Rodolfo J. Stusser, MD, MS (Retired in Cuba, 2005 to travel to the U.S., 2010) [591 SW 45 Ave, Coral Gables, Fl 33134; 786-216-8310; firstname.lastname@example.org]
Richard A. Dickey, MD, FACP, FACE, Retired [51 Players Ridge Road, Hickory, NC 28601; 828-495-1230; email@example.com] ( Graduated from Columbia College of Physicians and Surgeons)
AbstractThe simultaneous accomplishment of the U.S. Health Care Reform’s goals requires health services research to solve the clinimetric’s challenge of the generalist to evaluate and manage better the integral health outcome of the single patient evolution. This paper discusses the rationale and design of a research program to improve a balanced measurement and classification of the general health level and state -including the disease ones- of a patient using data in the electronic health record (e-HR). Main hypotheses, concepts, and elements of the project are described. It includes purpose, objectives, benefit, data and methods, validity and reliability clinical trials, health data integration, resources, institutions, times, and costs. As we move into what has been called the ‘third era of health’, the general health level and state of each patient could be estimated better, solving a ‘health equation of strengthens and weaknesses’ into an e-HR clinical-decision support system to the generalist’s clinical judgment and patient understanding and cooperation. It could help guide as a compass the indication of the most reasonable and necessary quantity and quality of health care technological and educative actions, in the right times and places, with lower costs, in everyday clinical practice and research. Four-dimensional numerical measures, and double-flow four-way classifications of the general health outcome of the patient, could contribute to transform the disease care in an integral health care worldwide.