A Century Of Medical Records
(HIT Lessons from History)
The Nineteen Hundreds
In 1901 Dr. Henry Stanley Plummer, a really immature "techie doc" joined the Mayo Clinic. By all accounts Dr. Plummer had both the peculiarities together with the unmarried mindedness of truthful genius. He was, of course of pedagogy an splendid physician, simply his largest contribution to modern medicine was the Medical Record.
In 1907 Dr. Plummer together with his assistants deployed a new way of keeping patient records. Up to that betoken patient records were kept inward ledgers. The multiple offices at Mayo each had its ain ledger. Once the initial watch was entered inward a ledger, all next visits together with procedures were added to that page, sometimes inward crowded text on the margins. One patient could direct hold entries scattered across a multitude of ledgers. Dr. Plummer introduced a centralized medical tape consisting of a large envelope where all doctors would aggregate all the information regarding a especial patient. Each patient was assigned a unique identifier together with his/her ain dossier of clinical documents. The medical tape would follow the patient everywhere at Mayo together with all physicians would direct hold access to all records.
Of course, Mayo was an integrated delivery system, bringing together specialists together with surgeons together with head tending physicians, all working together for the do goodness of the patient. The multi-specialty mortal grouping was Drs. Will together with Charlie Mayo's contribution to the changing human face upwardly of modern medicine.
But Dr. Plummer did non halt at creating the patient centric comprehensive medical record. After tinkering amongst a complex organisation of cables together with pulleys, Dr. Plummer came upwardly amongst a pneumatic organisation of tubes together with conveyors to rush patient records from ane utilisation to another. He also invented a communication organisation betwixt physicians inward examine rooms based on the telephone organisation together with a telegraph ticker.
Dr. Plummer implemented Will & Charlie Mayo's vision of clinical collaboration for the do goodness of the patient, using the latest technologies available during his time.
The 21st Century
One cannot simply experience humbled when exploring the early on history of Mayo, together with Dr. Plummer inward particular, because ane hundred years later, all of us inward Health Information Technology are nevertheless trying to implement Dr. Plummer's master copy innovation.
Times direct hold changed together with nosotros right away direct hold computers together with Internet together with iPhones on 3G networks. It seems nosotros direct hold all the tools needed to do a collaborative comprehensive patient centered tape system, hence why don't nosotros direct hold one?
Although Dr. Plummer's patient tape has changed really trivial over the terminal century, the exercise of medicine has seen pregnant changes. The integrated multi-specialty Mayo model has gained about support, simply around medical tending inward the the U.S.A. is non administered inward integrated settings. Hospitals today are much dissimilar than the master copy St. Mary's infirmary at Mayo together with around are turn a profit centers. And hence in that location is wellness insurance, which brought concerns of privacy together with injected fiscal considerations into every examine room across the country. Pharmaceutical companies, device manufacturers together with wellness related consumer marketing direct hold acquired immense ability over the exercise of medicine.
Dr. Plummer's patient tape morphed from a tool to do goodness patient care, into a legal document together with to a greater extent than oft than non a fiscal asset.
Legal documents together with fiscal assets are non readily shared. Hospitals are afraid of contest together with hence are their large firms of information technology vendors. Independent physicians are afraid of government, lawyers together with insurers scrutiny. Patients are afraid of loss of privacy translating into loss of insurance together with fifty-fifty loss of employment. On the other side of the chasm, pharma companies are itching to larn their hands on "the data" together with the straight marketing channel. Insurers are looking forrad to fifty-fifty to a greater extent than details to assist amongst direct chances assessment. And CEOs of every sort of information technology companionship are looking to "monetize" whatever treasures of "data" they tin amass.
It is interesting to discovery that inward unopen autonomous environments, where the legal-financial considerations do non exist, similar the VA or Kaiser Permanente, patient records are untethered together with collaboratively shared yesteryear all involved.
Today nosotros are inward the midst of a major HIT push, together with mayhap on the cusp of wellness insurance reform, together with the conversation revolves around enabling physicians to portion information. In other words, nosotros are trying to constitute a national organisation of pneumatic tubes, pulleys together with conveyor belts for medical records. The interesting component subdivision is that nosotros already know how to do that. The Internet moves terabytes of information at whatever given 2nd from ane halt of the Globe to another. We direct hold the agency to implement Dr. Plummer's communication system, together with nosotros direct hold the framework to enable collaboration, simply nosotros are non using whatever of this tremendous infrastructure. Instead nosotros are embroiled inward lengthy debates on the hence called Meaningful Use - a laundry listing of infinitesimal details that ask to locomote recorded together with reported to Government agencies.
I wonder if Dr. Plummer's organisation would direct hold been as successful together with resilient, if he insisted that every patient record, moving through his pneumatic tubes, had to include a smoking condition precisely stating "current smoker, never smoked or onetime smoker". And I wonder if his organisation would direct hold always taken off if he started yesteryear requiring that a special subset of the medical tape should become to the direction utilisation first. And I wonder why Dr. Plummer never referred to patient records as "data".
We may direct hold Dr. Plummer's plumbing inward place, simply what nosotros lost is Dr. Will Mayo's belief that "The best involvement of the patient is the alone involvement to locomote considered...".
