The proposed e-PHR is breaking a paradigm, since it is giving to the patient a direct access to all his or her medical data on real time.
The system is centered on patient’s needs and rights, favoring a sharing decision making.
Global e-PHR requests uploading of clinical data according to problem-oriented medical record (POMR) described by Lawrence Weed. Supported by a data base (anamnesis, physical exam and preliminary laboratory exams), physicians will create a sequentially numbered problem list. Each problem will require an intervention planning and progress notes, which should be continued until the problem is solved. All diagnostic exams including images, videos and reports should be uploaded in the appropriate icon (exams), providing an evidence base for physicians’ intervention planning and progress notes.
The proposed e-PHR automatically generates a timeline of events and a summary.
Since only physicians are allowed to write in patient e-PHR, the provided information should be multidimensional. Problem list, data base and progress notes should include physical, emotional, cognitive and social dimensions. A multidimensional integrative approach leads to a comprehensive understanding of patient’s needs and rights, further improving the sharing-decision making.
Patient would have as many physicians as needed to solve the listed problems. Each additional physician who is invited to write in e-PHR is advised to carefully read patient’s problem list. No problem should be repeated. If any invited physician detect a new problem, he must add it to the problem list and follow sequential POMR process. Each physician who work at patients’ e-PHR should mention the number of the problem before adding information to data base, exams, intervention planning and progress notes.
Physicians are encouraged to interact making comments on progress notes.
As long as you get started using e-PHR, the system will help you in organizing patient’s data.
Since e-PHR is a new concept of a well-stablished POMR methodology, your collaboration is very welcome.
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Global e-PHR was designed to meet the objectives of all stakeholders.
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The stakeholders are: