With all the attention and billions of dollars spent on EMR's (electronic medical records), most people are ignoring a crucial feature lacking from EMR's: portability. This abstract-sounding concept is practical, and could be implemented if the industry leaders deigned to do so. Without portability, EMR's are an incredibly expensive, doctor-dissing burden. Effective EMR portability would directly lead to many of the tremendous advantages in patient service and health that old-style, non-portable, legacy EMR's are incapable of delivering.
What is Portability?
A portable EMR has these key attributes:
- It's yours. You own it. It's not owned by some giant entity, sitting behind the impenetrable walls of a remote data center.
- It's controlled by you, just like you control your email.
- Others can help you update it and you can make it available as you choose.
Having a portable EMR is like having a portable personal computer: something that is so small and light but also powerful that you carry it with you everywhere. It's yours! It's got all your stuff!
More specifically, a portable EMR is an app with all your healthcare data and history stored in it. I've talked about this before.
Of course, just like you don't want to lose your contacts and photos if you break your phone, you wouldn't want to lose your medical records if something went wrong. So it would be backed up to the cloud, and automatically synced to any of your devices. This isn't magic; your email probably works this way.
Sometimes you use an app that asks your permission to access your data, for example your email contacts; if you give permission, the app would read your contacts and do something with them, for example send them an invitation. The portable EMR app would ask your permission when you went to a doctor's office or other medical facility, and if you gave it (why wouldn't you?), the medical people you're visiting would have all your records. No need to arrive early and fill out pages of medical history on paper! Similarly, when you leave, whatever they did would be added to your portable EMR, instead of being locked up tight in the hospital's EMR.
That's portability: a safe, secure, accurate, comprehensive EMR that is yours, that you carry with you, and that you and your providers use to assure you get the best medical care, totally informed of your conditions and history.
Why Portability matters
The value of owning your medical record and carrying it with you resembles the value of owning your money and carrying it with you in a wallet -- it's there for your use when you need it, and you can get others to help you. You can walk into a restaurant you've never seen before and get a meal -- if you've got your wallet with you and can pay for it. Similarly, if something bad happens to you while you're traveling, say, your portable medical record contains all the background information about you a medical provider who has never seen you before would need to give appropriate help.
To give you the best care, your doctor needs comprehensive and accurate information about your current medical situation and your medical history. A mistake or omission in your medical record can lead to anything from not helping to disaster.
Existing, non-portable EMR's have multiple versions of your medical history, versions that are almost always incomplete, inaccurate and inconsistent.
When you start an encounter with a medical professional, you are likely to be asked to fill out an extensive form to present your medical history. Then someone else is likely to repeat the exercise verbally and/or go through your written answers. The older you get, the more history you're likely to have, and the more likely it is you'll something out or simply forget something. The error or omission may not seem important to you, but it may be crucial to dealing with your current medical situation. Key parts of the misinformation will end up in the provider's EMR, making the problem worse.
What if your favorite doctor changes medical systems, or you for any reason need to go to a health system that is not your usual one? Then you're in for one of two equally awful ordeals: (1) start over in the new system as though you just stepped off a spaceship newly arrived from a galaxy long, long away; or (2) get involved in the you-hope-you-never-have-to-do-it-again experience of getting your records transferred. Think I'm exaggerating a wee bit? Put on your sarcasm-protection jacket and wade through my recent experience of doing just this and think again.
Portability leads to other good things
An EMR that supports portability is capable of exporting all the information about you it has in a format that lends itself to easily updating your personal, portable EMR. Similarly, it is capable of importing the information in your EMR, resolving conflicts and redundancies as part of the import. Guess what!? This is exactly what EMR's need to interchange information among themselves! You know, the EMR interchange capability that the government has been trying to ram down vendors' throats to little effect for years now. Building portability into EMR's is the vast majority of the work required to achieve inter-EMR interchange! What an idea!
Vendors, can we have a portable EMR? Please? Pretty please???