This will continue to be a challenge.
- Will clinicians continue to write about concerns with my safety and state of mind? Read more about this here.
- Improve the visual layout and style of the information from the medical record
- Create a human-centered design that makes it easier for patient to manage their health
- Enable health professionals to more effectively understand and use patients’ health information
- Help family members and friends care for their loved ones
The categories include best overall design, best medication design, best problem/medical history, best lab summaries, and designs that challenges the judges. All amazing and artful. Take the time to at least scan the possibilities and compare to the EMR(s) you use.
I have written about data and research in recent posts. Readers generally understand about data that is in their electronic medical record (EMR), but several readers have asked me about my interest in patient centered outcome research (PCOR). How does this affect me? Why your interest? Let me explain: The field of knowledge management speaks of DIKW Hierarchy (Data, Information, Knowledge, and Wisdom). For our purposes Data are individual observations, sensations, or facts about our health – temperature, pain level, calories, etc. Information adds context and makes some sense of the data: getting warmer, less pain, eating more. More useful than data. Knowledge takes information further: lower fever + less pain + eating more = feeling better. Wisdom is the so what? Leads to doing the right thing. Data, information, knowledge, wisdom lead to Action. You’ve heard me write about Just-In-Time Decisions. I care about having the information and knowledge to make decisions about our health. Data is collected and reported about us by us and by others either directly or through technology. Our health team (patients, caregivers, clinicians) takes that data and turns it into information and sometimes knowledge. Research helps turn data about many people in similar situations into information and knowledge. Only patients and their caregivers step on to wisdom and action. So research can help us get to wisdom and action if:
- it asks the questions patients and their caregivers ask about best health,
- patients and their caregivers have access to the research showing what has worked and what hasn’t, and
- it helps patients and their caregivers make decisions leading to action in their best health journey.
So, I follow and advocate for patients and their caregivers in the research world as I am able. I write about it to keep you informed and to stay grounded in what is important about research. You, my readers, inform my knowledge and wisdom, and guide my action. Thanks. Keeps it up.
1) Coordinating care – All of my health team has the same information to share amongst each other – primary care to specialist, specialist to specialist, specialist to primary care, and all to my lay care team (relevant history, allergies, medications, procedures, diagnostic study results, impressions, diagnoses, unresolved dilemmas, next steps).
Seldom do the underlined items exist in even the best EMRs, never are they retrievable by me or my health care team. This isn’t good enough.
1) the scenarios in your experience where medical record content was critical to care
2) the data set (information) the record should contain in those scenarios.