You cannot manage what you do not measure - the surprising history of health records!

We all know that physicians constantly took notes in patient files in the past, and now do so on computers. Patient files containing a person’s medical information are so valuable that special archive rooms are built for them, and they are not allowed to leave the hospital to prevent their loss. Today, as everything becomes digital, medical records made up of patient files have also moved to computers, creating electronic health records. So when did health recordkeeping first begin?

Medical books and written records about how to treat diseases are very old, but today’s patient-specific filing system, recording each patient’s complaint, its history, examination findings and treatments administered, dates back no further than the 1600s. More interestingly, the people who kept these kinds of patient records best were astrologer physicians.

Hippocrates referred to the relationship between astrology and medicine at the time by saying, “A doctor who does not know astrology has no right to call himself a doctor.”

The medical records of two English astrologer physicians, Simon Forman and Richard Napier, have gone down in history as probably the most comprehensive medical records written before 1700. People interested in astrology keep various records and perform calculations on them to make predictions, and have continued to do so since the 15th century. A.L. Rowse described Forman’s records in 1974 not merely as astrological records, but also as medical records.

At the University of Cambridge, The Casebooks Projects is a research project examining the medical records of astrologers Simon Forman and Richard Napier. When the research is completed, it is expected to include approximately 80 thousand cases and images .

Medical physicians began keeping patient records later than astrologers, and the first medical records contained patients’ names and the fees they paid for treatments and prescriptions. Before evidence-based medicine and other positive sciences matured, physicians other than astrologers did not feel a need to keep written records for each patient. They looked at the patient’s appearance, pulse or urine and administered immediate treatments.

Looking at medieval Europe, records exist of Greek physicians’ recommendations for treatments and diets to their patients in the 14th and 15th centuries. Physicians, especially surgeons, also began keeping various observation records to pass on their experience. We can also call these physicians’ first publications.

The transition to modern health recordkeeping

The records of Forman and Napier inspired and guided many modern physicians. The Englishman Theodore de Mayerne, one of the first modern physicians and also known as a famous royal physician, has records of approximately 1000 patients amounting to nearly 3000 thousand pages. His records include a list with names, dates, patient complaints and diagnoses, treatments and payments. He followed Forman and Napier’s example by preparing records more systematically in booklet form rather than on individual pages or sheets.

Although these records deserve attention and appreciation from a historical perspective, efforts today aim to transfer health records entirely into electronic form and include data not only about individuals’ illnesses, but also about their health and even their entire lives from birth. Smart wristbands, watches and technologies such as the Internet of Things (things of internet) bring us closer to the goal of a lifelong electronic health record with every passing day.

Below, you can find an engaging video showing how astrologer physicians Forman and Napier kept medical records.