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Healthcare transformation through the use of information technologies is partly dependent on effectively applying the most up-to-date knowledge to the complete representation of the patient's past medical history at the point of care. In order for health knowledge to be effectively used, patient information should be sufficiently detailed, and more importantly, the semantics of the data should be made explicit and machine processable. Often, the semantics of data are represented implicitly and are hidden in unstructured and disconnected descriptions of the data. Alternatively, they may be known to human experts, such as the researchers or caregivers involved in the generation of that data. Predefined schemas of health information systems are insufficient; it is extremely important to explicitly represent the patient-specific context of each discrete data item and how it relates to other data items (e.g., indications and outcomes of an operation), as well as how it fits into the entire health history of an individual. Dispersed and disparate medical records of a patient are often inconsistent and incoherent. An independent patient-centric electronic health record may provide an explicit, coherent, and complete representation of contextual data. This paper reviews healthcare transformations, with consideration of an independent health record.
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