Re: OT: EHR, etc.

JF Mezei wrote:

David J Dachtera wrote:
Well, the Electronic Health Record is not a "cure all", and cannot address the
issues you cite unless the staff accompanies the patient to his new unit - which
doesn't happen.

Perhaps this is an issue IT cannot solve yet, but it is very important
to health care. If a guy has a broken leg, it doesn't matter. But if a
person's mental alertness is affected by the problem (such as urinary
infection for elderly people), knowing about periods of mental alertness
while at ER, as well as transfering the knowledge that came from the
family on the metal status of the patient prior to that incident is very
important to all the staff in the new ward to gauge the patient's
current status relative to the other experiences so far.

Actually, that DATA *IS* carried forward. The experience of the ER caregivers is
only recorded, not "psychically transferred".

The Electronic Health Record adresses that concern, but also raises concern
about protecting the patient's privacy. Hence access controls are emplaced.

It seems to me that a lot of those thing are designed by people very
detached from actual emergency rooms (large consulting forms with big
fat contracts to generate books of documentation) as opposed to
designers who really know what should be done at the ground level.

Actually, they are designed by healthcare professionals who consult with the
areas of government which bring about the legislation.

At some point, the Electronic Health Record may evolve to that level. We're
already seeing some of this in the private sector. Wider acceptance will be
subject to all the usual flap over HIPAA and information security beyond HIPAA.

Well, once a patient check in, he/family should provide the OK to access
his/her records from another health care facility. Seems to me that this
should be automatic because in the end, doctors in the ER cannot really
make an good diagnostic if they do not have a patient's proper history.

The "checks and balances" still are required by current legislation, however,
and care givers cannot make certain assumptions without either the patient or
that person's elected having a say in such matters. Living wills, limited powers
of attorney and such, y'know...

Realistically, the back-end servers ("tier 3" or "tier 2") really are
transparent to the end user. The "user interface" ("tier 1") will be the issue.
Obviously WhineBloze is not acceptable, yet it is ubiquitous.

However, when you consider province wide systems like in Canada, the
provincial government is the one that signs the big IT contracts to
develop systems for hospitals. And they they to make "popular" decisions
instead of selecting obscure systems because they are better. I
underline OBSCURE here because this is what VMS is. In the case of
Québec, it is even worse because they really got burned by Compaq: they
signed a huge contract for Alpha servers deployers throughout the
province in February only to find Compaq announcing the end of Alpha on
the following June 25 a few months later.

Stupidity knows no boundaries.

Could we convince the industry to go with some other access model? Perhaps an
x-based thin client invoking software on a secured "middle tier" server
(instances, blade, etc.) (Gnome/KDE on *BSD, DECwindows on VMS, Gnome/KDE/X on
AIX or Solaris, etc.)

I agree. However, in the case of a province-wide system, should records
be distributed, but accessible from any centre/hospital, or should there
be one large central database that is fully redundant and available
7/24/365 no matter what. (this would generate some heated discussions
about privacy).

I should think that a distributed solution would be better to allow for
redundancy, though it will likely be argued that redundancy increases the
likelihood of a data security breach.

Anyhow, I have thought about you (since you are the health care guy on
COV) lately because I noticed a case where the hospital's system could
really be improved.

The healthcare field is always looking for IT talent. Cerner is not held in
irreproachable regard, for what that's worth (and I am aware more than one site
at which Cerner is "on probation"). If you have a better idea, approach someone
about it!

--
David J Dachtera
dba DJE Systems
http://www.djesys.com/

Unofficial OpenVMS Marketing Home Page
http://www.djesys.com/vms/market/

Unofficial Affordable OpenVMS Home Page:
http://www.djesys.com/vms/soho/

Unofficial OpenVMS-IA32 Home Page:
http://www.djesys.com/vms/ia32/

Unofficial OpenVMS Hobbyist Support Page:
http://www.djesys.com/vms/support/
.

Relevant Pages

  • Re: OT: EHR, etc.
    ... issues you cite unless the staff accompanies the patient to his new unit - which ... Perhaps this is an issue IT cannot solve yet, but it is very important to health care. ... But if a person's mental alertness is affected by the problem, knowing about periods of mental alertness while at ER, as well as transfering the knowledge that came from the family on the metal status of the patient prior to that incident is very important to all the staff in the new ward to gauge the patient's current status relative to the other experiences so far. ... It seems to me that a lot of those thing are designed by people very detached from actual emergency rooms (large consulting forms with big fat contracts to generate books of documentation) as opposed to designers who really know what should be done at the ground level. ...
    (comp.os.vms)
  • OT: EHR, etc.
    ... Change of doctor, change of nursing staff. ... experience of the ER nurses with that patient is essentially lost and ... Well, the Electronic Health Record is not a "cure all", and cannot address the ... Unofficial OpenVMS Hobbyist Support Page: ...
    (comp.os.vms)
  • Re: Clueless healthcare arguers
    ... read a good study on medical costs. ... that upgrade from paper records to electronic records. ... dramatic impact on patient safety. ... what if the reason we spend so much on health care is b/c ...
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  • Re: OT: Does anyone buy health insurance?
    ... centralized health care is that it not only ... save 500 billion out of Medicare right? ... attack patient they will have to wait one month for much needed heart ... for much needed cancer surgery is two months away; ...
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  • Re: OT: Does anyone buy health insurance?
    ... centralized health care is that it not only ... save 500 billion out of Medicare right? ... attack patient they will have to wait one month for much needed heart ... for much needed cancer surgery is two months away; ...
    (rec.music.beatles)