Electronic Patient Record Systems

In the 1980s, I became convinced that an interoperable electronic medical record system would bring as great benefits to healthcare as would a single revolutionary cure or medication. My main vision initially consisted of a patient card that would have a patient’s complete medical history in the form of copies of any medical services they have received throughout their life, independent of formats and structures of any clinic, hospital or practice. The International Patient Card Council (which I chaired) succeeded in motivating several countries in the 1980s and 1990s to introduce at least an insurance or identification card for patients.

In the 1990s, I envisioned that patient card to be a health card not limited to medical record information but also including information from health clubs, sports trainers, fitness devices, etc. Such information also should have a sealed private space in which individuals could document personal symptoms, experiences, and feelings. Of course, by 2010, I believed that a smartphone should be the home of such information.

Today, it appears that it would have been better to focus on automating care processes rather than documentation. Digital processes (e-care) should replace old EHR developments.

Mobile Health

I have been an influential patient advocate for several decades. My proposals and presentations regarding patient involvement in the care process have been sought after and acknowledged internationally. I am among the top experts and advocates for patient/consumer health records.

Early in the 21st century, I was among the first to recognize the potential value of mobile devices and apps in healthcare. Over the following decade, I chaired three mHealth organizations and witnessed the wide range of successes and disappointments in mHealth. Many of my analytical works were published internationally, among them:

• Der Weg von eHealth zu mHealth on page 20 of AFH Alliance

• Interview titled "mHealth: The Digital Future of Medicine," p. 20 in AlumniPortal Deutschland;

• The lead chapter, "mHealth: History, Analysis, and Implementation," in mHealth Innovations for Patient Centered Care, published by IGI Global (2016).

Experience and Work

To date, I have been disappointed in the slow process of implementation because no country has achieved an interoperable electronic health record system with all potential features. I have been recognized globally as one of the most important architects and promoters of electronic patient record systems. I was asked to testify to the US Senate and gave expert testimony in nationally broadcasted sessions of NCVHS.

My definitions of the CPR (computer-based medical record), EMR (electronic medical record), EHR (electronic health record), the new CPR (computerized patient record), and PHR (personal health record) have been accepted by the HIT expert community on a global basis. Many see me today as one of the very few independent consultants in the field.

Other Resources

A sample of my inclusive thinking about EHRs and the digital society can be found in this presentation on the History and Future of Electronic Health Records (2008).

My assessment of the low progress in The Post-EMR Era (2015).

Consider the article The Five Stages of Electronic Records and Necessary Steps for Implementation (published in 2011 as Current Status of EPR Developments in the US), as well as the presentation 25+ Years of EHRs.

Also see: mHealth Revolution

Unique Work on Documentation Methods

The Medical Records Institute also worked with a team of experts on key issues of medical documentation: Healthcare Documentation: A Report on Information Capture and Report Generation (2002)