User talk:Memcetme

In the November 2010 edition of Federal Practitioner there is an article entitled, "Assisting Patients in Developing and Maintaining a Personal Health Record." In this review, the author discusses several basic principles for organizing the personal health record (PHR) ---


 * FOLLOW outline format


 * AVOID acronyms, prepositions, conjunctions, pronouns, verbs


 * UTILIZE 'systems' and 'areas' as defined...
 * Area - Anatomical Region of the Body
 * System - Organ and Component Parts of an Organ with Designated Function


 * ARRANGE alphabetical order for...
 * Systems (Cardiac before GI before Neurologic)
 * Areas (Abdomen before Chest before Infections)
 * Medications (aspirin before glucophage before insulin)

ARRANGE chronological order for problems and diseases within systems (Cardiac --- high blood pressure 1996, heart attack 2000, heart bypass 2002, heart failure 2006) and areas.

-- COMMENTS: Most (many) card players organize their cards by suits (clubs, diamonds, hearts, and spades) which is analogous to Systems and Areas, and they organize them --- Ace, Two, Three, or King, Queen, Jack --- that is analogous to chronology. --

 EXAMPLE-PHR-EXAMPLE-PHR-EXAMPLE Principles into Practice

-- COMMENTS: The PHR starts out with the three most important categories --- CONTACTS, ADVERSE DRUG EVENTS, MEDICATIONS --                                        CONTACT INFORMATION
 * Patient - Date of Birth, Name, Address, Phone, EMAIL
 * Spouse/Partner - Name, Address, Phone, EMAIL
 * Primary Care Provider - Name, Address, Phone, EMAIL
 * Insurance Carrier - Name, Phone, EMAIL

ADVERSE DRUG/CHEMICAL EVENTS Note Chronological (by date) Organization
 * Strawberries, Facial Edema, 1951
 * Penicillin, Hives, 1960
 * Trimethoprim Sulfamethoxazole, Purplish Rash, 1978
 * Lisinopril, Rise Creatinine, 1998
 * Pomegranates (???), Hives, 2007

 MEDICATIONS Note Alphabetical Organization -- COMMENTS: Note the use of all chemical names arranged alphabetically, followed by brand names, dosing, instructions, and reason for taking the medication --- Arranging alphabetically makes it more efficient visually to reconcile medications for both the provider and the patient. --


 * Clonidine (Catapres) 0.1mg, one tablet bedtime, high blood pressure
 * Finasteride (Proscar) 5mg, one tablet bedtime, urinary flow
 * Hydrochlorothiazide (Hydrodiuril) 25mg, one tablet mornings, high blood pressure
 * Lovastatin (Mevacor) 40mg, one-half tablet evenings, cholesterol
 * Metformin (Glucophage) 500mg, one tablet mornings and evenings, diabetes
 * Nifedipine (Adalat) 30mg, one tablet mornings, high blood pressure
 * Tamsulosin (Flomax) 0.4mg, two tablets bedtime, urinary flow

-- COMMENTS: Note the use of all brand names arranged alphabetically, followed by chemical names, dosing, instructions, and reason for taking the medication. --


 * Aadalat (Nifedipine) 30mg, one tablet mornings, high blood pressure
 * Catapres (Clonidine) 0.1mg, one tablet bedtime, high blood pressure
 * Flomax (Tamsulosin) 0.4mg, two tablets bedtime, urinary flow
 * Glucophage (Metformin) 500mg, one tablet mornings and evenings, diabetes
 * Hydrodiuril (Hydrochlorothiaxide) 25mg, one tablet mornings, high blood pressure
 * Mevacor (Lovastatin) 40mg, one-half tablet evenings, cholesterol
 * Proscar (Finasteride) 5mg, one tablet bedtime, urinary flow

-- COMMENTS:
 * Note Alphabetical Order of CATEGORIES (Childhood Illnesses before Diagnoses/Problems before Education before Employment before Family History before Immunizations before Military Service, etc); SYSTEMS (GI before Musculoskeletal before Miscellaneous before Psychiatric before Renal/Urologic); and the Chronological Order within Each System or Area.

--
 * Note also the category "MISCELLANEOUS," the place where undefined and non-specific problems reside until more information is collected. Perhaps in the future the shortness might be due to pulmonary disease or cardiac disease, and the chest pain may be due to angina pectoris (cardiac pain). As such shortness will be deleted from the MISCELLANEOUS category.

ACTIVITIES
 * Habits
 * Coffee, Tea, Water
 * Tobacco, Alcohol
 * Sleep


 * Hobbies


 * Physical
 * Aerobic
 * Anaerobic


 * Volunteer
 * Community
 * Faith Based
 * Employment Based

BLOOD TYPE (If Known) CHILDHOOD ILLNESSES Note Chronological (by date) Organization
 * ABO Grouping
 * Rh Typing
 * Measles, 1958
 * Mumps, 1962
 * Chicken Pox, 1966

-- COMMENTS: Some entities can be placed in more than one category --- see Childhood Illnesses and Infections (Measles, Mumps, Chickenpox); see GI and Procedures (Esophagoscopy, Colonoscopy, Appendectomy), see Psychiatric and Procedures (Electroconvulsive Therapy)... --

