We're proposing a radical if low-tech idea ... let's agree on a standard patient medical history form (on paper or any digital format) and ask every healthcare provider to accept it.

Background
Many doctors complain that the medical history forms they are currently using are inadequate; patients complain that they have to provide the same information time and time again. In addition, no patient can remember, or have available, all the information that is asked for, if they have to provide that information spontaneously at a doctor’s office. Yet studies have shown that 80-85% of diagnoses are made based on historical information provided by the patient.

Electronic Medical Records (EMRs) and Personal Health Records (PHR) are increasingly promoted as being the answer to fixing our healthcare issues. But it may be years before all patient interactions are managed digitally, and even longer before all the proprietary systems are integrated and standardized. In the meantime, when most patients walk into a medical office for the first time, they still fill out a basic medical history form by hand, containing basically the same information.

Opportunity
There may be a low-cost low-tech way to accelerate the transition to an EMR / PHR future. If we all agree on a standard form, the patient can maintain that information themselves at home, and provide a copy when visiting a new provider. If the forms are standardized, it will be easy for the doctor to provide corrections and updates to the patient. The patient also has a transparent view into their own health and is hopefully able to make clearer, better informed decisions. The ultimate, but often ignored, goal is to encourage patients to own and take responsibility for their own health data.

Although it may seem like a step backward in technology, a standard paper form can help to bridge the gap between manual and digital information processes, and between the many different EMR and PHR systems. It will help us deliver on the exciting promises of health IT ... immediate access to patient histories; accelerated diagnoses; reduced errors and duplicative tests; reduced costs and improved care . . . but in a way that’s scalable, easily transferable and accessible now.

The Possibilities
Once a standard form has been designed and widely adopted, there are many ways to digitize and automate it, depending on the patient's comfort level with technology and privacy issues. For example, a simple editable .doc or .pdf file could be maintained by the patient, or an interactive dialogue-driven application could be developed in off-line or on-line formats; based on the standard form, a standard .xml file could be developed that would allow the data to be easily transmitted and integrated into EMR and PHR systems. The concept is similar to a Federal tax form; because it is standardized, any number of developers can create tools to capture and transmit the data. Like the tax form, we envision a core medical history form that would be supplemented by specialized forms used for specific scenarios, diagnosis and treatments.