Medical Student Blog

Electronic Patient Health Records

Having just got back from a series of meetings in Cambridge this week at the “Healthcare Special Interest Group – ‘Meet the Clinic: Personal Health Records‘” seminar, I wanted to share some of my thoughts on electronic patient health records and the technology that is currently available and being developed. This is by no means meant to be an exhaustive introduction, but just a summary of my understanding and opinion.

You may or may not have heard of Electronic Patient Health Records, or you may have heard of Electronic Health Records, or Health 2.0, or Health 3.0, or Patient Empowerment or even “the ability to securely and confidentially access your GP-held health” and you weren’t quite sure what that meant! It’s understandable, to be honest.

It’s a bit like Web 2.0, the term was used by every digital company going, every piece of marketing, every sales pitch; yet, when you asked someone to define web 2.0, it would usually follow with a long awful silence and some mumbling about big shiny font. Of course, now it’s ‘social media’, but anyway… that’s another story.

Some of you will probably be frustrated, shouting at the screen “Of course I know what electronic patient health records are! It’s my health record, in an electronic format”. You’re not wrong, but you’re not right either. It is your health record, the one your GP stares at on his/her computer screen–that computer screen that you always wondered what was on it, but the angle just wasn’t quite right for you to be able to see what was written about you; well, electronic patient health records now enable both you, and your doctor to stare into the computer screen and view your health notes, and more…

I’m making this sound really great aren’t I? and you want to know where you sign-up and login, don’t you?

Everything is a bit up in the air at the moment, certain groups are playing the thin line of bureaucracy whilst other are fighting to establish their dominance; and this is just within the NHS! Then we actually come to the digitalising of patient health records, which too is still being established and roles defined. So, for the moment I’m going to talk about where we are right now, today.

The BBC is reporting that repeated warnings regarding Melanotan I and II tan jabs, appear to be going unheeded in the UK. Evidentally Health experts have warned that using melanotan I and II could damage the immune and cardiovascular systems, whislt in some cases triggering other problems.
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To me online learning of clinical skills almost sounds like an abomination or contradiction in terms. You learn them knee deep in blood, saliva, urine you name it but not behind a computer screen.

Recently an article was published about the experience of developing an online learning resource that supplements the learning of basic clinical skills for undergraduate medical students. Supplements, so it doesn’t replace the learning of clinical skills completely. This got me interested about their experience with this kind of online learning resource. Mind you, this is not a randomized controlled trial but just some wise advice and clear instructions on how to make a video to be put online for e-learning.

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If you’re not familiar with PubMed, I recommend reading PubMed for beginners over at Student BMJ, authored by Mohammad Al-Ubaydli.

For those of you who are familiar with PubMed, I have written a Twitter Application that acts as a communication layer using NCBI’s Entrez Utilities and the Twitter API along with some other custom stuff too.

The application is still in Beta and not supported, approved, affiliated or anything else to do with NCBI — It was Sunday, the sun is shining and I figured the best way to spend my day was to write this tool.

To test the application, all you need to do is send me a message in the following format:

@pubmed your search term(s)

You will then get a reply with the first, most relevant result and a link to the article at PubMed.

If you’re getting unexpected or non-relevant results, this is not a fault of the application, please read PubMed for improvers, authored by Kirsteen Burton and Lorraine Toews.

PubMed is forgiving: it searches for whatever you ask it to. The answer you are looking for will probably be somewhere in those 645 papers. But being specific gets you the right answer quickly.

The application scans for new queries every two minutes so it should respond pretty quickly, however, I have implemented some restraints and there is a three second delay between each query to NCBI, as to be kind to their servers.

It’s also worth mentioning that I have integrated the Medical Abbreviations for Twitter from the wiki, which some healthcare tweeple have been working on. This allows the application in many circumstance to reduce the characters in the returned result and display more information.

As it stands the application currently only searches the pubmed database, however, in the next version I’m working on there will be an introduction of a new hashtag #db — which will allow you to utilise the entire NCBI including journals, structure, protein, taxonomy and all the many other databases available to you.

When I first heard about twitter I just assumed it was another fad — a pointless one at that.

How on earth anything productive could come from 140 characters was beyond me. Indeed, just going to the pubic time-line will often leave one wanting back the five minutes of their life they spent reading about how “@somefalsename just fed the cat, doesn’t like dry good anymore! Need to try alternatives, ideas?”

However the truth is, once you dig a little deeper you will find a wealth of interesting people and information, more than you could probably even imagine. With the introduction of many tools to filter and manage these tweets, it enables those willing to get real-time, relative information to pretty much any topic they might be interested in.

To bring this in to a relevant context, I’m a pre-med student who started this website as a means to blog my journey as a mature student wanting to study medicine. I didn’t know any doctors, medical students or anyone working in a healthcare setting, but I knew I wanted to. Networking in my opinion is key not just to being a pre/medical student but to life, after all it’s not what you know, but who you know, right?

