Yesterday I commented on the lack on cohesion in building an EHR infrastructure. Well, apparently the devil is in the detail here as well:
“Entre los temas abordados, ha destacado el tiempo que transcurrirá hasta que los sistemas informáticos de las autonomías sean interoperables. Mientras Lamata considera que esta posibilidad puede hacerse realidad en cuatro años, Güemes lo ve complicado “porque ni siquiera tenemos un sistema único en Madrid”. Noeno, en defensa de su homólogo castellanomanchego, lo ve posible en la medida en que “debemos dar un paso al frente e ir puliendo inequidades sobre la marcha”, y Roldós “firmaría por que el proceso estuviese cerrado de verdad en 2013″.”
(”The time by which Autonomies’ information systems are interoperable was prominent among the topics covered. While Lamata believes that this possibility can be realized in four years, Güemes sees it as complicated “because we do not even have a single system in Madrid”. Noeno in defense of his counterpart castellanomanchego, sees potential in that “we need to move forward and go on polishing inequities” and Roldós “wil sign that the process would actually closed in 2013.”)
Las autonomías discrepan del inicio de la interoperabilidad, José Mª Juárez, Diario Médico
as Europe also “suffers” from cohesion problems within the various countries. In a country like Spain, with its autonomous regions, the discussion deals with how to connect the regions. In The Netherlands, before the final, positive, parliament decision last February, the medical profession even doubted whether a national system would be of benefit as opposed to regional systems.
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Apparently the concept of Information Therapy has arrived in Britain as well. It would have been nice to see the report of the Patient Information Forum (PiF) includes the practice of linking to the Map of Medicine as mentioned in my observations yesterday, but unfortunately the findings are only available to members. In Josh Seidman’s overview: “Studying “Information as Therapy” in UK” no specifics are mentioned.
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Another observation today is about the patient’s information,
“Ideally, health information should be flowing both ways—from providers to patients, and vice versa. Patient generated data falls into a couple of categories. The first is data of the sort providers already have in their records—measures of, say blood sugar levels or blood pressure that can be generated by a patient through a wearable or other device that is outside of the provider’s office. It’s desirable to integrate this kind of data into a provider’s record because it shows a more continuous and accurate picture of an individual’s health than just the readings taken during brief and sporadic appointments.”
Health Information Should Flow Both Ways, Lygeia Ricciardi, Project Health Design Blog
Which, from another angle, was confirmed by Kimberley Moore in her article “Clinicians’ commitment to telemonitoring” in Mobihealthnews, also yesterday.
Who has followed the development of ICMCC over the years will recognise that these are exactly the issues we have been promoting:
“Patients should be encouraged to input their own health observations. Personal habits, use of over-the-counter drugs, sleeping problems, alcohol and recreational drug use but also work or relationship related stress are some examples of what could be included.”
Medical and Care Compunetics – the Future of Patient-Related Care [1]
“Information delivered by the patient about himself has no real medical or health value or benefit in itself. Only when linked to his medical records, both parts of the patient information, the scientific and the narrative can be valued against each other and complement each other. It would take another, much longer presentation to tackle problems concerning standards and privacy. I therefore am strongly against separate PHRs; once again, in my view the EHR, should contain all information concerning the patient.”
Speech at the ICUH Conference, 31 October 2007, Baltimore, USA
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Let me end today’s observations with 2 quotes, both worth some reflection.
“The reality is that you’re going to spend more time working in your EHR than you do with patients. Yes, that does sound wrong to say. It feels wrong to even type it here, but it’s the reality. However, don’t think that this is something new. You could have previously said that you spend more time doing paper charts than you actually spent with patients. Until we go back to the Little House on the Prairie days with one doctor who didn’t document anything, this will be life as we know it.”
EHR is the Life Blood of a Practice, John, EMR and HIPAA
“The PHR is the back up for when EHR/EMRs are not available or accessible.”
One More Good Reason for PHRs and EHRs – Temporary and Mobile Healthcare Workers, The Medical Quack
Lodewijk Bos
[1] Lodewijk Bos, Medical and Care Compunetics – the Future of Patient-Related Care, Medical and Care Compunetics 4, L. Bos and B. Blobel (eds.), IOS Press, 2007 (PubMed)
