The Risk Factor

As I wrote about in my previous post, world-wide efforts are underway to replace the paper-based medical record with electronic medical records (EHRs). For information on the US effort, you can visit the White House website to get some background information of the US effort, as well as the US Department of Health & Human Services (HHS) website to see current status information.

Something that has gone surprisingly unnoticed is that this month marks the hundredth anniversary of the modern paper medical record. This innovation, which we all take for granted, can trace its origins to Dr. Henry Plummer, a partner at the Mayo Clinic, in the year 1907. Plummer recognized that each patient’s medical history needed to be recorded, stored and retrieved in a different manner than was the current practice if the quality of patient care were to improve.

As most of you know, I have been regularly writing about the various initiatives involving electronic health records (EHRs). EHR advocates claim that they are necessary to empower consumer-driven health care.

One of the assumptions, however, is that consumers are medically literate - which is a problem if they are in fact illiterate. Articles in the New York Times and Baltimore Sun (registration may be required) this week highlight the problem.

As reported in the Sun in a study conducted by Northwestern University's Feinberg School of Medicine, for patients over 65,

Almost 40 percent of those deemed medically illiterate died during the study, compared with 19 percent of those who were literate. Factoring in health at the outset and other variables, medically illiterate patients were 50 percent more likely to die than the others.

IBM announced this week what they call an Anatomic and Symbolic Mapper Engine (ASME) that allows doctors to visualize patient medical records in 3-D using an avatar. Using a mouse, a doctor can click on a particular part of the avatar's "body" to trigger a search of medical records to retrieve relevant information.

The idea is to be able to display information contained within electronic health records in a way that a doctor can make sense of quickly, and is specific to the ailment a patient is currently complaining about. You can go to the press announcement link above and see a sample illustration.

I will be curious to see how this approach impacts how electronic health records are designed and what information is captured.

I guess soon our electronic medical records will be made up of our own avatars that replicate us down to our genetic code.