The first thing I did was to build a dictionary of medical terms that I could enter in to search.twitter.com to try and locate as many medical related tweets as possible. Once I had that information, I then went through each and started following people who were within or related to the medical and healthcare industry. Organically, your followers will in-turn start to grow as you find new people to follow and people follow back.

Within a month I had just over two hundred and fifty followers, all of which were tweeting about medicine and healthcare, great! But it took a lot of work to get that and not everyone has the amount of free time that I do, so I decided to publish and maintain a categorised list, “Twitter Doctors, Medical Students and Medicine related“.

Within a couple of weeks of publishing the list I was contacted by Dr. Mohammad Al-Ubaydli @idiopathic who had from my tweets, stumbled on to my blog and in-turn been able to access my resume to see my IT background. From here, he sent me a direct message via twitter and asked if I was interested in speaking to him regarding helping with Patients Know Best, an open source personal health records project; a few hours later we were talking on the phone and by the next day I was helping build the Wiki architecture and templates. This eventually led to me attending and helping him with a series of Wiki Medicine lectures at UCL.

The evening before the first lecture, I tweeted “@medicalstudent I can’t wait for tomorrow, going to UCL for the first lecture in Wiki Medicine by Dr. Mohammad Al-Ubaydli”. Within an hour I had received a response from Dr. Simon Brownleader @brownleader inviting me to shadow him at his Surgery in Camden, prior to the lectures at UCL. Again, within a few hours we had swapped numbers and sure enough the following day I found myself sitting next to a qualified GP getting valuable experience that I can now put on my application to medical school.

I hope this gives you an idea about the possibilities and power of Twitter, and this is just the beginning. As a pre/medical student Twitter can open so many doors, just remember to be pro-active, network, sociable and most of all have fun.

Start finding Twitter Doctors, Medical Students and Medicine related right now and get networking!

I would like to take this opportunity to say a big thank you to my mentor Dr. Mohammad Al-Ubaydli and to Dr. Simon Brownleader for offering their time and wisdom.

Firstly, I don’t want this post to make anyone doubt my commitment to medicine or its community, however, I just need to vent some …

Previous to Christmas I was happy with my decision to quit my comfortable job in IT, no one seemed to think it was a bad idea and I wasn’t being hassled by recruitment agents as the economy and market was at an all time low.

Since then, little things have been creeping-up on me, starting with family and friends making comments about how I must be mad to leave behind ten years of experience in an industry, let alone the very good salary. From here on I started to self-doubt myself a little (not something I usually do), almost convincing myself that maybe I hadn’t made the right decision, after all, I wasn’t even in med school yet, let alone access to medicine and it’s not as if either of them are easy to get in to. Then, let’s say I am successful and gain entry, will I manage the six years schooling? You see where I am going … just so many things are making me go mad. Yesterday I had to arrange for the finance company to come and collect my car (next wed), which was another factor. I know it’s stupid, I mean it’s just a car, what are material possessions anyway? But I worked so hard to get it and blah!

The final straw today was I got phoned-up about an amazing position in London with a six figure salary and they want to take me for lunch tomorrow to discuss it further. I said no at first, but then my Mum and a friend convinced me to go and just see what it’s about, so I phoned back and agreed to meet — and now, I feel sick to the stomach, in that I’m going back on all my plans and how far I have got, because I know if I go up there tomorrow and see all the glamour and the package they’re offering I’ll sign =(

I feel like I have let myself down and I just wanted to put this out there and hope some of my friends on twitter can offer some words of assurance from the other side, because at the moment I have no one telling me to go med school, but instead just to continue going for the money and with IT.

I hate IT, I love medicine, but hopefully some of you out there will understand that other variables get in the way and don’t always make things/decisions so clear cut.

Thanks and sorry for the rant.

Update 17/01/01
I cancelled the interview and I’m sticking with my plan. Thank you all for your kind comments.

The list of Doctors, Medical Students, and Medicine related tweets has been moved to Healthtechnica.com The new list is updated daily and now includes Twitter, Blogs, LinkedIn, Facebook, and country of origin.

Click the link below to get to the new list. If you are in health care, but are not listed you can add yourself on the page!

Integrative Biology 131: General Human Anatomy. Fall 2005. Professor Marian Diamond. The functional anatomy of the human body as revealed by gross and microscopic examination.

Integrative Biology 131: General Human Anatomy. Fall 2005. Professor Marian Diamond. The functional anatomy of the human body as revealed by gross and microscopic examination.

Integrative Biology 131: General Human Anatomy. Fall 2005. Professor Marian Diamond. The functional anatomy of the human body as revealed by gross and microscopic examination.