{"id":15880,"date":"2014-01-23T12:11:00","date_gmt":"2014-01-23T17:11:00","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=15880"},"modified":"2014-01-24T11:32:31","modified_gmt":"2014-01-24T16:32:31","slug":"evernote-is-my-emr","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2014\/01\/evernote-is-my-emr.html","title":{"rendered":"Evernote is my EMR"},"content":{"rendered":"

This post\u00a0originally\u00a0appeared on NickDawson.net here<\/a>.\u00a0<\/em><\/p>\n

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\"EvernoteEMR\"
\nSpoiler alert: I\u2019m not dying and there doesn\u2019t appear to be anything major wrong with me.<\/p>\n

I know, you hate spoilers. But I thought I\u2019d get that one out of there way. It makes the rest of this considerably more pleasant for us both.<\/p>\n

I\u2019ve got a new personal electronic medical record. I\u2019m able to store and track my health history. I can add and edit my own notes. I can pull in data from external sources like my quantified self gadgets. I can share data with my provider, or family members. It\u2019s secure, it\u2019s cloud-based, it\u2019s mobile and it\u2019s on all major platforms.<\/p>\n

Evernote<\/a> is my personal EMR.<\/p>\n

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For the uninitiated, Evernote is a cloud-based, free service with apps on every major desktop and mobile platform. It\u2019s general purpose is to store, sort and help you find anything you throw at it. You can upload a PDF, email a note, clip<\/em> an image from a website. You name it, and Evernote can probably store it. Take a picture of a wine label, and Evernote will transcribe the text in the image using optical character recognition<\/em>, so when you search for Zinfendel, you\u2019ll find the image of the wine bottle. But wait there\u2019s more. Since you took the picture with your phone, Evernote also has the gps data, time and date attached to the image. You can add some tags<\/em> such as \u201cCalifornia\u201d, \u201czin\u201d, and \u201cjammy\u201d to make the note even more specic and personal.<\/p>\n

Evernote has a widely supported API (applications programmers\u2019 interface), so many other apps can read and write data into Evernote. For instance, the web-based automation service if this then that<\/a>, IFTT as it\u2019s known, will, for instance, append a line to an Evernote note every time you get a tweet; creating an effective backup solution.<\/p>\n

I personally throw everything I can into Evernote. When I book travel, and the print window pops up over the itenary confirmation, I select PDF to evernote<\/em> rather than print. When an online store emails me a receipt, I forward the email into Evernote. I have more IFTT rules logging things to Evernote than I can feasibly recount, but a few stand out. When I step on my Withings wifi-enabled scale, IFTT adds a line to an Evernote note with the date, time, my weight and body mass data. I can do the same thing with my Withings blood pressure cuff. And, it turns out, Evernote is pretty much perfect as a personal EMR.<\/p>\n

In short, I get a lot of meaningful use<\/em> out of Evernote.<\/p>\n

Recently I was asked to get an MRI (see above re spoiler). I had the MRI done at a health system an hour away from my home. The system uses Epic and has the MyChart patient portal available. My primary care doctor also works for a system which uses Epic and has MyChart. But these two Epic installations might as well be separated by lead walls. My PCP ordered some labs, that the other doctor needed and my PCP, in turn, wanted a copy of my MRI results. So one doctor calls me and says can you please print a fax to us the lab results<\/em>. Mummmm, ok. It\u2019s 2014 and I, the patient, am transmitting my own clinical data between two systems via analogue fax? Then my PCP wants a copy of the MRI results. Same problem. I am again reduced to data mule. I am Jacks health information edchange<\/em><\/p>\n

\"title\"<\/p>\n

So now we have two identical multi-million dollar EMR installations, each with some data about me, but neither having a complete picture or seamless interchange. Again, I\u2019ll point out that this is 2014 and I can FaceTime someone around the world on my phone. And we\u2019re using faxes?!?<\/p>\n

But there is one place where I have a complete record of my health and health-related behavior. You guessed it, Evernote. Everytime I have a test done, I get an email from which ever isolated multi-million dollar Epic system at which I\u2019m seen. I log in, and click a button on my web browser tool bar which instantly clips the entire page as both text and image and stores it in an Evernote notebook called Health<\/em>.<\/p>\n

The images from my MRI? They are in Evernote.<\/p>\n

Last year, before my annual physical, I decided to eat my own dog food. I started a new note in my Health<\/em> notebook called health observations<\/em>. I captured the little things I wanted to remember throughout the year: an ache here, a reminder that I saw a physical therapist, a picture of the vitamin D supplement I started taking\u2026 Before my physical, I typed out an agenda in an Evernote note:<\/p>\n