I’m always looking to improve how I use technology. My latest move is to clean up the AVS . The AVS is the after visit summary created by our EHR – it’s an aggregated mashup of meds, recommendations, and clinical goodness. The power of the AVS is in the hands of the provider who shapes smart phrases and customized text for an patient experience that extends beyond the constraints of the face-to-face.

I’ve got to do a better job with this.

So I turned to one of my millennial colleagues. Great workflows they’ve got.

Me: So Bryson, how do you pump out you AVS so quickly? You come out of the exam room and bam, you’re done.

Bryson: I type my plan in the room, then paste in into the patient comms panel. Easy cheesy.

Me: So the patient reads your plan? How does that work? Doctor speak and all…

Bryson: Dude, you gotta stop thinking so much. I make the plan so everyone can read it. Makes sense and it saves the step of translating it …. I heard in grand rounds at the VA that patients are reading my notes anyway.

So it got me thinking: Who’s the chart for? As the information it holds becomes transparent to patients, the question of target audience becomes interesting. Old physicians think it’s a doctor’s tool. Patient activists believe it’s of, for and by the patient.

Both are right.

Sure it’s a legal record. And it’s a communication tool and a space to justify a level of care. It’s a place to record what happened in the past and and area for housing the data that increasingly foreshadows our genetic destiny. And, as important, this record is evolving as a dashboard that allows us to watch things change in real time. In that respect The Record now bridges the episodes of care that have traditionally defined health and disease and their ultimate relationship to the healthcare system.

We’ve got to shake the constraints of what we’ve come to see as The Record. Let’s get down to the practical reality of how humans and emerging forms of AI connect around a piece of technology housing a dynamic panel of data, information and stories. But what do you call that? And who’s it created for?

And all because I took a deep dive into the AVS.

The chart is evolving as a living, breathing platform. And as my millennial associate made clear, patients are reading their records. Something I never would have imagined at his age.

Image via Tom Maglieri/Flickr