[LINK] Open source health records

[Stephen Wilson]

G'Day Roger.

I certainly do pardon your cynicism -- it's well grounded. 

I think the constructive way forward is to establish common ground with 
regards to what everyone would agree are worthwhile, feasible outcomes 
of shared EHR, and then attempt to derive (and debate where necessary) 
proper privacy controls and policies. 

Seems that wherever one is paced on the privacy spectrum, everyone would 
likely agree that SEHRs would be valuable for better public health 
management, and for better communication between secondary/tertiary 
(hospitals) and primary carers (GPs).

Cheers,

Steve.



Roger Clarke wrote:
> 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.
>
>
>