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We had fully open records in the military in that DOD relied on patients to hand carry paper records from facility to facility. A significant minority would edit their charts , removing psych diagnoses they didn’t agree with.
We’d keep shadow copies of signficant notes (supposedly against the regs) to protect us in case of a claim (the step prior to a malpractice suit in federal health care).
Open health records in the sense that the patient has view only access to records and the records are in a common standardized format would be great.
I remember to this day how a Navy officer altered his medical record to make it appear as if a diagnosis had been missed by his doctor when it was not. Good thing she kept a second set of records. That guy should have seen the inside of a jail cell, but brave one that he was, he blamed his wife and said she made the changes.
An “open EMR” record is an oxymoron. If it is a record of the findings of professionals, then those records should be as unchangeable as their authorship.
I am family physician, and have developed a Personal Heatlh Service online: http://www.keyose.com/
The reason is my concerns about big companies missing the point. Most of the leaders of that projects are not doctors (nor patients).
I agree with that post: a open medical record has not sense at all.
BUT… what about a PERSONAL HEALTH RECORD (PHR)?. In keyose, we do not want to remove the EMR. We see our PHR as an aditional source of information (and a very useful one).
It is curious how I saw the same limitations for keyose from the beginning of the project. You can read, for example the “FAQ” in our website:
http://www.keyose.com/help/#q10
“What if the patients lie about their data?
Patients don’t usually lie about their condition. However, Keyose is a “personal health record”, so it cannot be seen as a certified medical document. The truthfulness of the data stored in Keyose is equal to the truthfulness of the patient, or the truthfulness of a medical report given by the patient (that can also be made up).
Doctor can trust Keyose data at the same extent at which they can trust their patients. Keyose cannot be used as evidence in court (since it is not a certified medical document).”
My second concern was privacy. And we have solved it by building the first totally ANONYMOUS PHR.
In keyose we use to say: “Confessors and prostitutes do not ask your name.. so why do we?”
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