World is changing
More people
Less resources
Higher expectations
More elderly
Not enough doctors
Need for global health care
Current Health care
Medical files on paper
Every hospital works with own electronic or paper files
Not enough cooperation between
doctors and patients
doctors and doctors
hospitals
pharmacists en doctors
countries
So we need to do it better
Databases must be available, with copies in every part of the world and supported by physicians
Patient responsible for own file
Simple and Cheap
Easy and Fast
Research-possibilities
Link to knowledge and expertise
Payment healthcare centralized
How can we make it better
We need the IT work for us
Use the results of the information of other doctors and patients
Advise based on the information of the patient linked to new data from labs and tests
Every physician
1 HealthIPAD And use only one database for
the information of the patients
Let the physician be able to adjust the HealthIPAD with apps according to own needs in their own language
Here is my dream HealthIPAD
To be adjusted by programmers who have more time and knowledge than I have
To be adjusted by many physicians working with the program
HealthIPAD Log in
Physician
Password
Iris scan
Finger scan
HealthIPAD
Search own patients
Add new patient
Phone numbers colleagues
Background information
Own files
Calling and e-mail
Other apps
NameDOB: --/mon/--Tel / e-mailGeneral PhysicianInsurance
Medical historyDate: diagnoseDate: diagnoseDate: diagnoseDate: diagnose
Family medical history
AllergiesDate: allergyDate: allergyDate: allergy
Current medicationsMedication 1 doseMedication 2doseMedication 3 doseMedication 4 doseMedication 5 doseMedication 6 dose
IntoxicationsSmoking: Current PastAlcohol: Current PastOtherCocaine: current Past
Social informationRaceCountry of BirthIn country sinceFamilyJob
Timeline
16/mar/10 General physician15/mar/10 lab10/mar/10 pharmacist
04/jan/10 eye laser31/dec/09 eye doctor hospital12/nov/09 brain contusion12/nov/09 radiology x4
Sep/09 labSep/09 internal medicine
5/jul/09 internal medicine1/juli/09 cardiologist hospital20/jun/09 lab20/jun/09 general physician
04/apr/09 chirurgy hospital16/mar/09 lab02/mar/09 OK – nefrectomyri01/mar/09 radiology
General information Patient DOB
NameDOB: --/mon/--Tel / e-mailGeneral PhysicianInsurance
Medical historyDate: diagnoseDate: diagnoseDate: diagnoseDate: diagnose
Family medical history
AllergiesDate: allergyDate: allergyDate: allergy
Current medicationsMedication 1Medication 2Medication 3Medication 4Medication 5Medication 6
IntoxicationsSmoking: Current PastAlcohol: Current PastOtherCocaine: current Past
Social informationRaceCountry of BirthIn country sinceFamilyJob
Timeline
16/mar/10 General physician15/mar/10 lab10/mar/10 pharmacist
04/jan/10 eye laser31/dec/09 eye doctor hospital12/nov/09 brain contusion12/nov/09 radiology x4
Sep/09 labSep/09 internal medicine
5/jul/09 internal medicine1/juli/09 cardiologist hospital20/jun/09 lab20/jun/09 general physician
04/apr/09 chirurgic hospital16/mar/09 lab02/mar/09 OK – nefrectomyri01/mar/09 radiology
General information Patient DOB
Current information
Specific Anamneses:
General Anamneses:
Physical examination:
General
RR, pulse, length, weight, BMI
Head/Neck
Cor
Pulm
Abd
Extremities
Skin
Lymfenodes
Specific for specialty
Additional testing
Laboratory results
CDC
Chem
Bacteriology
Virology
Radiology
Date X-ray: conclusion
Date Echo abdomen: conclusion
Pictures and movies
Connecting care
Glucose
Tension
Other?
Problem list and Conclusion
Problem list
Problem 1: differential diagnoses
Problem 2: differential diagnoses
Problem 3: differential diagnoses
Conclusion
Free text
Summary for letter
Free text
Arrangements for patient
Order tests
• Laboratory
• Radiology
• Nuclear
Inter collegial consults
Orders in case of clinical admission
Make appointments
Medication changes – link to medapp
Generate and send letter / mail
- Period … - …
- To others involved
Research and teaching value
Having information of diagnoses, laboratory results and medication together during period of time will give much more insight in medication working and side effects
Information can be collected anonymous
Putting on and off suggestions of the program will give the student and physician a quick learning curve
Attaching with background information and links to articles and “up-to-date” will promote evidence-based healthcare
End of consult
Patient decides if the physician keeps access to the file
Use information for research purposes
Use information for preparing for next consult
Enable physician to give answers on additional question patient
Just a HealthApp?
No, we need one database,which has to be maintained centrally, which has to have multiple copies and has to keep the patient information private
No, we need medical knowledge to implement
guidelines, protocols and evidence based information
We have to work together!