Keyose Blog - Personal Health Records

The first statistics about the use of Keyose are coming. And the first surprise has came up. The most active city in the world using (not just visiting) Keyose is Quillota, in Chile. We have around 25 users/visitors from that town that spend a 20 minutes each time they visit the keyose tool.

It is incredible how broad is the distribution of users (not only visitors) of keyose. Buenos Aires, Lleida, Paterna, Badajoz, San Cristobal de la Laguna, Granada, Vicente Lopez, Asunción, Chihuahua, Citrus Heights… Chile, Argentina, Paraguay, Guatemala, Colombia, Portugal, Spain, United States, Indonesia and Peru…

As Keyose is an anonymous database we can not greet our users directly so we want to thanks them through our blog.

The Keyose team reads sometimes news that get us shocked. As this one, where is said that the Industry Ministry of Spain has spent 75 millions of euros (and will spend a total amount of 252 millions) in a interoperability system for clinical health records titled “Health Online”.

There are stil no real restuls that patients can use, after spending 75 millions, and if you read the source you will see it always talk about future.

The included actions in Health Online will allow the health care record use, the electronic prescription and telematic citations. In the other hand the interoperability between information systems of Autonomic Communities will be possible. The goal is to put the citizen in the center of the healthcare system, to reduce uncertainty in the medical decision making and to improve the access to relevant information for the provision of healthcare.

We, in Keyose, have always thought that before offering a solution you have to spend time to understand the problem. And that only when you understand it you must offer the simplest solution, that will be the more efficient.

Of course, the understanding of the problem is within those that suffer the problem. For that reason Keyose is a tool that came out the mind of a medical doctor that works every day treating patients. And for that reason we give the highest importance to the opinions and suggestions that the patients using Keyose provide us every day.

Moreover, our engineer is obsessed with simplicity and is an expert in usability. For him, the challenge is not about using the lastest technology, but the simplest one able to solve the problem.

250 millions of euros are far enough to many millions of liters of Arab tea (our favourite drink when our team meet to produce new ideas).

Our goal, as the Ministry is: to put the citizen in the center of the healthcare system, to reduce uncertainty in the medical decision making and to improve the access to relevant information for the provision of healthcare.

And we are proud of say that we have biuld a tool that real people is using all over the world, in 5 months of work.

And, by the way, drinking much less teas in the process.

It’s Christmas time; the family time. So I am specially glad to know the case of a grandfather that has decided to sign up all his family (including his grandchildren) in Keyose.

The ages of life where we need more healthcare, and the help of our caregivers to manage our clinical information, are the first years (a fundamental time for our physical and mental development) and the old age. Who will take care of us better than our closer relatives?

In that sense we like a lot the idea of parents being able to use Keyose for the management of the personal health records (vaccines, height and weight and so on) of their children. We are working on that way rigth now.

We send a warn greeting to the first Keyose family!

Our users are constantly suggesting improvements or new ways of using Keyose. Some of them ask to be able to add some test’s results in their Personal Health Record (as X-rays, CTs, blood analysis, densitometries and so on).

We are working hardly so in short time you can upload images to your Keyose profiles, but in the meantime we would like to help you to improve your PHR.

The first advise is crucial. And it is something I use to recommend to my own patients: take into account that in medicine more information is not equal to better healthcare. In an emergency setting your doctor needs the most important information, because time is critical.

So don’t upload all that huge amount of reports and tests you have been storing during the last 20 years. Take your time to select and resume the most relevant informtion (and most updated one). Talk with your most trusted doctor if you need, so he helps you deciding which information is more important. The time you invest in obtaining a good selection will be well used time.

Once you have selected the tests to be added, and until the keyose’s service for uploading images is available, the next step is to find the reports of those tests.

A MRI or TC comes with a little report from the radiologists that have studied the test, where the findings are descripbed in words. If a X-ray or electrocardigraphy was done by your doctor the findings are often described in the medical report.

Even is not always needed to include all the text in the radiologist’s report, but just the section titled: “Conclusion: No pathological findings.” or similar.

In the case of blood testing the same is applied. In general it is not needed to copy all the values within the normal ranges, but only those that are out of range (usually marked with a star-asterisk). For instance, if you have a test with hemogram, blood biochemical parameters and urine analysis and all the values ar normal but a high cholerestol (300 mg/dL for example) you can summarize that information in a way like this:

Analytic October 6, 2006: Cholesterol 300 mg/dL, hemogram normal, urine normal, biochemical normal.

