Commentary: the patient's memory stick may complement electronic health records

Abstract

THE SITUATION DESCRIBED by Stevens1 in the foregoing article is similar to that navigated by thousands of individuals in hospitals around Australia each day. Stevens has been able to identify gaps in communication, processes and timely availability of pertinent information which potentially put her health at risk. There is little doubt that her call for ?legible and enduring record systems accessible by appropriate people? (page 400) would be supported by most of the general community. Health information management is hugely complex, with large numbers of concepts and high rates of clinical knowledge change. Electronic health records (EHRs) are definitely not simple concepts that are solved by storing information in a relational database for use in a single organisational silo, but require the capture of the full breadth of health information in a manner that can be easily stored, retrieved in varying contexts, and searched. Then there is the additional and unique requirement of sharing this same information with a range of health care providers with differing foci, requirements, technical tools and term-sets. When you add in some of the other more lateral requirements such as medico-legal accountability, pooling data for public health research, and privacy, consent and authorisation for sharing sensitive health information, it becomes increasingly evident that health data management has no real equivalent in other industries. In order for shareable electronic health records to become ubiquitous, there are numerous building blocks that need to be in place ? appropriate levels of funding, legislative changes, consensus on a range of standards, stakeholder engagement, implementation of massive change management programs and so on, as outlined by Grain.2 Australia?s solution is the HealthConnect program ? a joint Commonwealth and state government initiative ? which is gradually identifying the required pieces, and laying them out in a systematic way to solve the e-health system puzzle.