In 1998, in a Salzburg Global session attended by 64 individuals from 29 countries, teams of health professionals, patient advocates, artists, storytellers, policy makers, representatives of the media, social scientists and other lay individuals created the country of PeoplePower, a nation whose health system was built "through the patients' eyes."
Central to this future projection of the individual patient-clinician relationship was an Internet-based patient record that "resides nowhere but is available everywhere. Patients are offered complete access to their medical record and urged also to...write in it - elaborating, tracking and explicating problems, correcting mistakes, prioritizing needs, and at times suggesting both diagnoses and treatment plans."
Health professionals, patients and lay people work to promote health and manage illness more successfully through both individual initiatives and public health measures. And today, self-care combined with team care and broad-based efforts at collaboration, within families and communities as well as between individuals and their clinicians, are gaining new currency and understanding.
To support such central goals and processes, how should one chart an individual's course through health and illness? In the future, could a transformation of the traditional medical record become a central part of an individual's management of health and illness? Could collaborative records, shaped both by clinicians and patients, become an integral part of the patient-clinician relationship? Could transformed, fully transparent records become central to the evolution of a true culture of health? How can that then be built on by communities, helping to shape the health care they want as well as need? And how can we ensure that these communities are made up of activated patients and citizens, sharing a culture of health with their clinicians?
Since that seminal Salzburg meeting in 1998, new approaches to medical records have spread rapidly. In the United States, millions of individuals now have access to records through secure electronic patient portals. In addition, spurred by the OpenNotes movement (www.opennotes.org), major health systems are now inviting patients to read and respond to notes written by their clinicians and other health providers. In many other parts of the world, similar practices are spreading - at times aided by evolving health information technologies, at others based primarily on hand-written communication. This both empowers individuals, enhances health equity and draws on the cultural resources of communities.
Teams of four or five Fellows were selected from diverse countries. Each team drew from a cross-sectoral mix of health professionals, providers, policy makers, patients, commentators and journalists, and representatives of communities and voluntary organizations, who were leaders and change agents and demonstrated creativity and the ability to stretch traditional boundaries.
The five-day meeting was be highly participatory, with a strong focus on aggregating perspectives and experiences in order to create new approaches to developing and recording the journey through health and illness that every individual experiences.
Participants were supported by a panel of experts from a broad range of domains, including medical practitioners, the arts and humanities, the media, informatics, health policy and research.
Prior to arrival, the expert panel provided the Fellows with materials, so that each participant arrived with a firm grasp of fundamentals. The session established a "playful" atmosphere in which the teams worked to address the challenges articulated in PeoplePower. Along with work in country teams, plenaries and knowledge cafes, role plays mixed members from different country teams. Participants also used a mix of social media to enlist real-time participation by outside groups and individuals. Key questions addressed were:
For details regarding "OpenNotes", please visitwww.opennotes.org.
For "OpenNotes" Associated Publications, please visit:www.opennotes.org/research/publications.
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HEALTH AND HEALTH CARE INNOVATION IN THE 21ST CENTURY
Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series – Health and Health Care Innovation in the 21st Century – to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.
For more info, visit: health.salzburgglobal.org