A US group of health reformers has advocated the development of a Personal Health Journal, a voluntary system of electronic medical records that would be transportable over the Internet, but owned and controlled by individual patients.
The proposals suggest how the NHS’s electronic health records programme may become a key tool to promote quality, patient choice and diversity of healthcare provision in the UK.
The plans were put forward by the Jackson Hole Group, a loose coalition of US healthcare reformers who spearheaded the development of health maintenance organisations in the US in the 1970s, and were involved in President Clinton’s failed 1990s healthcare reform plans.
The Jackson Hole Group’s plan, called HEROIC Pathways, calls for expanded use of information technology to make medical information and health records more accessible to patients
At the heart of the idea is the concept of a voluntary system of personal lifelong electronic medical records that could be transported and accessed the Internet, but would remain owned and controlled by individual patients.
Rather than being buried in files in family practitioners offices and hospital record rooms, each person’s lifetime medical history, from blood tests, medical treatment, drug allergies and insurance data, would instead be electronically compiled and held in one record.
Patients could then make this record available to any nominated healthcare provider. According to a report in the Wall Street Journal the Jackson Hole Group believe such a patient-held record would empower patients and help overcome many current problems in the current US healthcare system.
This Personal Health Journal would provide a key tool to enable patients to move between different healthcare providers. New technologies, meanwhile, would enable patients to get access to information about treatments based on medical evidence, and provide tools to help them judge the performance of their doctors and hospitals.
Patients would contract with a care provider who would then provide personalised information about developments in medical treatment, health warnings and reminders. Patients could opt to share their Personal Health Journal with any care provider.
The Wall Street Journal article points out that the barriers to the Heroic proposal are ‘formidable’. Electronic medical records are currently only available to a fraction of the U.S. population and are not easily shared between different healthcare organisations.
However, the proposals may have more immediate saliency in the UK where the NHS which is committed to an ambitious national programme to introduce electronic health records, promote a diversity of provision in healthcare, and to provide patients with the ability to exercise choices in who supplies their healthcare by 2005.
In addition, the UK government has already pledged to provide citizens with personal access to their electronic health records by 2005. Pull together these policy strands and you begin to get the foundations for something closely resembling the Jackson Hole Group’s proposals.