Wednesday, August 11, 2010

Plog My Medical Records

I'm shopping for a new contact management solution. Used to be I would say software. But now it's in the cloud. At least I hope so because my main computer keeps crashing, and the software I use now is old, and the new version is too expensive and won't work on this machine.

The service (ASP for application service provider?) I'm looking at now uses a blog format for working on projects. I thought, "How could I use that?" What about for medical records? (If someone is already doing this, please tell me.)

Suppose you could access the same records your doctor keeps and make changes or add comments. It goes without saying that this would require an audit trail so you could keep track of who entered what. For medico-legal purposes the doc would always have to be able to retrieve and display her records, distinct from any proposed changes or comments made by you the patient. The doc would also have to read and respond to every comment or proposed change. Something like a new phone number might be easy. Rewriting part of the history might not be.

The good part would be the resulting collaboration between doctor and patient to get everything right. Comments added to progress notes (Let's see, progress + log = PLOG.) would take the place of email for updating the doc on changes in symptoms, side effects of drugs. The doc would review and approve each one the way bloggers get to accept or reject comments on posts.

The bad news would be the extra time for the doc. Patients who leave long voice mail messages would probably leave frequent and detailed comments. Patients would also have to understand that urgent or emergent matters would require different methods of contact, like telephone or even 911.

Suppose the doc prescribes venlafaxine and the patient experiences nausea. The patient would send this fact as a comment on the plog post from the last visit. Instead of waiting for the next visit the doc could suggest a change in dosing or when to take the drug relative to meals in another comment delivered to or accessed by the patient. Both doc and patient would be alerted to any change, maybe included incoming lab results.

The plog could also solve treatment team communication problems. For example, in psychiatric treatment, which might involve a non-physician psychotherapist, all three parties might share access.

We just need to see how the HIPAAcrits feel about it.

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