Digital Medical History – Background

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The Electronic Medical Records issue is quite complex, because there is no standard yet, and thousands of competing applications try to conquer the big clients. Some are Open Source, some are free, many are sold. A few countries and states have decided to implement a single EMR application, to lower costs and focus all the development effort in a single product. However, not even Socialist countries have reached that goal.

The Electronic Medical Record (EMR) is the centre of many new health businesses. Health care is now 95% direct and 5% remote. In the near future, it will be the other way around.

The need for competition in this area is possibly paramount to achieve safety, usability, acceptance and other quality parameters.

EMR is also mentioned as EHR, Electronic Health Record, involving a wider data set. The only standard that has been established is for data exchange among the different EMR applications, and it is called HL7 (Health Level 7). This is a considerable advance in the field, and allows coexistence of many competing applications.

By request from a client I recently presented a paper at the Latin American Congress of Medical Informatics, INFOLAC, here in Buenos Aires. He produces an EMR product with some state-of-the-art features, and he wanted to introduce the subject into the med-info community. In parallel, I was looking for a product that I could use for remote consultation patients. So, finally both lines converged and I had resources to do a quite complete research on the subject. I was surprised to learn that, in spite of being in 2008 at full IT speed, most hospitals in Latin America and other places still keep medical records only in paper. The opportunity is ripe to advance in this matter.

The universal EMR will be the centre of many Health Information Processing activities. The EMR hosting service can be sold directly to consumers, to clinics or doctors, and can be the marketing vehicle for medical services or products.

Paid EMR will provide full confidentiality, but free or cheap EMR hosting can open the way or facilitate for:

  • Recruitment of patients for clinical studies
  • Patient referral services
  • Diet Supervision and guidance
  • Marketing of pharmaceutical products and medical devices.
  • Application of Medical software to the data
  • Medical record transcription, standardization and storage
  • Organ donor networks
  • Telemedicine – Global or partial medical, psychological or related services
  • Expert systems processing the data to reach conclusions

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