 DIAGNOSES and PROBLEMS Note Alphabetical Order of Categories (Systems Areas) Note Chronological (by date) Organization within Categories -- COMMENTS: Diagnoses are more specific and usually more evident after evaluation from tissue biopsies, procedures, consultations, and hospitalizations; Problems are non-specific and more focused on patient symptoms that have not yet been evaluated to any depth. --
 * DIAGNOSES: Angina Pectoris (history); Asthma (physical); Pneumonia (Xray); Diabetes (Lab)
 * PROBLEMS: Low Back Pain, Chest Pain, Shortness of Breath, Headache, Weakness

GASTROINTESTINAL (GI) (System)
 * Appendectomy, 1970
 * Duodenal Ulcer, 1990
 * Upper GI Bleeding (Major), 1992
 * Esophagoscopy - Stomach Ulcer
 * Transfused 2 units blood


 * Stricture Esophagus - Esophagoscopy - 1995
 * Colonoscopy - 2002
 * Colon Polyp (Hyperplastic), Benign Pathology
 * Internal Hemorrhoids
 * Diverticulosis

INFECTIONS (Area)
 * Measles, 1958
 * Mumps, 1962
 * Chicken Pox, 1966
 * Malaria (Vietnam), 1973
 * Carbuncle Excised, 1976
 * Prostate Infections, 1978, 1988, 1993
 * Walking Pneumonia, (antibiotics), 1981
 * Shingles (R Chest), 2000

MISCELLANEOUS
 * Shortness Breath, 1991
 * Dizzyness, 2008
 * Chest Pain (Not cardiac), 2009

MUSCULOSKELETAL
 * Fracture R Wrist, 1956
 * Rupture R Biceps Tendon, 1960
 * R Rotator Cuff Tear, 1980
 * MRI - Complete Tear
 * Surgical Correction, 1981


 * Lumbar Stenosis, 1999 (CT Scan)
 * Osteoporosis, 2005 (Bone Densitometry)

PSYCHIATRIC (System)
 * Post-Traumatic Disorder (Vietnam); VA Disability, 2002
 * Major Depressive Disorder, 2006
 * Electroconvulsive Therapy, 2008


 * Panic Disorder, 2008
 * Anxiety Disorder, 2008

RENAL/UROLOGIC (System)
 * Prostate Infection, 1978 (Antibiotics), 1988, 1993 (Antibiotics)
 * Blood Urine, 1990
 * Cystoscopy, Bladder Stone
 * IVP, Benign R Renal Cyst


 * Rise, Creatinine (Lisinopril), 1998
 * Kidney Stone, Emergency Department, 2000
 * Erectile Dysfunction, 2002

 EDUCATION
 * High School, Dates
 * Junior College, Dates, Degree
 * College, Dates, Degree

EMPLOYMENT
 * Organization/Industry/Profession - Position, Dates
 * Organization/Industry/Profession - Position, Dates
 * Organization/Industry/Profession - Position, Dates

FAMILY HISTORY
 * Paternal
 * Granfather - Blood Clot Brain, Emphysema
 * Grandmother - High Blood Pressure, Diabetes
 * Father - Kidney Cancer
 * Mother - Healthy
 * Aunts/Uncles


 * Maternal
 * Grandmother - "Old Age"
 * Grandfather - Killed, WWII
 * Mother - Breast Cancer
 * Father - Dementia
 * Aunt - Breast Cancer
 * Uncle - Stroke


 * Siblings - Sister, Breast Cancer; Brother, Multiple Sclerosis
 * Children - Son, Migraine Headaches

IMMUNIZATIONS Note Chronological (by date) Organization
 * Hepatitis A Series, 1989
 * Hepatitis B Series, 1989
 * Pneumovax, 2008
 * Zoster Vaccine, 2009
 * Flu Vaccine, Yearly (Most Recent 2010)

 MILITARY HISTORY
 * Branch, Dates
 * Rank, Discharge
 * Locations Served, Dates

 PROCEDURES Note Chronological (by date) Organization
 * Appendectomy, 1970
 * Carbuncle Excised Back, 1976
 * R Rotator Cuff Tear Repair, 1981
 * Cystoscopy, Bladder Stone, 1990
 * IVP, Benign R Renal Cyst, 1990
 * Esophagoscopy, 1995
 * Colonoscopy, 2002
 * Electroconvulsive Therapy, 2008

SOCIAL HISTORY
 * Married, Date
 * Children: Dates of Birth, Gender (F or M)
 * Caregiver, if Applicable

ADDITIONAL COMMENTS: Based on this article, I recommend the authors add a section of the PHR titled, "Organization of the Personal Health Record," to follow the section on "Definition."

Finally, this article offers beneficial suggestions to websites offering PHR access for the public. These are USE-of-SYSTEMS/AREAS CATEGORIES, FREE-TEXT-ENTRY, and CLICK-and-DRAG as permitted on weather (moving Columbus Ohio to the top of the list) and fantasy sports (placing a player on the bench and moving another player from the bench to the active roster) sites.

REFERENCE: Nardone DA. Assisting Patients in Developing and Maintaining a Personal Health Record. Federal Practitioner 2010; 27 (11): 27-31; E1-E2.

Thank you for your consideration.

Memcetme (talk) 03:49, 17 November 2010 (UTC) memcetme