Care card: a proposal

This essay is, ultimately, about technology and why the emergency room doctors at Nanaimo General, in dispute with Vancouver Island Health over keeping their prescriptions and notes electronically, need to get with the times and embrace digital record-keeping. However, first we need a little background:

Until the last few years, I have always been a very occasional user of medical services. Like most of us, in many years I never saw a doctor at all. When I did, the visit and any subsequent tests and procedures  were recorded on paper and kept in a folder kept centrally in the clinic. That folder went with me whenever I saw a doctor at that clinic: standard medical practice of the time, in other words.
Then our fine but old-school GP, the one who delivered all our kids and who Sandy and I had had since arriving in Campbell River, nearly replicated Icarus’ death spiral by running his plane into the Nanaimo Airport tarmac. I was sad for him and, like much of Campbell River, seriously worried about his survival, but didn’t spend much time wondering how our future medical requirements would be met.
Happily, we live in Campbell River, possibly one of the most desirable places in the entire world to live, so when I finally needed a consult, I phoned our clinic and was immediately given an appointment.
A young man the age of our kids, the doctor immediately impressed me by coming to that first appointment carrying his laptop. He dealt with my issue (annual prostate check) and took a complete history, including prodding all my body’s corners and byways. All was entered into the computer.
Having found something he wasn’t sure about, he sent me to a urologist in Courtenay to have that checked out. And here’s the point: the urologist had my complete history on his computer when I saw him a couple of weeks later. No trees had been sacrificed; no postage had been purchased, and nothing had been held back.
Repeat exactly for the allergist I consulted in Victoria.
Our GP’s laptop has subsequently morphed into a tablet and then a smartphone, and there’s a computer on his desk which gives larger-format access to everything medical that has gone on with me since we started with that initial visit, including the results of the referrals to specialists and of various lab tests.
You can probably see where this is going: there’s also a computer on the desk of the specialist who has treated me since my GP ran out of ideas for dealing with my cough. Everything available to my GP is available on the specialist’s computer as well: the results from all the blood and sputum tests, the X-rays, a CT scan, the bronchoscopy results, all the antibiotics I’ve ingested, the courses of prednisone I’ve taken, what we’ve discussed at every visit, etc.
And when that specialist thought maybe it would be helpful for me to see another specialist in Comox for a second opinion, I wasn’t at all surprised to see he had my complete medical history on his computer as well.
Not a sign of a folder, but entirely dependent upon my GP piloting my health care through the system and documenting it.
This was brought home to me when I ended up first in emergency and then in the hospital overnight after I reacted badly to the bronchoscopy: I obviously wasn’t at my best, so when the docs there wanted to know what drugs I was taking I knew there were only two, and I knew what they do, but could I remember what they’re called? Could I remember what colour puffer? Not a chance. Furthermore, the very competent emergency room doctors knew nothing of my medical history beyond what I could tell them, because they had access to none of my files. So they sent me for yet another chest X-ray, just in case it would be needed, and put a call in the specialist who had performed the bronchoscopy.
The same shooting-in-the-dark thing happened another time when my GP wasn’t available and I had to deal with a doctor at a drop-in clinic.
This doesn’t make any sense to me. It’s 2017, and we have a unified provincial system of health care.  There is no technological reason why my files cannot follow me around, at least in my own province. If systems are “incompatible”, as is sometimes argued, hire someone who can make them compatible!  Other agencies do it all the time. “Privacy issues”? Bogus argument. They’re my files, ultimately, and I should be able to give permission for any doctor I need to consult to see those files. Too expensive? So is the system we have, because it’s terribly inefficient.
So I have a practical suggestion: if a central registry for all clients of our health-care system is simply to cumbersome or ethically-challenged to imagine, how about issuing each patient with his own digital card, containing all his own records. This would be updated every time he sees a doctor or pharmacist, and only doctors or pharmacists would be able to read it, because to do so they would need to enter their own personal code. We all already have such a card in BC called a “Care Card”, but it is, at present, singularly useless to the client, in that it only gives access to treatment, and doesn’t tell the provider anything useful for the care and treatment of the patient.
My experiences with our present system have all been excellent, but I recognize that a major reason for this is the fact that my GP and my other providers have coordinated my care, thanks to the process my GP started. I realize I’m very lucky, and that not everyone – because of where they live or circumstances beyond their control --  can count on the same level of service. What I have proposed, I believe, could narrow the gap.
However, all the doctors working in the public health care system, even the Nanaimo emergency doctors, would have to learn how to use a computer!