A patient's medical record has always been a dispersed entity. Literally defined, it is the accumulation of medical information concerning the patient. Ideally, this information is bundled in a single folder with the patient's identification data on the cover. In real life, this information is scattered between several archives (computerised and paper based) in various locations, often under different identifier numbers. Much of the information in the records is obsolete, redundant, duplicated, or indecipherable to the extent that it does not benefit the patient at the point of care. 1Ownership of the data is also a limiting issue. Many hospitals consider the records in their systems to be their property, whereas many patients argue that their medical information is their own.2 3 Consequently, a distinction is made between ownership of the physical record and the right to access (or duplicate) data that are stored in it. Policies on this issue differ substantially between delivery networks, states, and countries. That said, it is typically agreed that patients have the right to be informed of the general content of their medical record and that patients' care providers must be allowed access to any information that is relevant to a patient's treatment. This approach endorses locking sensitive information (such as psychiatric evaluation or various serological findings) from some care providers but promoting access to what is "needed to know" for the provision of appropriate care. It is thus reasonable to assume that, between the patient and his or her primary healthcare coordinator (such as the family doctor), most of the "critical information" is within reach. For the purpose of our argument, we will assume that patients have rights of access to their medical information and are entitled to decide which parts of their record can be exposed or electronically published.In this article we describe a patient controlled, "granularly secured," cross sectional medical record that is accessible via the world wide web. Unlike existing information systems, the patient initiates the service. The patient's primary healthcare coordinator suggests which clinical content is worth "risking" for the benefit of making it available when needed. The patient secures his or her identity and each data element in the medical record by specifying which identifying data anyone requesting the information must supply in order to gain access. What is relevant in the record?The content of the medical record is extremely heterogeneous. Information is gathered over time from various sources that use different formats and standards (which also change over time), making the record difficult to follow. 4 In addition, medical terminology and diagnostic techniques change over time, so that the record becomes an aggregation of loosely related documents.It can be argued that most of the information relevant to a patient at the point of care is in the most recent entries of the record or, if one is produced, its abbreviated summary. Thus, it is a pati...
Technology is continuously making significant steps toward becoming a viable platform of healthcare delivery in America. Recent advances in telecommunications and healthcare connectivity have converged to create a telehealth service channel and leverage the same technologies that have revolutionized commerce in other industries. Centered around synchronous technologies that link the patient and provider in real-time through video consults, telehealth is offering both patients and providers new avenues to access and deliver healthcare services. In the wake of substantial and ongoing regulatory reform of the American healthcare industry, telehealth now provides a pivotal solution to help meet future patient demands and alleviate acute provider shortages. By efficiently matching patient demand with provider supply in a convenient and cost-effective online network, telehealth promises to alleviate not only issues of accessibility, but also spiraling costs. As payment systems transition from volume-based incentives to those centered on value, transparency of cost, quality and accessibility all become paramount to a successful healthcare delivery channel. Telehealth vows to meet the evolving needs of all three facets of the triple aim in health care and be an increasingly central avenue for providers to manage panels stressed by high-cost, chronic care patients. This chapter examines the progressing role of technology in healthcare delivery and details the emergence of telehealth as a cornerstone solution to the growing problems plaguing the American healthcare system. A final discussion is made regarding the future of telehealth and its role in making consumer-driven health care more patient-centered.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.