Dear Richard,
As a retired GP I read your paper, Patient data, patient records, information and semantics, with great interest as medical records were the cornerstone of my daily work. I totally agree with your clinical record standards and the functions of patient records. In retirement, working with our UK Charity Outreach EMR we provide primary care focused Electronic Medical Record software free to suitable clinics in low- and middle-income countries. Currently with 23 clinics in 9 of the poorest countries in the world. See www.outreachemr.org.
A global take on access to medical records, and challenges faced, often reverts to providing the very standards you discuss which we take so much for granted. In a recent visit to Uganda I asked patients with HIV if they had noticed any improvement from the introduction of our computerised records. A resounding yes was their response stating the most important thing was no longer having to repeat their complicated history every time they saw a different clinician as it was all on screen including all their drugs! A clinic, in Afghanistan, enquiring about our system see it as a possible answer to their problem. They use patient held written records in notebooks like the jotters we used in primary school in the UK. Unfortunately the women and girls they prioritise have been physically chastised as the Taliban authorities see these patients with what they see as a schoolbook when education is forbidden for them.
This does not diminish the power of health information, to clinicians, either as patient records or accurate reliable medical information. Thank you for your thought-provoking paper and thank you Neil and HIFA for providing it.
Bill
HIFA profile: Bill Tams is a retired UK and works as clinical officer to outreachemr. We work with NGOs worldwide to provide electronic medical records software for primary care clinics, simple hospitals or refugee camps for as near to free as we can. Look at outreachemr.com bill.tams AT outreachemr.org