[Re: https://www.hifa.org/dgroups-rss/critical-illness-african-hospitals-3-pr... ]
Venus,
Our group of Patient Access to Medical Records advocates agree with your summary.
Almost all acute illnesses begin away from the presence of a health professional. We have begun to teach year 7, 8 and 9 students about mangaing their own diagnoses at Sheffield Springs Academy by using health portals and their own records.
Access to medical records and health portals is not a passive process. It gives citizens agency and it is a culture change. The citizen/patient has access to clinical tools of history taking, examination, diagnosis making and intervention choice.
The citizen with agency is better placed to manage acute illnesses as soon as the symptoms, or digns, (say for example raised glucose, blood pressure)
The patient agency semantic is encapsulated in a simple mnemonic - SOAP **
"S" - Subjective - symptoms - history taking - portals can supply the tools for this
"O" - Objective - clinical findings - examination - pulse rate, temperature, respiratory rate, number of episodes of diarrhoea, production of phlegm, wheeze, dizziness etc. portals can supply the tools for this and many examination tools are available in the community. portals can supply the tools for this.
"A" - Analysis - putting symptoms in context of age, gender, past medical story, medication etc - portals can supply the tools for this
"P" - lan [Plan] - deciding what to do - portals can help with this too.
Literally as easy as "ABC"...
** Clinical thinking and practice : diagnosis and decision in patient care / by H.J. Wright and D.B.... - Catalogue | National Library of Australia
** SOAP note - Wikipedia
This benefits them and service providers in two ways:
1. Citizens with symptoms and with higher health literacy ** attend A and E departments less.
2. Citizens with higher health literacy attend earlier with serious diseases such as malaria, meningitis, cholera etc
** Health literacy and patient safety: Help patients understand
The University of Manchester Institute of Science and technology studied this at Hadfield patient centred medical centre in 2000. Culture and Change at Hadfield Medical Centre - Research Explorer The University of Manchester
Here is part of the summary
Summary
This report was commissioned as part of the ERDIP Patient Held Records, Modernisation Enabling Project[1] at Hadfield Medical Centre (HMC), in order to document and analyse the background to the organisation and its culture prior to its involvement in the current project. This report endeavours to explain the practice’s activities with respect to patient involvement, patient access to their records, and health information relative to the NHS Plan. This is achieved by examining the process of organisational change, the organisational structure, and the culture and leadership of the HMC. The report draws on empirical evidence from a variety of sources related to HMC as well as a range of theoretical models which are used to present the data.
Purpose of the Report
This report endeavours to explain the practice’s activities with respect to patient involvement, patient access to their records, and health information relative to the NHS Plan[1]. This will be achieved by examining the process of organisational change, the organisational structure, and the culture and leadership of the HMC, in order to understand the changes that have taken place to date.
The activities at HMC and the resulting involvement of patients are considered by the NHS Information Authority (NHSIA) Electronic Record Development and Implementation Programme (ERDIP) to be a significant component of the organisational change necessary in moving towards shared electronic health records, including patient interaction with records and patient held records. The NHSIA ERDIP programme and West Pennine Health Authority have supported the production of this report as an example of good local practice. Other communities may wish to consider the relevance of aspects of this approach to their own communities.
3.1.3 Disseminating Knowledge
Having gained indispensable, internal and external support, it was time to move to the next phase, that of educating patients so that they are better informed. It was thought that a patient information room and a computer system (IN Touch with Health) would facilitate this process.
3.2.2 Levels of Culture
Many different and varied models describing organisational culture are available. Of these, a model was chosen that best reflects the purpose of this report and best describes the organisational culture at the HMC. This model is that of Cummings and Huse (1989), who describe culture as 4 elements existing at different levels of awareness within any organisation. These levels are:
1. Basic assumptions
2. Values
3. Norms
4. Artefacts
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT gmail.com