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COMPUTERIZATION OF MEDICINE
ORIGINAL WORK
Dear Doctor:
At our last Computer Club meeting, Doctor came up with a wonderful idea, which sparks hope for physicians in that they may be able to regain control of the care of patients and the dissemination of patient data that up until this point has been in the domain of the insurance companies. By regaining our proper foothold, we will no longer be at the beck and call of neither insurance companies nor large health care management organizations, but be responsible for our own destiny.
I propose that we organize a nonprofit consortium of five to seven physicians with collaboration from the University Computer Science Department to form an area patient database. If successful I imagine that this database will be a pilot project for the rest of the country. The patient data will remain the property of the patients. The control of the data will be by the patient's doctor. The management of the data will be by the nonprofit consortium of physicians and University. All doctors in the area may participate. The fee for participating is that once a patient is seen in a particular office, that office has the responsibility of updating the information. The data will be the collection of all patient health information and the data base administrators will govern the ultimate access to the collective.
The information that will need to be gathered, as well as the management of the database, should be the collaboration between the computing experts at University and the nonprofit physician consortium. The physicians have the ability to query other individuals that may help in developing the concept. The patient data should consist of and not be limited to their name, social security number, date of birth, place of birth, address, phone number, handedness, mother's maiden name, past medical-surgical history, medications, allergies, children with dates of birth, insurance company and number, physicians seen by dates, physical summaries per visit, summary of office visit to be less than 50 words, list of prescription refills, dates of hospitalization, dates of emergency room visits, some ancillary tests, new diagnosis, new surgeries, ICDM codes, CPT codes, and health traits such as smoking, family history, alcohol use, careers, employers, etc. It will be the responsibility of the computing department to develop a program to manage this data. The information should be managed in such a way that if a patient presents to your office, your office has the ability to query the data base and print up the patient profile. It may also list medications separately, hospitalizations separately, E.R. visits separately or a combination of data as the consortium believes will be beneficial to all.
Each time that a patient comes to a physician's office, the office makes the inquiry into the database. The patient's data record consists of a prefix of three spaces, each space will be alphanumeric, followed by two initials, followed by the social security number, followed by the first and second letter of the mother's maiden name. When the inquiring office requests the data, they will need the patient's initials, social security number, and first two letters of the patient's mother's maiden name. If the patient does not exist in the database, it will be that office's responsibility to enter all of the information. Therefore, there will be the need of a general intake sheet to be used by all offices. Any inquiries into the database are recorded. If there is an inquiry without input such as updated information within five days of the inquiry, or as many (Continued on page 45)
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