[LINK] Open source health records

Roger Clarke Roger.Clarke at xamax.com.au
Tue Apr 28 11:23:45 AEST 2009

At 8:48 +1000 27/4/09, 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.

There seem to be few attempts to de-identity such records.  The 
medical profession, or frequently the bureaucrats on their behalf, 
claim angel status for the medical profession, and a higher value in 
their work than in patient privacy, and hence no need to waste time 
and money on de-identification.

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

There's no evidence to support the claim that access to prior test 
results is even utilised, let alone valued.  Clinicians want a test 
done recently, according to their own spec.

>- 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.

No argument about that one though.  It's a scandal that hospitals are 
so under-resourced that discharge summaries are seldom even done, let 
alone sent where they're needed (and that nursing staff aren't 
permitted to even draft them).

>Some of the seemingly worthy but maybe untested ideas revolve around
>patient-centred care and patient-managed health maintenance.  ...

When bureaucrats use the word 'patient-centred', they're talking 
about the bureaucrats (and secondarily clinicians) having access to 
all data about a patient, not about the *patient* having access.

Pardon my cynicism, but every involvement I have in the health care 
sector reinforces it.

Roger Clarke                                 http://www.rogerclarke.com/

Xamax Consultancy Pty Ltd      78 Sidaway St, Chapman ACT 2611 AUSTRALIA
                    Tel: +61 2 6288 1472, and 6288 6916
mailto:Roger.Clarke at xamax.com.au                http://www.xamax.com.au/

Visiting Professor in Info Science & Eng  Australian National University
Visiting Professor in the eCommerce Program      University of Hong Kong
Visiting Professor in the Cyberspace Law & Policy Centre      Uni of NSW

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