By my late teens I could tell the clinic receptionist which medical records were mine: the two massive folders held together by a heroic rubber band. When a new doctor saw my folders – and I mostly saw new doctors – I could hear them sigh as they tried to broach the topic of understanding my health quickly. I tried to help, giving them the highlights which I had practiced.
But even with practice I struggled to remember exact dates from the past year in response to the simple question “how have you been?”. Had I had two ear infections or four? Is that more or less than the previous year? So does that mean the medication dose should be increased or that it was fine? Most embarrassingly I would often start with the typical patient’s “I’m fine doctor”, eager to please and keen to end the appointment.
Understand your patient
So it’s with pleasure that I have been watching PKB’s product designers and software developers create the timeline view. Here is what a very unwell patient’s record would look like to the clinician on the wards.
You can see a lot going on with the patient, including one hospital admission in December 2017 and another in February 2018. Clicking on the attachment for the latter admission shows the discharge letter.
Clicking on any of the dots at the bottom shows test, imaging results, symptoms and measurements from the day of the dot. The diagnoses, medications and allergies from the GP record appear below the timeline.
All of the data from all the specialists appears in one place. By contrast Graphnet’s view replicates the silos:
And unlike the Summary Care Record, all of this works great on your mobile phone. In portrait view the screen automatically shows 3 months.
And if you flip to landscape it switches to 6 months:
You can watch the flip in action in this video:
FHIRed up APIs
For our developers, this upgrade is the tip of the iceberg. Beneath the user interface is a more scalable implementation of our encryption layer, consent rules and developer APIs. The encryption is faster and stronger, concentrated in one easy-to-maintain service built on our next generation consent rule engine. Part of the new engine is clear documentation about the behaviour of the system. And we are migrating all our REST APIs to FHIR.
Moving to FHIR makes it faster for developers to learn how to read and write data from PKB. These open standards allow interoperability with your future chosen systems. PKB’s timeline view is using these FHIR APIs to show the record in PKB’s GUI. The APIs allow you to show PKB’s data in your system as well, from smartphone app to desktop electronic medical record.