Internet could spawn patient-oriented EMR

Patients are breaking out of their traditional passive role in medicine and taking a more active part in the management of their healthcare.

Using the Internet, patients have become more informed about healthcare in general and medicine in particular, especially as it relates to preserving or regaining their own health.

"The technical and socioeconomic development of the Internet has led to a situation in which it appears to be appropriate to give patients access to their own medical data to encourage intelligent patient-oriented decision-making," said Heinz U. Lemke, Ph.D., a professor of computer graphics and computer-assisted medicine at the Technical University of Berlin.

To aid this movement, Lemke has designed a patient-oriented Internet medical record scheme called PREPaRe. The Internet portal combines access to commonly available medical information:

?encyclopedias
?anatomic atlases
?discussion lists
?physician, pharmacy, and clinic directories
?a user-friendly personal electronic medical record (PMR)

When a hospital connected to the PREPaRe system creates or adds data to a PMR belonging to a PREPaRe user, the PREPaRe proxy is informed and the data are either transmitted to the repository for archiving or stored locally and accessed via linking mechanisms.

Except in special circumstances, patients should be given the opportunity to access their electronic medical record in order to build up their own personal medical record, according to Lemke.

PREPaRe potentially enables interested patients or their families to use a worldwide fount of available information, services, and technologies for improving medical care, Lemke said. Appropriate visualization techniques are offered, tailored to the patient's knowledge.

"This system would give patients the opportunity to participate in the management of their disease or disability, especially patients with chronic complaints such as long-term orthopedic or cardiovascular disease," he said.

Not everyone is eager to embrace the technology. So far the PREPaRe scheme has encountered a curtain of skepticism, especially from medical professionals.

During a special discussion at the June CARS (Computer Assisted Radiology and Surgery) 2001 meeting in Berlin, a panel of physicians (radiologist and surgeon) and a patient representative and the audience viewed the active inclusion of patients in their disease management with mixed feelings, Lemke said.

"The concept of the PMR needs more discussion and refinement before it can become reality in the foreseeable future," he said.