Personal Portable Electronic Health Record
Businesses create popular culture; popular culture is an offshoot of the profit machine. Without a desire for profits there is no need for a popular culture. Business need to create and manipulate excitement about their products so the public will develop a desire for the product.
Popular culture creates a bond of sharing amongst society and a point of reference to facilitate conversation and share feeling while engaging in the use of an artifact. For example:
- People who drive Jeeps® wave or nod as they pass a fellow Jeep® driver, and when questioned about it respond, "It's a Jeep® thing".
- People with iPods reminisce about their affection for the device.
- Macintosh users give each other a knowing nod when they make eye contact with a fellow aficionado.
- Cell phone users can not stop themselves from envying the next generation of cell phones, and talking about who has a better plan.
For a business nothing says you've made it more than endless love chatter among owners of your product. As an individual I find myself desiring all the latest gadgets, home products, clothes that everyone else has to the point that it is distracting. I find myself thinking of far fetched remodels, different sized iPods®, Blackberry's®, and tools of every kind.
The value to the study of popular culture would be awareness to what is influencing our decisions and why. By understanding the existence of marketing schemes we as a society can make more thoughtful choices about needs rather than wants. Individuals can understand what is going on around them by studying popular culture and the nuances which go with it, such as why rap songs are so angry, why teenage girls dress the way they do, why teen sex ebbs and tides. For a business not to understand popular culture is to go out of business for a failure to adapt to the target audience. A business must stay relevant to the populace, to be a business.
Abstract
To create a popular culture artifact takes elements of what is popular, relevant, needed, and desired to be assimilated into society. I propose for my artifact, a dedicated Portable Personal Electronic Health Record or PPEHR. The PPEHR will come pre-installed with open-source software, readily available at medical facilities and be inexpensive, come in variety of colors and be cool looking. The design of the PPEHR will in and of itself will become an icon playing off the current icon for medical care, the caduceus. The function of the PPEHR will be to ensure that patients can have ready access to their complete medical record in a format that any computer can recognize and access and hence insure that at the time of need as in an emergency or in the regular course of accessing health services all parties have accurate information.
The Popular Culture Artifact
To create a popular culture artifact takes elements of what is popular, relevant, needed, and desired to be assimilated into society. Our nation is going through what at times seems like an obsession about health care. People are learning what blood tests they need to establish their current health condition, they are finding out what each specialty of medicine concerns itself with and they are frustrated each time they see a healthcare provider they must regurgitate their entire health history in the lobby on paper and again in the exam room with the doctor. Doctors likewise are frustrated because they spend their time gathering a good history from the patient only to find later that important information has been left out that was vital to an accurate diagnosis.
What is a PPHR
I propose for my artifact, a dedicated Portable Personal Electronic Health Record or PPEHR. The electronic health record replaces the current paper that doctors offices, dentists, labs, x-ray departments' use to document and report findings to patients and other healthcare professionals involved in the patients care. An Electronic Medical Record in theory allows all providers of medical care to an individual to see the individuals' entire, accurate, medical history without having to wait for the records to be mailed, faxed, transmitted, or recalled by the patient. The medical community, insurance industry, and the government, as a result of Medicare and Medicaid, have all encountered spiraling costs, duplication of tests, deaths due to poor diagnosis and pharmacological interaction are screaming for shared medical information. The problem from a consumer standpoint is that they do not trust these entities to be guardians of their records and hence block efforts toward the sharing of their medical information. Since the consumer
accepts the myth that Big Brother is watching and therefore lacks the trust to entrust the government or large unseen entity to guard their medical information, I propose the PPEHR. The consumer will now be able to carry their medical record to their appointments, add daily blood pressure readings, blood sugar results and how they feel on a regular basis to their portion of the PPEHR. The doctor is then assured of an accurate history which can be reviewed before talking to the patient and the visit is more productive because the focus is on the treatment of a more accurate diagnosis from an accurate, exhaustive history. The patient is happy because they can add to their medical record, have the feeling of control of their information, and receive better care. The government, insurance industry, and medical professionals are happy because they reduce duplication, inaccuracies, time, money, and lives.
PPEHR.
The PPEHR will come pre-installed with open-source software, readily available at medical facilities and be inexpensive, come in variety of colors and be cool looking. The Veterans Administration currently utilizes Electronic Medical Records named VISTA and allows for free distribution of the software (va.gov). I propose a thin client based on VISTA be developed and installed on the PPEHR which will synchronize the PPEHR with the main system at the medical facility providing the service provide. The PPEHR unit will be based on open standards so that any manufacturer may produce the device to the standard which will promote competition and lower costs to the consumer.
