From bridges to super-highways: transmitting meaning within and between professions, and across time and...

As development of health informatics, including electronic patient records, proceeds apace there is an innate tendency to focus on acute and primary care, and upon bio-pathological data sets. This is where virtually all research and investment is being directed. However, the core purpose of health care (and mental health care in particular) is to improve and maintain the individual's functioning and sense of well-being, not simply to eliminate adverse pathology. It is therefore vital for health care records to contain subjective, descriptive, and self-expressed components if the record is to have true health meaning. This in turn raises challenges about meaning and context, terms and language. Most informatic systems run the risk of being Islands of Automation, linked at best by bridges conveying data sets rather than knowledge. If health informatics is really to serve people and their health, attention needs to be given to developing the recording, communication, and understanding of perception through shared meaning. Only then will informatics systems be full supporters of the people's health, and record system linkages become Super-Highways of Knowledge between patients and their supporting professionals.