[LINK] Open source health records

Stephen Wilson swilson at lockstep.com.au
Tue Apr 28 18:34:52 AEST 2009

Marghanita da Cruz wrote:
> Stephen Wilson wrote:
>> 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).
>> <snip>
> This is a gross oversimplification of parties with an interest in various
> snippets of health information ...

Yeah I get that, but I was *trying* to simplify things in a effort to 
create a common basis for privacy analysis.  Yes, a full blown EHR is a 
mega project, and the requirements are notoriously complex (looking at 
public hospitals alone, they're often said to be the most complex 
management systems known).  But if we're interested in analysing the 
privacy of EHRs, then I think we first need to establish a model EHR, 
and agree on a set of functions that we want to make happen.  Then we 
can turn to privacy, and maybe derive principles, policy settings, and 
controls.  But without an agreed core model, we'll keep going round and 
round arguing the toss over all those different facets ...

> *Not everyone has a private/personal GP
> *A big costs is Prescription Drugs (patient and prescriber misconduct)
> *Overservicing/multiple tests/while we are at it lets test for 
> everything (Roger
> has raised this)
> *Ambulance/First Aid
> *Super, Life Insurance, Actuarians ....
> I would be really curious to see the business
> case and governance framework you had in mind.
> Marghanita
The business case for most EHRs described to date is controversial, 
which is why I am keen get to a stripped back EHR model that we can all 
agree would be worthwhile.  Then we can set business case aside while we 
debate privacy. 

As far as governance model goes, phew, I'm glad that's not my world!



Stephen Wilson

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