Your Community Health Index (CHI) - belongs to you!

PATIENT EMPOWERMENT - every citizen should own their own CHI information.

As a nation, we should follow the example set by Estonia, the global leader in e-citizen empowerment and create a personalised e-Health Record for every Scottish citizen, based on the Scottish CHI.

Scotland has a real opportunity to become a world leader in digital health and social care, based on 3 unique Scottish strengths that have developed through the years and now come together in time.  

1. CHI - valuable medical data held on every citizen

2. REALISTIC MEDICINE - philosophy that moves us from paternalism, towards empowerment

3. DIGITAL EXPERISE - significant public, private expertise and a new Estonian partnership

This is my personal view as an NHS Consultant surgeon, having worked in Scotland for 30 years: 


"I find it staggering that we still accept that every citizens health and care record is held by  the NHS and that we as individuals have no access to our own data. This system has been entrenched in healthcare organisations for years and somehow has been accepted by UK society, without standing back to look at the elephant in the room. Money is managed by banks, but we can still access our bank balance - why should health records be any different? Currently, even as a Doctor it is considered illegal to access my own records! My challenge is to turn this mindset around 180 degrees and design medical records that are owned by each one of us. We have the CHI system in Scotland, the envy of many nations which is being used very effectively for academic research and patient care. Our challenge is to personalise the CHI for every persons health and wellbeing  - creating a journey for every citizen from birth to death​. We should all have access to our own medical data at home, on mobile devices, accessible when we need it. In summary, we need to change our entrenched healthcare model of paternalism and do this through creating the e-empowered citizen, like the Estonians do!"

Why the contribution is important

Global economic predictors for healthcare provision reveal spiralling health and social care costs that can't be met through current ways of working. I believe that we need to open a much more realistic discussion with citizens and healthcare workers about the true cost of care.

As a small nation, Scotland has a once in a lifetime opportunity to completely rethink our models of care and take a revolutionary new world lead, creating a health and social care model where patients are empowered by owning and sharing the managment of their own helath and data.

The benefits of birth to death personalised access to our own data would help in the following ways:

1. Economic - empowerment, through decision making based on measureable e-Health data

2. Realising Realistic Medicine - empowerment, through patient education about their health

3. Moving Scotland into a high tech Digital and Communication age - becomming an e-Nation

Most global healthcare systems are unfortunately are based on the power of money and the control of the flow of money, the USA probably being the worst example of winners and losers in care.

Scotland fortunately still manages a helath and social care sytem that is far more socially equivalent. Despite our great system, we need to change and do this through citizen education, information sharing and the clever management of e-data.





by RodMountain on November 19, 2017 at 06:45PM

Current Rating

Average score : 3.5
Based on : 4 votes


  • Posted by suilven November 20, 2017 at 11:39

    I completely agree that patients should own, and have access to their own CHI. This is the first step towards Patient Empowerment and could move us away from the traditional model of doctor as god towards doctor as guide (see 2011 Maastricht TED talk by Baas Bloem: YouTube: TEDxMaastricht – Bas Bloem – "From God to Guide" (2011).

     Furthermore, the sharing of the CHI would provide a fantastic digital resource to underpin all kinds of scientific research such as epidemiological studies.
  • Posted by AJ November 28, 2017 at 14:23

    I would support the idea that the records system should be designed to enable patient access. However the average patient does not have the knowledge to interpret what they would see. and the average medical personnel does not write or think with the perspective of patient seeing information - some of what we might see currently could be upsetting or even insulting.

    yes, this should be the goal, but lots and lots of education from both ends needs to happen first.

    the biggest worry is security. but that is not just with this idea. that is with all of them.
  • Posted by ktgollan December 22, 2017 at 23:12

    Hi Rod, I completely agree. I work in healthcare software UX design (also in Dundee), and this is an "ideal" that comes up more and more. Especially with the increase in uptake of Blockchain. We (as an industry trying to seek assurance from NHS) are so weighed down by legacy thinking and policy, that it has a hugely detrimental impact on how we can make our users' experience of healthcare better.
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