Most patients believe that once they grant permission that a health care provider has access to their full health history. In fact, what is shared is limited in many ways. Jack Lewin and I had our Commentary on Interoperability and the need for the full patient record published in StatNews.
Some medical records are very lengthy and go back decades. Is all that information really necessary? It depends on the situation. One reader from Norway shared their story.
"This is interesting, since I recently witnessed how lack of available medical records may change a planned surgical procedure just minutes before an operation.
Norway has less inhabitants than Manhattan, but the principle of making medical records available to all medical health providers, is universal. Over here, Southern Norway has a system whereby all MDs and all hospitals may access any patient medical record, - if (note!) the patient has been treated in southern Norway. If a patient has had an operation in Northern Norway, a health provider in Southern Norway will not learn about this, unless the patient mentions it. And the same goes the other way around, - south vs. north. To my surprise this system has remained for the last 10 years, without health authorities doing anything about it.
On December 4 I was going to have a hernia operation in Bergen, - on the southwest coast of Norway. The hospital has a section specializing in hernia repair with 3 surgeons performing only this kind of operation. They have extensive experience with laparoscopy (lap), and as I met my surgeon on the morning of the operation, she told me that the lap method was their standard procedure, unless the patients' condition dictated otherwise. I then told her that I had been operated for intestinal loop (blockage) back in 1970 in Bodø (Northern Norway), and she was surprised. She had not read anything about that in my medical record, and I showed her the remaining sutures. That made her change her mind regarding her planned way of repairing my hernia just minutes before the operation as the 1970 operation had actually accessed both the stomach lining and cut a muscle. So she decided to make an open repair."
What do you think about the need for access to the full patient record? If AI is seen as the solution how can we expect AI to guide clinical decision making if the data on the patient are at best incomplete.
We have a long way to go...and we need to get there soon.
