Open MedicDrive:Introduction
From Open MedicDrive
[edit] Open MedicDrive
Personal health records in digital format
Worldwide use of information technologies in Health care industry is estimated to be around 5-10% as compared to other industries like financial or aviation. The decreased implementation of information technology in Health care leads to increased incidence of medical related errors due to delay in accessing critical medical information during emergencies. Despite the tremendous growth of internet over the past several years and also the ease of accessibility of internet services around the world today,accessibility of medical information of a patient today is not yet easy. Whereas,we can easily gather information about current news from around the world but retrieval of patient related information is always rapid and many times not feasible. Storage of Personal health care information electronically offers the key step in maintaining a robust health of any individual.
Personal health records in paper based format have been used since the beginning of modern health care services. These have several disadvantages as they cannot be accessed rapidly during emergency, difficulties in sharing of these records, security and vulnerable to physical destruction as shown in recent Hurricane Katrina disaster in New Orleans in 2005. These records are also difficult to carry around for the individual when migrating to another medical center or health care provider.
Electronic management of personal health records were developed in the last 2 decades by several electronic health software vendors. Rapid growth in this sector was noticed during the dot-com bubble era.Today,with the growth of Web 2.0 in the internet, there is renewed interest in Personal health records in electronic format. Many still have confusion about Personal health records (PHR) and Electronic health records (EMR).PHRs are different.EMRs or electronic medical records are developed in Hospitals and medical centers, these legal health records are created and stored in health care settings and patients have no control over these records. They contain the longitudinal medical information of any patient over a period of time. A fully functioning EMR is described as one that includes a clinical data repository, controlled medical vocabulary, computerized provider order entry, clinical documentation or charting, pharmacy management, electronic medication administration record, major ancillary systems (for example, laboratory, diagnostic imaging, cardiology, and so on.) and picture archive and communication systems (PACS). However, PHRs or Personal health records are created by the individuals and patients can have full control over these records. These can contain in addition to medical illness information, health related information. The models are shrink wrapped unlike the EMRs.They could also include complete demographics of the patient along with essential health insurance details. In addition they could also include record of illness over a period of time.
There is lack of consensus about the definition of Personal health records in digital format. Two of the widely accepted definitions are by the Markle Foundation and the American Health Information Management Association (AHIMA).
The Markle Foundation’s 'Connecting for Health' collaborative is a public-private endeavor that is working toward establishing an interoperable health information infrastructure for the U.S. health care system. The Markle Foundation definition is'An electronic application through which individuals can access, manage, and share their health information and that of others for whom they are authorized, in a private, secure, and confidential environment.'
According to the American Health Information Management Association (AHIMA) PHR is defined as: 'The personal health record is an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions. Individuals own and manage the information in the PHR, which comes from health care providers and the individual. The PHR is maintained in a secure and private environment, with the individual determining rights of access. The PHR is separate from and does not replace the legal record of any provider. ' The recent burgeoning growth of internet access and also ease in availability of Health related information across the web has resulted in tremendous growth of personal health record information storage in digital format. “According to a 2005 survey by the Pew Internet and American Life Project, over 8 in 10 Americans (82 percent of Americans aged 50-64 and 81 percent of Americans aged 30-49) with Internet access looked online for information on at least one of 16 health topics.” As more individuals become concerned about their health and shift of trend towards adoption of healthy lifestyle will lead onto further development and progress of personal health records in electronic format. There are different types of electronic personal health record formats available in the market today. These could range from online versions to off line memory storage device versions. Both have significant advantages and disadvantages.
Online versions enable storage of personal health information in a distant server and patients and also their health care providers could access and update this information easily. They are beneficial in case of emergencies, wherein a emergency physician can retrieve the vital health data of any individual. The main drawback of these systems is the security of the information, safety of these servers along with the risk of the network being not able to access the patient's records during critical times.
To overcome, these issues there another system of personal health record in portable format was developed. There is an assumption that once the patient has a small portable device with their emergency information stored in them; personal vital information can be rapidly accessed from their storage device using any standard or portable computer with any operating system.However, some studies have shown that these devices are vulnerable to viral attacks and that the data may not be secure. To overcome these hurdles and develop an ideal electronic personal health record will not be an easy task. Development of a new Personal health record which is ideal in all areas is difficult. It is important to start with a short term solution and then progress onto more complex long term solutions.
An ideal electronic personal health record application should have the following features:
• The emergency file should contain information such as the patient’s name, insurance company details, medical conditions, medications, allergies, emergency contacts, advance directives, and so on. If desired, patients can and should consult with their Primary care provider about exactly which types of information should be included in the file.
• The patient creates the emergency file with the understanding that it will not be protected or secure. The application will immediately pull up and present to the viewer the emergency medical information. The file is not protected so as to allow ER personnel to rapidly access the important health data if a patient is unconscious.
• Patients should be able to leave the information on their personal computer and refer to it and update it as needed.
• Store health data on a USB drive itself. If the patient information is contained on the USB drive, the application will automatically save a backup copy on the individual’s home computer in case the USB drive is lost or stolen, the patient will have their record in an emergency if needed and they will have it if they go to a new physician on a new USB drive.
• The USB should be encrypted in order to safeguard the privacy and information of the patients. So that in case the USB is misplaced or stolen the data cannot be retrieved easily.
• User friendly application program of the Portable Health Storage system without the need to install any specialized software program in the computer. The learning curve is decreased considerably by using Graphic User Interface Design.
• The Software is able to work on both Mac and Windows and also Linux operating system, regardless of the processor speed of user computer.
• Should have features to store in health fitness profile of an Individual over a period of time.
• Audit trailing of health record data entry by individuals or health care professionals.
• Ability to synchronize the data between different computers across hospitals.
Developing a web based model would depend on the server wherein the information resides. This should maintain uptime of nearly 99.99% since critical health information is stored and also the server should be located in a secure area with uninterrupted power supply. The bandwidth for the flow of information has to be by using at least OC 768 connection (39,813.12 Mbit/s (payload: 38,486.016 Mbit/s; overhead: 1327.104 Mbit/s) to maintain large volume of internet traffic and also to prevent any down times. In addition these servers should be fire walled to prevent any outside unauthorized intrusion.
Establishing new infrastructure models will take time; especially in the healthcare IT world. In order to get started, a patient can begin creating their own Personal Health Record (PHR) using existing applications and carry it in a portable format and subsequently the complexity of the applications could be added on in the future.
Personal Health Records provide tools to physicians which enables them to enhance their relationship with patients. They prevent duplication of testing and also over prescription of medications. By offering patient-specific reminders and health care information, they also help in better collaborative management of chronic diseases like hypertension and diabetes and also tracking of patients.
[edit] About MedicDrive
Our goal is to create a common standard new Portable Personal Digital Health Record Manager called MedicDrive™ (MeDisque™ is the French version). The name implies a ”drive” toward good health by keeping medical records with you always.
We Hope that MedicDrive helps you take control of your health. MedicDrive can be life saving in emergencies—especially when you travel overseas.
What if you were traveling and were injured or became ill? Providing emergency personnel access to your medical information through MedicDrive could save your life.
