words of WISDAM from the Electronic Encyclopaedia of Personal Data (EEPD)

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The WISDAM of interoperability

10 December, 2012 (13:40) | Casenotes, hand held records, Initiatives, Interoperability, Paper Records, Patient-Centered Care, S.IN.B.A.Ds | By: rupertfawdry

Having seen the incredible inefficiencies whenever my 99 year old mother made her many trips to the hospital via an ambulance I was amazed that my mother, even in her own home, had so many separate paper records with her.

Even when the ambulance staff did have the sense to take the main care record with her to A&E, the hospital staff totally ignored it (and twice lost her hospital records – giving her the same antibiotic twice four days apart as they were unable to access her previous A&E records that were locked in an office waiting for the secretary to put on the computer;  and lost her ‘not to be resuscitated’ form, which we had to get the GP to re-write; and claimed, even after scores of admissions, not to have any record that she had gluten intolerance and therefore gave her ordinary bread etc, etc)

A similar stupidity used to happen when hospital maternity staff frequently ignored the small hand-held GP maternity co-op card.

35 years ago in Milton Keynes, then in the whole of the West Midlands and then everywhere throughout Britain, maternity services have made the hand-held record the antenatal master copy.

As a result, antenatal care has gradually become much more interoperative throughout the UK (the only group of people having medical care about whom this may be said), all other groups of patients having both multiple paper documents as well as electronic records in incompatible silos.

There is a general delusion that eventually all health and social care electronic databases will “talk” to each other. But if  Santander has had to give up its bid to take over many RBS bank branches because of the cost of reconciling two comparatively simple banking systems, what possible hope is there of paying the trillions of pounds which would be required to write the thousands of lines of computer software code it would take to reconcile all the hundreds of NHS and Social Care electronic database silos.

Don’t kid yourselves. It will never happen.

I am currently working on the concept of what I am calling the WISDAM unified patient held core record (W.I.S.D.A.M. = With Individual – Social, Demographic And Medical record).  See  for further details.

Although such a concept would not improve A&E efficiency and reliability of the handovers for every patient, there is no doubt in my mind that such a revolution would help significantly in the care of every mainly housebound or institutionalised patient in the UK (and even internationally), especially if such patient-held paper records contained:

a) sticky labels of the patient’s basic medical details which could be used by ambulance crews to reduce time spent on filling in forms about such things as the name of the next of kin, long term medical problems and handicaps, and the name of the patient’s Primary Health Centre etc

b) if the same information were also printed as QR codes which can be read by any smart phone – in time, software could be written to allow the data to be easily transferred to any hospital computer anywhere in the world without someone having to key in all the same information over and over and over again.

Such an innovation would save a great deal of the time currently spent both by paramedics and by A&E staff entering the same information on multiple different forms and into many incompatible computer systems.


The above is an expanded version of my comment on a recent article in National Health Executive entitled ‘Zero Tolerance’ for Ambulance Turnovers.
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