Thursday, October 20, 2016

Personal Health Records on cell phones


I bought a new cell phone recently and was happy to find a facility it provided for creating a simple Electronic Health Record (EHR) for myself. EHRs can be quite complex as you can find by looking through the document http://www.nhp.gov.in/NHPfiles/Comments_invited_on_the_draft_of_Revised_EHR_Standards_for_India.pdf

What will work in the near future are simple forms of records that can be created on one’s cell phone by oneself or by a hospital. Typically, the EHR should provide for capturing information such as:
  •      Name, date of birth, blood type, and emergency contacts
  •      Name and phone number of doctor
  •      Major illnesses and surgeries (giving dates)
  •      A list of medicines being taken with dosages
  •      Any allergies
  •      Any diseases one has had over many years
  •      Major illnesses suffered by one's parents, brothers or sisters
  •      Habits such as smoking and alcohol consumption 

I urge students to experiment with simple apps to enable the creation and use of EHRs. Why an app? Why not a simple file created with a text editor?

I think an app can provide many advantages such as the following:
  • The app will enable content to be created with prompting, and to be displayed when necessary. Users with sufficient knowledge may handle the app themselves. In other cases, someone else could handle the app on the user’s behalf. The app may protect the contents by going through a dialog that prevents careless handling by users who cannot cope with the complexity of handling medical information using a text editor.
  • The app may allow a hospital staff member to access the data using Bluetooth connection and update it. Design issues that arise include safeguards to protect privacy.
  • A well-designed app may allow the storage of doctor-generated information on the cell phone, replacing handwritten notes. This may include a section on medicines to be issued by a pharmacy giving dosages and directions for use.
  • The app may allow a display of directions for taking the medicines and may also provide an alarm at the right time, once a day or more often as required.
  • The app may give information in the patient’s own language whenever this is possible.
Different apps may provide different levels of capabilities, but should ideally be able to handle migration of essential information between apps at different levels as the user changes his cell phone or app. An interesting question that arises is that of securely storing doctor-generated information. Perhaps this can be digitally signed in apps running on smart phones with adequate resources.
The important point to note is that projects like this work best in environments in which the developer works closely with a doctor or hospital. Pure technology is not enough.  

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