Dynamist Blog

Health History on a Card

Physicians (including my brother) often wish their patients carried full health records on smart cards, so that a new doctor could easily see a full history and various specialists could all know what was going on. But paranoid patients have two worries: What if I lose the card? And, what if someone steals it?

This report suggests that the first concern isn't that serious. Patients treat smart cards with care, just as they do driver's licenses and other must-have IDs:

Low-income residents of the New York City borough of Queens are taking active roles in their healthcare by carrying their personal health records on chip-embedded "smart cards," public hospital officials have reported.

Preliminary data presented here last week at the international MedInfo conference on medical informatics found that 99% of returning patients retained their cards during a one-month study period, according to researchers with Queens Health Network (QHN), part of the New York City Health and Hospitals Corp.

"They've really developed a sense of ownership [of the cards], like they were driver's licenses or state IDs," said lead researcher Glenn Martin, M.D., QHN director of medical informatics. Each smart card is a photo ID with an embedded chip that holds 64 kilobytes of data. QHN gave cards to about 10,000 primary care patients at Elmhurst Hospital.

The ready availability of patient records helped reduce the number of hospitalizations during the study period.

"The relatively high density of healthcare facilities within New York City, the mobile nature of the public hospital patient base, and the relative over-utilization of emergency rooms (ER) rather than primary care doctor or clinic settings, make the need for a portable patient record essential for good patient care," according to a QHN description of the project.

Like credit cards, smart cards are, of course, in danger of being stolen--but they aren't all that valuable to anyone but their rightful owner. This is probably a case where paranoia over medical privacy is far less justified than concern over mistreatment because doctors don't know a full history (or patients aren't in the condition to give one).

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