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Conclusion: Health Record Portability

  • Egondu R. OnyejekweEmail author
  • Cory L. Hall
Chapter
Part of the Health Informatics book series (HI)

Abstract

We conclude this book by revisiting Health Record Portability. The future of the provision of healthcare in the United States (US) of America is not dependent on any single factor. Several—internal and external factors—such as skyrocketing costs, personalized medicine, regenerative medicine, evidence-based medicine, gene therapy, robotic surgery, artificial organs, technology and their applications—all affect the delivery of healthcare in the US. The social impact will be enormous as society struggles to align priorities and deal with socioeconomic inequalities. Health Record Portability involves spacetime because the movement of health records or parts thereof expend time and space for the interactions. Many chapters of this book try to present the different aspects of the healthcare ecosystem, which includes the electronic health record (EHR) or electronic medical record (EMR). Integral to these is how EHR or EMR is moved from point A to point B. As articulated in the introductory paragraph, frequency and magnitude of spacetime and the interactions of space and time at every encounter of such a motion increase cost. Some emerging technologies are envisaged to provide one or more directions that conserve/s time and space and thus reduces the spiraling cost/s of a fragmented US healthcare system. As indicating earlier, every porting (movement) of an electronic health (medical record) involves time and space, the interaction of which results in a specified cost. But the diversity and variations of today’s EHRs (EMRs) make it difficult to pigeonhole them inside any standardized form. The costs of processing them have become incalculable, and the healthcare costs in the U.S. are spiraling out of control. Moreover, notions of EMR/EHR vary across the globe, but the US definitions are a far cry from the European definitions. Yet, the US EMR/EHR are governed by certain laws, whose limits are unfortunately worrisome. In many cases patients find themselves carried along the currents and eddies of their local healthcare system unable to break free from an inherently myopic system. This system locks patients into healthcare delivery pathways created for the benefit of the organization providing care that are not always aligned with patients needs. For example, the best treatment for a specific cancer may be proton therapy, but the integrated delivery system that the patient is locked into does not have a proton accelerator, or the needed infrastructure, so the patient is treated with suboptimal radiation therapy. What then, is our stance for the portability of health record? Within the array of emerging and mobile technologies, including the Internet of Things (IoT), both the US healthcare at large and the EHR (EMR) have found some strongholds. There are now evolving technologies and approaches which could reduce the lag and uphill cost for the U.S. The Blockchain technology has been presented as one such promising technology. Commoditization is an approach that is also gaining grounds. These have been discoursed adequately in the book to warrant attention. They suggest future directions the US healthcare could take to lower costs (and possibly) provide better care. At the core of such reduction of costs is the refinement of time and space interactions.

Keywords

Portable health record Electronic health record Electronic medical record Bockchain Commoditization Time Space Spacetime 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Public Health, Health Administration, College of Health SciencesWalden UniversityMinneapolisUSA
  2. 2.Department of Information TechnologyUniversity of Miami Health SystemMiramarUSA

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