“You don’t build it for yourself. You know what the people want and you build it for them.”
Those words were Walt Disney’s discussing customer service. No one questions Walt’s ability to create and build exactly what people want; movies, theater productions and theme park rides. In contrast, Healthcare in America was never created to give the patient what they want. It has been built for payers, physicians and in general, patients are last.
While there are many aspects to healthcare that are not patient-centric, one specific item that deserves a reevaluation/(or reinterpretation) is the medical record. For years there was never a “medical record” of care, just the trust in your physician’s clinical acumen and memory. Then there was a hand written note about patient encounters, then dictated notes until today when the majority of physicians use some type of electronic medical records.
Electronic medical records are difficult to use. For patients it can be impossible to obtain or transfer one’s own medical record. Physicians loathe EMR’s for taking their gaze and attention away from the patient to document in the EMR, all the while feeling like creating a note in an EMR is geared solely towards obtaining reimbursement from an insurance company.
With respect to Mr Disney, why didn’t we create a medical record for patients? With the technology we have today why shouldn’t the patient be in charge of their own record, releasing physicians and their offices from maintaining thousands of patient records.
Let’s call it a Patient Health Record, or Patient’s Own Record. The patient would have access to update their personal and family history anytime they want. If they have a family member diagnosed with colon cancer, they can add it immediately. They aren’t waiting until their next office visit, when they are more than likely ill and focused on more immediate concerns.
Every physician, nurse, hospital that a patient visited would have access to every patient’s entire medical record because the patient would bring it with them. This could be on a device or web-based portal. A physician or member of the healthcare team attending to a patient could record the necessary medical issues, findings and results and most importantly instructions for the patient. All this would be then given right back to the patient. The medical record would be a living history of the patient and for the patient.
Of course there are downsides to a plan like this. Medical liability issues would be first and foremost. How could you defend your medical care when you don’t have a copy of the patient’s chart and do not know the fallibility of those notes? Without a record keeping system of some sort, how would physicians submit claims and be reimbursed? A change like this is really almost inconceivable. But anything that creates a conversation and stimulates ideas that would limit the burdens on physicians and empower patients to be more proactive in their health, is something worth pursuing.