[LINK] Open source health records

[Marghanita da Cruz]

Stephen Wilson wrote:
> Lea de Groot wrote:
>> I've always wondered why spending a fortune on computerising medical  
>> records will be so good, myself.
> The case for EHRs is a hotpot of intuition, epidemiology, public health 
> policy, and hyperbole. 
<snip>
> Some of the seemingly worthy but maybe untested ideas revolve around 
> patient-centred care and patient-managed health maintenance.  Basically, 
> if patients have more involvement in their own healthcare, aided by 
> online Personal Health Records (PHRs), then it is thought that they will 
> turn out healthier.  Seems reasonable, but on a population-wide basis, I 
> am not sure if the idea is scalable and therefore beneficial across the 
> board.  Nevertheless, really big employee PHRs are rolling out in the 
> USA (at Walmart for instance) where they might have a special place in 
> their weird and wonderful Health Maintenance Organisation (private 
> insurance) managed care model.
> 
<snip>

I think we need to distinguish between medical records for individuals and
health data. With regard to involvement in your own healthcare, I prefer the
prevention model to the acute medical care - emphasis on link between
alcohol/speed/large vehicles and road trauma, substance abuse, effects of
unbalanced nutrition/exercise, cancer and alcohol/cigarettes etc.  - rather than
cures.

> In Sweden the responsibility for providing health care is decentralized to the county councils and, in some cases, the municipalities. A county council is a political body whose representatives are elected by the public every four years on the same day as the national general election. According to the Swedish health and medical care policy, every county council must provide residents with good-quality health services and medical care and work toward promoting good health in the entire population.
<http://www.sweden.se/eng/Home/Work-live/Society-welfare/Health-care/Facts/Swedish-health-care/>

> Aboriginal and Torres Strait Islander health labour force statistics and data quality assessment provides comprehensive data on the Indigenous health labour force. Data are drawn from censuses, surveys and administrative data sources. The report presents information on Indigenous medical practitioners, nurses, Aboriginal health workers and those studying health. The report also assesses the quality of Indigenous labour force data. It provides a useful resource for policy makers, administrators and researchers interested in the Indigenous labour force.
<http://www.aihw.gov.au/publications/index.cfm/title/10684>

It would be useful to contemplate the parallels/overlaps with compulsory 
Superannuation.

and to get more understanding of the US model....
> Small Businesses Struggle to Provide Health Coverage
> 
> A Large Fraction of Uninsured Workers are in Small Businesses: Nearly one-third of the uninsured ? 13 million people ? are employees of firms with less than 100 workers.1
> 
> Fewer Small Businesses Are Offering Insurance: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%.2 Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%.3
> 
> Workers Not Offered Coverage Are At Great Risk: Half of workers in small firms that do not offer health benefits are uninsured. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse.4
> 
<http://www.healthreform.gov/reports/helpbottomline/>

and for those interested in surveys...the AIHW is asking for feedback on their
publications:
<http://www.aihw.gov.au/publications/effectiveness_survey.cfm>

Marghanita
-- 
Marghanita da Cruz
http://www.ramin.com.au
Phone: (+61)0414 869202