Digital patient record

THE NEXT DECADE PERSONALIZED MEDICINE AND THE DIGITAL PATIENT RECORD... 

When we first planned this book, a widespread abundance of digital patient records seemed just a science fiction dream, and companies keeping them were pioneers. Now, however, companies like Cerner and General Electric vie for acquisitions and mergers, and critique each other s philosophies. But the status at this time is still mixed. One of the authors can go to his local government... 

In late 1999 we began to set up a research unit to study what it would take to have a digital patient record that includes details about the patient s DNA. It was then considered unique to think about the patient record in digital form... 

THE DIGITAL PATIENT RECORD AND THE CASE OF THE VENOMOUS NORWEGIAN BLUE PARROT... 

As in the bizarre story of the Norwegian Blue Parrot, in the diagnosis, therapy selection, and prognosis, and in all the other manipulations of data that take place to ensure your health and well being, your digital patient record will be frequently manipulated. The issues, benefits, and risks that genomics-based profiles will entail are described in the rest of this chapter and the chapter following. 

It should be noted from the outset that the current systems related to billing are rather weak on outcomes data. In reduced structured data from such sources for analysis of outcomes research, it is not always possible to deduce directly whether the patient died or got better, which are startily different outcomes. All that can then be learned with assurance is that the patient has currently passed beyond the concerns of healthcare insurers. So for this reason alone, aside from other omissions, these data are not a replacement for the digital patient record, but only a good first step and supplement. 

The difficulty will not be in the novelty of computers, but the novelty and variety of the options it reveals. Enabled by the digital patient record and the Internet, there will soon be a bewildering number of diagnostic and treatment options to choose from. While new, innovative technologies can be confusing and difficult to assimilate by physicians and patients, as Moses and... 

Against the background of these trends, extensive use of the digital patient record seems inevitable. 

In 1999 and early 2000 the authors were involved in architecting one of the first clinical-genomics systems including the digital patient records with genomic data, and security, privacy, and analytics features (http //www.wired. com/medtech/health/news/2001/09/47083). 

The digital patient record will be the heart of future medicine, and such a record needs to be a little more conceptually structured. It should be a structure to which we can apply statistical methods because, if we can find correlations between things in many patient records, we can use them for diagnosis and prognosis for a specific patient and also for medical research. 

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