Forget EMR. We Need Electronic Human Record

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Artificial intelligence systems being used to determine the best possible therapy based on an analysis of the medical data filing systems and the patient’s individual profile offer a chance of more effective treatment and better disease prevention. However, the personalization of healthcare also means taking into account the wishes of the patient, which may not necessarily be aligned with the procedure determined technologically.

Individualized electronic medical records (or electronic human records) give us the hope that the patient’s needs will be placed above technology and procedures.

Health digitalization gives us hope that the patient’s central role in the system will be restored. The information gathered in the patient’s electronic record, available to every physician tending to the patient, precisely presents the medical history, test results, treatment to date and currently administered medications. The information follows the patient, it is objective and it does not have to be repeated (retold) during every visit. This is already happening. In a few years, the process of diagnosing and of determining the optimal treatment or prophylaxis scenario will be assisted by artificial intelligence and clinical decision support systems. After all, computers are able to analyse an unimaginable quantity of data over a short period and make the best possible decisions based on the knowledge thus gained. Technology optimizes medical decisions and puts evidence-based medicine into practice.

But there is one more element that can complement treatment and prophylaxis personalization in the era of digital health – the patient’s individual point of view and wishes. These issues are barely taken into consideration in the bureaucratic system, where the treatment applied is the outcome of the available procedures, their price, and a short period of face to face contact which prevents the formation of any meaningful relationship between doctor and patient. In the absence of such a relationship, the patient remains merely an element of the health industry.

In electronic patient documentation, the patient’s wishes and expectations can be included in the decision-making process relatively easily – with a questionnaire where the patient defines their needs and expectations in the event of extreme conditions, e.g. in terms of life support in critical states or pharmacotherapy with uncertain effects that place a burden on the body. The patient’s point of view should also be included in the approach to prophylaxis (the freedom to make certain lifestyle choices notwithstanding the health recommendations determined by the system), their preferences with respect to access to information by specific healthcare professionals or e.g. the maximum monthly budget that the patient can spend on medications. Today, nobody asks such questions, which means that the needs, milieu and social determinants of the patient are excluded from treatment and prophylaxis.

These factors can have a tremendous impact on how the patient behaves after leaving the doctor’s office. At present, an electronic record of the patient’s wishes is only an emerging philosophy, which is being introduced by the digitalization leaders, but it should soon attract the interest of healthcare providers implementing electronic medical documentation. After all, such an approach may change the image of e-health by strengthening the trust in technology. The problem of how to prepare the questionnaire template to mirror the patient’s (always current) point of view is yet another challenge.

 

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