History

IndivoHealth

   The technology behind MyOSCAR is based on the Indivo project from the Harvard-MIT Children's Hospital Informatics program (http://www.chip.org/research/ping.htm).  The origins of this project are found in the team's 1994 publication (the Guardian Angel Manifesto), in which it was proposed that health information software move away from complete control by doctors and hospitals and focus more on the individual. The Manifesto argued that because current health information systems were "built for the convenience of health care providers," the patient's records tended to be fragmented, and were sometimes incomplete, incorrect, or inaccessible. The vision was to develop software that would help track, manage, and interpret the patient's health history. 

    These concepts evolved over the next decade, as did the innovative software that was developed as a result.  In 1998, the team began developing portals, or programs allowing patients to view portions of their electronic medical record.  Then, in 2001, the focus shifted to software that enabled patient control. Originally called PING, IndivoHealth is the world's first personally controlled record system, a free, open source application built to public standards.

The principles that guide development of patient controlled records were written in a 2001 BMJ paper:

• Electronic medical record systems should be designed so that they can exchange all their stored data according to public standards
• Giving patients control over permissions to view their record (as well as creation, collation, annotation, modification, dissemination, use, and deletion of the record) is key to ensuring patients' access to their own medical information while protecting their privacy
• Many existing electronic medical record systems fragment medical records by adopting incompatible means of acquiring, processing, storing, and communicating data
• Record systems should be able to accept data (historical, radiological, laboratory, etc) from multiple sources including physician's offices, hospital computer systems, laboratories, and patients' personal computers
• Consumers are managing bank accounts, investments, and purchases online, and many turn to the web for gathering information about medical conditions. They expect this level of control to be extended to online medical portfolios.
  

The architecture that achieves this vision was described in a 2004 JAMIA paper. An overview of the architecture can also be found here.

MyOSCAR

    In 2002, the Department of Family Medicine at McMaster University in Hamilton, Ontario, Canada launchedOSCAR (Open Source Clinical Applications & Resources), an open source software project designed for the delivery of evidence-based resources and decision support at the point of care for both patients and providers.  Applications included programs for office automation, decision support tools, and an electronic patient record.  Among other things, OSCAR is a electronic medical record system that enables clinics to move away from paper-based records.