The Only Difference Between a Vision and a Hallucination
The difference is the number of people who can see it. That’s why I was interested in the news from NewYork-Presbyterian. They are piloting a project that will feed a patient’s medical record into Microsoft’s Health Vault, while still giving the patient control to add or edit content. It’s called MyNYP.
It’s a step towards a complete online medical record, which in my view teeters between a vision and a hallucination.
The concept isn’t new or unheard of, but it remains rare, and largely incomplete. Many health providers using Epic’s MyChart expose portions of the medical record to their patients. And some hospitals and health systems offer some form of a personal health record, where the patient enters his/her own data, with the option of sharing it with their doctor.
But the holy grail of a truly complete online health record remains elusive, for a number of reasons:
- It’s a rare patient that gets care from only a single hospital or health system, and rarer still who has received a lifetime of care from a single entity. If even one is not feeding their online record, it’s incomplete.
- Uneven use of EMRs by some doctors makes even the best tools shaky at best. I had a doctor who had full access to a very robust EMR, but his failure to consult it caused him to prescribe a medication three times that caused a potentially life-threatening complication the first time.
- Patient-entered data is fraught with error. Some patients will claim an allergy to asparagus, when they just don’t like the taste. Others forget key elements or just have them wrong. Yet others don’t want to admit that they smoke, or never exercise.
Still, you have to applaud what NYP is trying. It’s a big improvement, but the picture it provides will still be incomplete. Step at a time, though, and this is a good step.
I totally agree. I’m working with the HealthVault team, and making sure folks maintain the best and most complete possible data is key. We’re trying to get people to make the case for EHRs to their providers to provide pressure from all sides, and we expect that greater control over health information will yield greater reliability in reporting. If not, that’s an issue that will need to be addressed by all players. Thanks for the post!