This will help much more your doctor as he can go directly to the significant results.

As you have selected the significant tests and have summarized them we recommend you to add them at section “Personal History”. Add them just below the list of your main diseases.

The order is the key point. The better way to organize the information is by grouping by type of test (x-rays, blood tests, MRI …) and next by inverse chronologic order (it means the last tests in first place).

Following those simple advices you will get a efficient and useful Personal Health Record!

Here is an example of how to do it:

Personal history

Hypercholesterolemia under treatment with statins (1999)

Acute myocardial infarctation required stent (2001)

Chronic bronchitis under treatment with inhalated medication (2004)

—-

X-Rays:

03/02/07: Chest X-Ray: Vascular redistribution (cephalization).

20/05/06: Chest X-Ray: Normal.

Blood tests:

05/08/07: Total Cholesterol 180, HDL 20. Hemogram normal, biochemicals normal, urine normal. PSA normal.

05/06/99: Total Cholesterol 320, HDL 15. Hemogram normal, biochemicals normal.

I love to read emails from real patients that find benefits from Keyose tool. We have received an email from John’s father (fictional name), a 10 years old child that unfortunately suffers from Primary Hyperoxaluria.

Primary Hyperoxaluria is a congenit disease of genetic origin. Due to a problem in the metabolism the patients have high levels of oxalic acid in urine. This leads to the formation of renal calculus and finally the early loss of both kidneys. In the long time deposits of oxalic acid are formed in other body parts as liver and heart producing added problems.

Unfortunately the Juan’s disease has not known treatment, although somethings have been proved (as B6 vitamin or double liver-kidney transplant) with variable results.

Moreover it is a rare disease in the world, so Juan must be visited by different specialists and sometimes travel to be treated by doctors from other countries.

Juan’s parents have found in Keyose a way to store the most relevant data of their son’s medical record and a way to support the job of his doctors.

They have asked us to improve Keyose so they can add some images (as X-rays or CTs) that are so important in the management of a chronic and complex disease as the Juan’s one.

We are currently working on, in order to improve the quality of live of Juan and his family. These are the things that give a sense to this project!

We would like to thank Juan’s family for their support and their permission to comment his case on the Keyose blog.

The American Health Information Management Association in its website www.myPHR.com is a well known supporter of the adoption of Personal Health Records by patients. In that website we can read:

All individuals should be able to readily access, understand, and use their personal health information. Your health information is scattered across many different providers and facilities. Keeping your own complete, updated, and easily accessible health record means you can play a more active role in your healthcare.

Your own personal health record (PHR) offers a different perspective, showing all your health-related information. It can include any information that you think affects your health, including information that your doctor may not have, such as your exercise routines, dietary habits, or glucose levels if you are diabetic.

In a medical emergency, quick access to your health information is vital so that you can receive the best possible care. If you are in an accident, the Emergency Responder needs three things: quick access to your medical information, the delivery of that information by trained professionals, and accurate, up-to-date information. Most people think that an emergency room can obtain their medical information, but almost none can.

Also, the PHR is a critical tool that enables you to partner with your providers. It can reduce or eliminate duplicate procedures or processes, which saves healthcare dollars, your time, and the provider’s time.

And the PHR empowers you, the patient. The information you gather gives you knowledge that assists your preparation for appointments. Overall, it gives you more intimate knowledge of your health information, including an active role in preventive care and care management. This way, you are more involved in your own care.

A Keyose’s user has had a great idea. You can add some contact phones to call in case of an accident into your Keyose card. In such a way if somebody finds you unconcious, they will know not only your allergies and blood type but also they will be able to phone your family or friends as fast as possible.

We explain you step by step:

1. Login into your Keyose account.
2. Go to “See my card” option.
3. Click on the card’s area where your allergies appear, just below the Blood type.
4. Now you can edit the card’s text!
5. Add something as “In case of emergency phone: + 34 91 555 45 32 / +34 696 555 555″.
6. Print your new Keyose card.

Don’t worry about privacy. The text you type into the card will not be stored anywhere and will be deleted from the computer as soon as you print the card. Is like you write it by hand but much more elegant!