Injecting Science into Medicine: Technological Determinism and the Medical Record
Mr Max PerryZoom
Medical Records have a long history dating back to the 16th Century. Throughout the 20th and 21st century calls to make medicine more scientific have been bound together with agendas to transform record keeping practices in medical work. Arguments about how to centre care on the patient are articulated in the creation of the ‘Unit Medical Record’ at the beginning of the 20th Century and in the 1960s Lawrence Weed created the ‘Problem Oriented Medical Record’ to make medical practice more like the laboratory sciences.
Weed’s model is still widely regarded as the exemplar for Medical Record keeping practice, however Digital Health initiatives propose significant transformation to Medical Record keeping in the name of making medicine ‘more scientific’. It is said they will create the evidence base for Population Health and Precision Medicine innovations, and that they can ‘insert the evidence base’ into medical practice (via decision support technologies).
In this presentation I will demonstrate a history of medical records that shows their embeddedness within socio-legal and bio-scientific contingencies before interrogating how technologies of Digital Health are presented as a scientific evolution, and question to what extent we should or should not consider them more epistemically sound than paper technologies.