[LINK] Open source health records

[Jan Whitaker]

At 08:48 AM 27/04/2009, Stephen Wilson wrote:
>Amongst the most robust arguments in favour of comprehensive EHRs are
>the following ideas:
>
>- Population-wide longitudinal health records (de-identified of course)
>will be a crucial resource to underpin evidence-based medicine, better
>health policy, better public health monitoring, and more targeted
>expenditure in government health programs, like the PBS.

assuming that a firehose of data is more valuable/reliable in a 
complex world of human health than a targeted sample. More data is 
not always useful because the effects wash out in regression toward 
the mean. [bet you guys didn't know I'd even know that phrase did 
you? ;-)] Population data isn't always what it's cracked up to be.


>- Better access to test results (x-rays, pathology etc.) means less
>repeat testing and less cost.

---depending on many variables: time since testing, degree of rate of 
change in the particular condition on a particular person, degree of 
indemnity against a doctor who relies or prior tests instead of 
repeating them [a legal/admin decision, not a medical one and the 
BIGGEST reason for why retesting is done]


>- Better access to data from hospital stays (e.g. by GPs seeing their
>patients soon after hospital discharge) means better follow-up therapy,
>better outcomes, fewer repeat tests, less hospital re-admissions, less
>cost, and better allocation of scarce hospital resources.

---assuming that there is capacity for follow-up, resources for 
after-release therapies by physios, home nursing, etc.

What makes me nuts is that the cost benefit of EHR in the totality of 
the health system is not known. We back to the similar situation of 
the Victorian transport ministerS spending nearly a billion$ on a new 
non-functional, late ticketing system while we wait for trains during 
a use surge of 30%! I think they missed the point of the exercise: 
accommodating more passengers instead of selling tickets with a 
marginal efficiency or even a marginal DEfficiency [is there such a 
word?]. Same in health care. Spend the billions on doctors, nurses, 
therapists, medicine -- ie direct care -- instead of the trappings, 
even epi studies.

Jan



Melbourne, Victoria, Australia
jwhit at janwhitaker.com
blog: http://janwhitaker.com/jansblog/
business: http://www.janwhitaker.com

Our truest response to the irrationality of the world is to paint or 
sing or write, for only in such response do we find truth.
~Madeline L'Engle, writer

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