From 1997 to 2001 I experienced first hand the shortcomings of the Canadian healthcare system. Over this period my family saw the death of three close relatives. We experienced the fragmentation of the Ontario health care system. From community hospital to academic health sciences centre, private homecare and nursing care, cancer care centers and palliative care, each doctor and hospital maintained a health record, yet none had access to the information from the previous location. Blood work done one day would be repeated because the lab results were not shared between providers. New specialists would conduct the same interview done the previous day or just the same morning in a different clinic. The only full health record was what we, as a family, maintained. It kept us involved in the care process and we were able to inform new clinical staff with the details from previous visits saving time and money for us and the healthcare system. We were not the first family to experience nor the last, others have expressed similar frustration with medical records.
My background is not medical. My experience is in information technology. For two decades I worked in the financial sector developing software for banks, trust companies and credit unions. In the late nineties I deployed financial solutions, supported document scanning and presentment for cheque recognition and bill payment on the internet. The financial sector has benefited greatly from technology advancement, greater efficiency and performances. With my experience in IT and the eye-opening experience of the fragment healthcare system it was apparent that health information exchange could be and should be improved.
In 2001, with a strong team of developers we began the process of creating an eHealth solution. The Clarity Healthcare Framework was the starting point.
Over this previous decade we deployed electronic form applications to collect patient assessments. These are used to measure quality of care in hospitals. The ultimate goal, to create a personal health application that would allow patients and their families to keep and monitor all the health details, a life-time health record. The Clarity Health Journal focuses on the patient and their family to help them manage and monitor their health.
There are challenges to maintaining a full and complete health record. You can start and keep your own information easily enough. You can maintain a blog or a website with the details of your diet, exercise and even medication, but what do you do about doctors’ notes, lab results or hospital visit details?
Health information exchange can be used to improve the overall health delivery. Easier access to health records means better quality health. Each doctor, hospital and clinic maintains health record for the patient, only the family maintains a fully holistic view of the personal health information.
While we do online banking and use ATMs around the world to withdraw cash from our bank accounts, pay bills with Paypal and other online services our health information is locked up in a filing cabinet someplace. We can’t access those records. Our caregivers have access to the record they created, but we have no way to access them or share them with family and friends involved in our care. Even when permission is granted to a spouse, partner or adult children; doctors or hospital administrators can still refuse access or prevent flow of some information needed for your care. 2010 needs to be the year we take control of our health information.
These days most patients have access to the internet in some form. Digital cameras, scanners and fax machines can be found in many homes. Larger percentages of patients have cellphones and computers. Technology is no longer a barrier for patients and their family. Still many doctors’ offices and hospitals still maintain paper records and written notes.
Back in 2001, I started a family history using a family tree maker software. Online I found resources that included ship manifest of 18th century that had been scanned, OCRed, categorized into a database. Old paper records hand written using quill pens are now indexed and searchable online. You can expect hospitals and doctors’ records could be as advanced as genealogy software makers. Technology can offer a solution to making paper health records available online very easily.
Ontario eHealth can easily offer a service to scan all health records and categorize the data for patients. The process doesn’t have to be a mega project. Each hospital can maintain a scanner to OCR records into a database. When a patient arrives for a new visit, if they already have a paper record the history can be scanned. New visit details would be collected electronically online. Within a very short period of time all patients health records would be online. Doctors offices could either scanner records internally or send out the records to a services bureau. Within 2 or 3 years a majority, if not all, records would be online. The resulting database would have both the images of the paper records plus the categories details of the electronic data. It would be indexed and searchable and could be made available to patients and their families to use.
The personal health record can then be enhanced with the individuals own data. Once online the patient and their family uses and share this info wherever they are, with doctors, hospitals and clinics. A truly universal healthcare system is possible.