The Icon and its Function
The design of the PPEHR in and of itself will become an icon playing off the current icon for medical care, the caduceus. The caduceus has been an icon of healing for 2.6 to 2.8 thousand years (Wikipedia) and therefore seems a likely candidate for the current job. Most people today do not realize that the origins of the caduceus are biblical and really it does not matter that it is. For the sake of background information though the caduceus first appears in the book of Numbers:
Num 21:8 And the LORD said unto Moses, Make thee a fiery serpent, and set it upon a pole: and it shall come to pass, that every one that is bitten, when he looketh upon it, shall live.
Today people see the caduceus and know they can receive health care related services. The portability of the PPEHR is accentuated by the small unit which can be carried on a chain around the neck carried in a pocket, purse, or wallet. Just as other icons symbolize computers, music
, love, cars, stop, walk, don't walk, the PPEHR in the shape of a caduceus will symbolize healing.
Function of the PPEHR
The function of the PPEHR will be to ensure that patients can have ready access to their complete medical record in a format that any computer can recognize and access, hence insure that at the time of need as in an emergency or in the regular course of accessing health services all parties have accurate information. A patient's medical record from the time of birth until the time of death can now with the PPEHR remain on their body to fill prescriptions, access specialists, receive diagnostics imaging, and have needed surgery. The patient will be in control, not a doctor in an office, or doctor who has retired, not a distant hospital, a forgotten pharmacy, a forgotten comparison x-ray. The patient is now free to show up at any medical facility with access to a computer and hand over their PPEHR, the receptionist plugs it into a computer, the information is synchronized or viewed or transferred, the patient is registered, taken to a room and new vitals added to the current record which does not allow previous entries to be altered, the doctor then makes his examination adds to the record by adding prescriptions, orders for labs and x-rays. The patient leaves the office and goes to a pharmacy of their choice in any city presents their PPEHR which is accessed and the prescription filled and noted in the unalterable record the patient is free to go to the lab and x-ray facility of their choosing where services are rendered and unalterable notes are entered at their completion. The PPEHR ends duplication, fake scripts, over prescribing, illegible notes, waits of days and weeks; confirmation phone calls to other providers are eliminated. Nirvana!
Myth of the Icon
The icon of the caduceus, oddly enough, is the icon of a myth of a deity that created us some five thousand years ago. The myth goes that God created heaven (space and the sky), earth, and all the plants animals, fishes over a period of seven days. We as men and women are made in his image with God being a male (bible.org). At any rate, as God's people are traipsing through the desert for 40 years they were frequently bitten and died from snake bites so the deity told a follower to throw a dead snake on a staff and all who looked upon it would be healed. The caduceus is part of the most popular myth of all time and the PPEHR will use that for representation.
I chose the biblical myth because I work in the healthcare field and study all I can about the origins of the profession and have always been intrigued that the caduceus is used and has a biblical origin. The health care field prides itself on being all about the science of healing but somehow finds its origins in a mythical deity of gargantuan proportion and following. The interesting stereotype is that people some 2600 years later still look toward a snake on a stick to be healed. By doing good deeds, loving one another, and believing in a good and pious deity we can be healed and freed of our suffering if only we believe, has been the stereotype of Christianity and other worshippers for eons. Baal along with Ra will save us.
It's All About the Money All the Time
A port of the open source VISTA software could be made for a few thousand dollars, but the big stepping stone to rolling out the PPEHR nationally would be getting the doctors to give up some of their control and power by accepting an electronic health record. I have been in the health field for 18 years and I have seen repeatedly that doctors relish the power and control they wield. The greatest thing to a doctor is an ignorant patient, because an ignorant patient needs lots of care and regular visits which translate into a steady income for the doctor. If patients suddenly have a portable health record to take to any provider, the primary care doctor loses his power and control and the patient is free. So the value of my artifact is freedom and as former slaves know, freedom is very hard to achieve.
Conclusion
Icons, myths, heroes, artifacts, culture and business as it turns out have a common thread or two. One thread would be the significant impact business, money and power or the perception of power has on our civilization. Businesses create, manipulate and nurse the icons, myths, heroes, and artifacts that surround us and direct much of the efforts of our lives. It is done so skillfully we do not even comprehend it is happening. Ignorance is bliss.
My PPEHR is a small effort to bring a small amount of understanding and education into the public mind about their health and healthcare. My hope is that such and artifact will not only liberate the patients from the tether of the current healthcare bureaucracy but also by plugging the PPEHR into their home computer will start a cascade of understanding as they review their history. Perhaps, just perhaps patients will awaken and see that they control their wellbeing, their health and hence will be free.
Reference
http://www.va.gov/vista_monograph/
http://en.wikipedia.org/wiki/Book_of_Numbers
http://www.bible.org/