This is the second article in a series on digital innovation in the medical field and how it will affect, improve and change medical practice as we know it. The writer is Simon Spurr, CEO of HealthCloud.
Prior to the 1960s, all medical records were kept on paper and in manual filing systems. Diagnoses, lab reports, consultation notes, and medications prescribed were all written and maintained using sheets of paper bound together in a patient’s medical record. Those records were labelled using the patient’s last name, last few numbers of the patient’s social security number, or some other chart numbering system. The records were then filed and retrieved from specially made shelves designed to hold vertical file folders.
In the mid-1960s, Lockheed developed an electronic system known then as a clinical information system. One of the first and most successful attempts to streamline and improve the keeping of patient records is the problem-oriented medical record (POMR). Developed by Doctor Lawrence Weed in 1968, POMR is still used by some medical and behavioural health providers today. As this evolved, a broader definition became available basically stating that an Electronic Health Record (EHR) is an electronic version of a patient’s medical history.
In the 1970s, the US federal government implemented an EHR in the Department of Veteran Affairs called the De-Centralized Hospital Computer Program and the Composite Health Care System in the Department of Defence.
By the early 1990s, hardware had become more affordable, powerful and compact, and the use of personal computers, local area networks, and the internet provided faster and easier access to medical information. The 2000s saw a rapid improvement in the adoption and utilisation of EHRs. Between 2001 to 2011 physician use of EHRs increased from 15% to 57% in the US.
Today, the EHR is a secure and effective tool for maintaining a patient’s healthcare data, for communicating with patients and other providers, and for supporting the patient-physician relationship. No more shuffling through paper files, waiting for faxes, or searching for paperwork to be able to provide quality care for patients. There is no doubt that health records have become increasingly more digital and, therefore, accessible. However, despite all the advancements in technology and electronic communication methodologies multiple challenges exist…
Technical issues have been overshadowed by procedural, professional, social, political, and especially ethical issues as well as the need for compliance with standards and information security. There have been enormous advancements that have taken place, but many of the early expectations for EHRs have not been realized and current EHRs still do not meet the needs of today’s rapidly changing healthcare environment.
Importantly, interoperability, which has been a concern since at least the mid-1990s, has not been adequately solved yet. This is mostly due to a growing clinician user base that have made it necessary for systems to communicate with each other to effectively co-ordinate care. Due to the nature of healthcare services, records are disparate, exist in many different formats and places. But more about this in the next piece…
To read the first article in the series, go
About Simon Spurr
Simon is a senior executive with 14 years’ experience in the South African health and insurance industries. Having worked in established multinational corporates, and more recently in his own ventures, he has developed a deep understanding of these industries– including digital innovation, funding, insurance risk design and modelling, wellness programmes and rewards platforms.
In 2013, he co-founded his first digital health venture, called Folup. In 2015, he launched Care Delivery, a digital platform which helps patients connect to healthcare providers for home- and work-based care. In 2017, he led the merger of his company with another to form HealthCloud, a platform that consolidates and standardises data from multiple sources, allowing partners to access more complete health records using sophisticated API layers.
He is also an accomplished speaker and panellist having presented at numerous healthcare conferences and events, in SA and abroad, including: AfricaCom, Tech4Africa, The Gordon Institute of Business Science (GIBS), Longevity Healthy Ageing Congress and eHealth Toulouse (France).
Simon is the current CEO of HealthCloud (https://www.healthcloudsa.com/)
based in Johannesburg, South Africa.