Current health care records are rife with problems. Most of these can be solved using iotaMed.
Current EHR systems lack the concept of "disease". The diseases or symptoms that a patient has are sprinkled throughout the text in the records without any defined structure. Standardizing the terminology used in the text has only a marginal effect on this problem and is extremely workinstensive. iotaMed introduces diseases and symptoms as "issues" and gives them full status as a structural element in the relationships within a medical record. This way, diseases can participate as a full member in relations and interactions between elements.
Manageable structure of data
A major problem with current EHR systems has recently surfaced as more and more information is pumped in. The problem is that the individual doctor becomes incapable of reviewing the information before or during a patient encounter, due to lack of summaries or correct views on data. Summaries used to help us a lot when EHR systems were not interconnected, since any EHR records that were received from other systems usually arrived on paper and had to be added to your own EHR as a concise summary. This only had to be done once. With interconnected systems, such summaries aren't made anymore, and every doctor that accesses the EHR needs to do this summary himself in his mind, only to lose it again after the encounter. This has quickly overwhelmed doctors and in practice, most patient files are now only skimmed instead of read, making the doctor's awareness of the patient's history more sketchy that ever before. iotaMed, on the other hand, introduces "issues" that present a top-down view of diseases, supplying the missing element that allows an overview of the EHR contents at a glance.
Contra-indications are a much more important attribute of pharmacological therapy than interactions, but can't be handled by current systems, simply because the entity "disease" on which contra-indications are largely based, does not exist in these systems.
It has been shown that it takes, on average, 17 years for new knowledge about diagnostics and therapies in medicine to spread for scientific publication to actual use in medical practice. iotaMed uses "issues" and "issue worksheets" which effectively distribute new clinical guidelines into actual practical use almost immediatly, so as soon as the local medical authority decides to create or change a guideline, it is applied in practice.
Checklists have already proven their immense worth in reducing medical complications and accidents. iotaMed issues are, in effect, checklists and will achieve the same effect in clinical practice as checklists have already proven to have in surgical operating theatres.
The interconnection with quality registers requires structured input per disease and a mimum standard set of observations. This is exactly the structure of an iotaMed "issue", so this interconnection becomes much easier to implement.
Database structure flexibility
Since iotaMed is based on a graph database, it can include a great variety of medical data structures without any data element restrictions applied at the design stage, which is the major problem with current systems that use relational databases.
The graph database format is based on RDF, which makes the reference to external data sources much simpler and allows inclusion of documents into a medical record irrespective of the source of those documents, greatly reducing the effort needed to interconnect different sources of records data for the patients.