Digital Medical Records, A Modest Proposal

For years and years (and years) there has been talk about the digitalization of medical records to enable portability. There are three primary problems that obstruct this vision, the first being a somewhat murky legal and regulatory environment with regard to what are the implications of the many laws dealing with privacy, data, and medical records, the second is a process issue dealing with how doctors work and their reluctance to embrace technology solutions that they perceive as inefficient, and lastly, it’s not clear that once you have your medical records how you will benefit from them.

On the last topic, one thing that should be obvious on its face is that walking into a ER with a few hundred megabytes of medical records on a flash drive is a non-starter… what would they do with them? I wonder if most doctors would want to have these records either, the burden of storing them and/or manipulating the unstructured text would be prohibitive. This issue speaks directly to the digital detritus problem I wrote about a while back, we have an exploding corpus of unstructured text data and the solution seems to be building bigger storage arrays… at some point we have to start getting rid of data that ends up not being useful.

I have a modest proposal to put forward that provides great utility, few objections, and achieves the goal of portability and digitalization of a specific kind of medical record, child immunization histories.

My idea is for an healthcare provider organization like the American Academy of Pediatrics (AAP) to sponsor an open source project to deliver a simple immunization database on a USB flash drive, with a simple but secure app that enables the printing of that record in a format that schools and other interested parties can accept. For the care provider side the app pairs to an app in the doctors office and allows for updating.

Rather than a boil the ocean approach this provides parents and other interested parties access to comprehensive immunization data for a child while not risking privacy or placing burden on care providers or parents, while doing away with the silly immunization cards that every parent has to deal with.

As a society we fail on the big things… let’s take small bites and build momentum that leads to additional progress on problems that we can solve.