The Race to a Paperless Society








It is amazing how once you notice something, you begin to pay attention and in paying attention you discover a whole new world.


Several weeks ago I wrote an article on portable medical records and the possible uses of technology to bring part of the medical records from novelty status to a mainstream medical device. A few weeks later I was introduced to a new generation of portable medical records that were capable of synchronizing with the electronic medical records at a physician’s office or at a hospital.



For those of you who are not familiar with portable medical records allow me a moment to give some definitions. A portable medical record is a USB drive device

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such as a Thumb Drive, a USB wristband, a USB flash drive wristwatch, pendant, or other portable mass storage that can be worn on the body attached to a belt or keys and holds basic medical information in a database form. Almost all these devices now are password protected and offer varying levels of functionality.


A personal health record is the online equivalent of the portable medical record. This software exists on the Internet with storage maintained at a third-party site. The information is again password protected and in an emergency can be accessed by the healthcare provider with an Internet connection and that password.


An electronic medical record is a software package utilized by hospital healthcare

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facility physicians that replaces the paper patient chart. This is an official document and subject to significant government regulation. By 2008 every healthcare provider in the United States must be executing concrete plans to transition from paper to electronic records and by 2014 all paper must be gone.


With that in mind let’s turn now back to the portable medical records. This is a market that is exploding. A few short weeks ago I wrote an article, my second in this arena, that described nine products of this type. Two days ago I did a new Google search on this topic (okay, I was desperate for an article topic) and I found no fewer than

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24 companies now offering these devices in the United States, Canada and England. Many of these devices are now being made in Taiwan and China and installed directly on the flash drives. They are coming in every shape, size and form but unfortunately with little or no functionality.


Yes, they all have some form of password protection and an emergency screen where basic information can be seen without the use of the password. They hold information such as living wills, organ donor cards, healthcare surrogate contracts, past medical histories, allergies, medications and a few hold greater levels of data. Two of them integrate with online personal health records but only one can import and export to

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electronic medical records.


None of these systems however have one basic piece that is required for credibility in the medical world. It is called change tracking and it is the ability for the healthcare professional reading the portable medical record to look at what changes have been made in the portable medical record and what existed in the record before the change was made. Change tracking is an internal audit of the system and ensures that there has been no tampering that could threaten a patient’s life.


At least there was not such a system until this week. This week www.theoriginalmymedicalrecords.com announced the prototype release of Version 1.2, a portable medical record with change tracking, high-level encryption

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and password protection.


This is truly something new and represents a second generation of portable medical record.


Where will this new medical device find a home?


As the water resistant or splash resistant USB devices these units are already finding a home on the wrists of scuba divers, sky divers, mountain bikers and others who enjoy high fun/ high risk sports.


But I envision a larger market. I envision a day when rather than receiving a flimsy paper wristband at the hospital or nursing home a patient has a portable medical record in a waterproof band around their wrist. When the nurse comes by with their wireless Tablet computer to chart she simply plugs the patient record band

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in and the records are immediately synchronized. The patient goes nowhere without their chart on their wrist.


When they go home the patient takes the band with them carrying the entire chart in miniature form. The hospital has its copy. The patient has their copy and their copy goes back to the doctor’s office.


In the event of an emergency the patient’s band is on their wrist and it does not matter what emergency room they go into, what EMS service picks them up all the important information is at the fingertips of those there to save their life.


I envision a day when my disaster medical assistance team (MDMS/DMAT-FL3) provides care in a Katrina like event

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after a natural disaster with subsequent flooding and places a USB flash drive wristband around the wrist of every evacuee. Information on federal assistance, registration for finding lost family members, their own personal information as well as a health record will travel with them from the moment of rescue until their final destination. If they already had a personal medical record on their wrist or in their pocket or around their neck as an independent we in the MDMS/DMAT-FL3 would be able to plug their device into our computers and upload the important information to help them recover their lives and help us treat their injuries.


This second generation of flash drive device holds tremendous promise not only

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for the transfer of information but even the prevention of medical errors by ensuring that the most basic information is in the hands of those who are making the most important decisions.


Dr. Maurice A. Ramirez is co-founder of Disaster Life Support of North America, Inc., a national provider of Disaster Preparation, Planning, Response and Recovery education. Through his consulting firm High Alert, LLC., he serves on expert panels for pandemic preparedness and healthcare surge planning with Congressional and Cabinet Members. Board certified in multiple medical specialties, Dr. Ramirez is Founding Chairperson of the American Board of Disaster Medicine and a Senior Physician-Federal Medical Officer for the Department of Homeland Security. Cited in 24 textbooks with numerous published articles, he

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is co-creator of C5RITICAL and author of Mastery Against Adversity. Dr. Ramirez invites comments at: http://www.disaster-blog.com










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