The Nineteen Hundreds
In 1901 Dr. Henry Stanley Plummer, a really immature "techie doc" joined the Mayo Clinic. By all accounts Dr. Plummer had both the peculiarities together with the unmarried mindedness of truthful genius. He was, of course of pedagogy an splendid physician, simply his largest contribution to modern medicine was the Medical Record.
In 1907 Dr. Plummer together with his assistants deployed a new way of keeping patient records. Up to that betoken patient records were kept inward ledgers. The multiple offices at Mayo each had its ain ledger. Once the initial watch was entered inward a ledger, all next visits together with procedures were added to that page, sometimes inward crowded text on the margins. One patient could direct hold entries scattered across a multitude of ledgers. Dr. Plummer introduced a centralized medical tape consisting of a large envelope where all doctors would aggregate all the information regarding a especial patient. Each patient was assigned a unique identifier together with his/her ain dossier of clinical documents. The medical tape would follow the patient everywhere at Mayo together with all physicians would direct hold access to all records.
Of course, Mayo was an integrated delivery system, bringing together specialists together with surgeons together with head tending physicians, all working together for the do goodness of the patient. The multi-specialty mortal grouping was Drs. Will together with Charlie Mayo's contribution to the changing human face upwardly of modern medicine.
But Dr. Plummer did non halt at creating the patient centric comprehensive medical record. After tinkering amongst a complex organisation of cables together with pulleys, Dr. Plummer came upwardly amongst a pneumatic organisation of tubes together with conveyors to rush patient records from ane utilisation to another. He also invented a communication organisation betwixt physicians inward examine rooms based on the telephone organisation together with a telegraph ticker.
Dr. Plummer implemented Will & Charlie Mayo's vision of clinical collaboration for the do goodness of the patient, using the latest technologies available during his time.
The 21st Century
One cannot simply experience humbled when exploring the early on history of Mayo, together with Dr. Plummer inward particular, because ane hundred years later, all of us inward Health Information Technology are nevertheless trying to implement Dr. Plummer's master copy innovation.
Times direct hold changed together with nosotros right away direct hold computers together with Internet together with iPhones on 3G networks. It seems nosotros direct hold all the tools needed to do a collaborative comprehensive patient centered tape system, hence why don't nosotros direct hold one?
Although Dr. Plummer's patient tape has changed really trivial over the terminal century, the exercise of medicine has seen pregnant changes. The integrated multi-specialty Mayo model has gained about support, simply around medical tending inward the the U.S.A. is non administered inward integrated settings. Hospitals today are much dissimilar than the master copy St. Mary's infirmary at Mayo together with around are turn a profit centers. And hence in that location is wellness insurance, which brought concerns of privacy together with injected fiscal considerations into every examine room across the country. Pharmaceutical companies, device manufacturers together with wellness related consumer marketing direct hold acquired immense ability over the exercise of medicine.
Dr. Plummer's patient tape morphed from a tool to do goodness patient care, into a legal document together with to a greater extent than oft than non a fiscal asset.
Legal documents together with fiscal assets are non readily shared. Hospitals are afraid of contest together with hence are their large firms of information technology vendors. Independent physicians are afraid of government, lawyers together with insurers scrutiny. Patients are afraid of loss of privacy translating into loss of insurance together with fifty-fifty loss of employment. On the other side of the chasm, pharma companies are itching to larn their hands on "the data" together with the straight marketing channel. Insurers are looking forrad to fifty-fifty to a greater extent than details to assist amongst direct chances assessment. And CEOs of every sort of information technology companionship are looking to "monetize" whatever treasures of "data" they tin amass.
It is interesting to discovery that inward unopen autonomous environments, where the legal-financial considerations do non exist, similar the VA or Kaiser Permanente, patient records are untethered together with collaboratively shared yesteryear all involved.
Today nosotros are inward the midst of a major HIT push, together with mayhap on the cusp of wellness insurance reform, together with the conversation revolves around enabling physicians to portion information. In other words, nosotros are trying to constitute a national organisation of pneumatic tubes, pulleys together with conveyor belts for medical records. The interesting component subdivision is that nosotros already know how to do that. The Internet moves terabytes of information at whatever given 2nd from ane halt of the Globe to another. We direct hold the agency to implement Dr. Plummer's communication system, together with nosotros direct hold the framework to enable collaboration, simply nosotros are non using whatever of this tremendous infrastructure. Instead nosotros are embroiled inward lengthy debates on the hence called Meaningful Use - a laundry listing of infinitesimal details that ask to locomote recorded together with reported to Government agencies.
I wonder if Dr. Plummer's organisation would direct hold been as successful together with resilient, if he insisted that every patient record, moving through his pneumatic tubes, had to include a smoking condition precisely stating "current smoker, never smoked or onetime smoker". And I wonder if his organisation would direct hold always taken off if he started yesteryear requiring that a special subset of the medical tape should become to the direction utilisation first. And I wonder why Dr. Plummer never referred to patient records as "data".
We may direct hold Dr. Plummer's plumbing inward place, simply what nosotros lost is Dr. Will Mayo's belief that "The best involvement of the patient is the alone involvement to locomote considered...".
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