The Right to Relationship in Healthcare
Three years ago, an ECG apparently found atrial fibrillation.
I found out last week, three years later.
The data was there. The test was completed. Somewhere, a result was recorded under my name and NHS number in a system.
But that information never turned into knowledge.
Nobody told me.
I believe the real problem in healthcare is becoming dangerously clear: we are losing the relationship that turns information into knowledge.
We talk constantly about healthcare data, interoperability, digital transformation, shared records, AI, patient portals, data lakes, platforms, and dashboards.
We keep building larger warehouses for information, while quietly breaking down the human relationships that give that information meaning.
Primary healthcare is becoming platformised.
Systems change. Providers change. Contracts are issued and then reissued. New political leaders come in with a new vision, a new digital plan, and often a new group of companies to help make it happen. One platform is shut down, and another takes its place. Data gets moved, mapped, cleaned, reformatted, and connected through yet another API.
Somewhere in this long chain of technology, there is a patient.
Still in the same body.
The patient is the only constant part of the system.
I have had a strange relationship with physical intensity for as long as I can remember.
My toddler’s nickname was “Wait for me”.
If I push myself too hard, get too hot, stop suddenly after activity, or experience any big physical change, my body can react in a dramatic way. I call these episodes “passey-outey” because I work in marketing, not cardiology, and no one ever gave me a better word for it.
Over the years, there have been conversations with doctors, pulse readings, an ECG, and episodes discussed in different rooms with different people.
Individually, these are data points.
Together, they may be a pattern.
But who is responsible for holding the pattern?
Increasingly, the answer is the patient.
We are the only ones who stay with you throughout your healthcare journey from start to finish. Doctors come and go. Practices merge. Software changes. Services are started, stopped, and brought back with new names.
The patient remains.
Yet healthcare still tends to treat the patient as the least reliable part of their own long-term record, even though the patient is the one who carries the continuity.
“I was told…”
“I remember this happening before…”
“I’ve always reacted like this…”
These statements are often seen as soft information, just anecdotes or patient memories.
Meanwhile, the computer has a result from 2023 sitting in a database, and apparently, nobody has told the human being whose heart produced it.
Excellent. The database is informed.
Data without a relationship is just storage, not knowledge.
There is a difference between storing information and knowing a patient.
Relationship creates context.
A doctor who has seen someone over time may know that a pulse of 95 is unusually good for that person. Another clinician, seeing the number in isolation, sees only its relationship to a population reference range.
A patient may describe a lifelong physical pattern that sounds vague in a ten-minute appointment. Across ten years, however, that pattern may become clinically meaningful.
Continuity allows individual data points to accumulate into knowledge.
Without continuity, healthcare repeatedly meets the patient for the first time.
This is not just annoying; it leads to dirty data.
It’s not dirty because the blood pressure reading is wrong, but because its meaning is incomplete.
The number is clean.
The context is missing.
Now we expect AI to fix this problem.
This matters enormously as healthcare begins its inevitable love affair with artificial intelligence.
AI is exceptionally good at finding patterns.
But it cannot find patterns in information that has been repeatedly separated from its context, inconsistently recorded or left stranded across systems.
The idea of ‘garbage in, garbage out’ has never been exciting, but calling something ‘clinical AI’ in a presentation does not change that.
If we want better AI outputs in healthcare, we need better longitudinal data.
If we want better longitudinal data, we need continuity.
And continuity is not purely a software problem; it is a relationship problem.
It is a relationship problem.
A clinician who knows the patient contributes something extraordinarily valuable to the dataset: longitudinal interpretation.
The patient contributes something equally valuable: continuity of lived experience.
The technology should connect those two sources of knowledge.
Instead, we seem set on removing relationships, breaking up the system, and then asking AI to piece together the patient’s story from scattered digital clues.
This is a costly way to try to regain context.
The right to a relationship
Perhaps continuity of care should stop being discussed as a pleasant feature of an ideal healthcare system and start being treated as something patients need.
Perhaps patients need the right to a relationship, because continuity should be treated as essential, not optional.
This does not mean seeing the same doctor every Tuesday at 10:15 for forty years. Healthcare systems are complicated. People move. Doctors retire. Life rarely follows neat plans.
I mean the right to a healthcare relationship that persists.
A named clinical home.
Clear ownership of longitudinal information.
Responsibility for connecting significant findings to the person they concern.
Systems should be built around the patient’s ongoing care, not just the length of the latest contract or platform.
Because ‘first, do no harm’ does not start only when a doctor chooses a treatment.
It starts with making sure the patient is not lost between visits.
It starts with making sure an important test result leads to a real conversation.
It starts with keeping the context intact.
Better relationships. Cleaner data. Better AI.
We often act as if human relationships and technology are two opposite ways to do healthcare.
They are not.
In fact, the future of healthcare AI might rely on bringing back something very traditional: truly knowing the patient.
Relationship creates continuity.
Continuity creates context.
Context creates cleaner, richer longitudinal data.
Better data creates better AI output.
Three years ago, a machine might have correctly detected something in my heart.
The technology did its job.
The data existed.
What broke down was the connection between the information and me.
And no amount of digital transformation can truly be called progress until we restore that relationship.
Call to action
It is not the clinician’s fault- it isn’t the patient’s fault – my call to action is: Let’s work together for a <<RIGHT TO RELATIONSHIP>>