[LINK] Open source health records

Jan Whitaker jwhit at melbpc.org.au
Tue Apr 28 21:03:14 AEST 2009

At 01:07 PM 28/04/2009, 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.

Google Nehta. There is lots of info there. It's been going on for the 
last 2-3 years. and it's still not finished. and don't get me started 
on the millions already spent.

And if you want to know when a lot of this started, check back in the 
late 1990s. I worked on a project in Southern Health [was Southeast 
Health then] in Victoria to do info transfer through an integrated 
care model. It NEVER worked for a whole lot of reasons. There was a 
report on the web about that one somewhere.

Here's a book chapter for you:
Iacovina, L., Mendelson, Danuta and Paterson, M. 2006, Privacy 
issues, health connect and beyond, in Disputes and dilemmas in health 
law, Federation Press, Annandale, N.S.W., pp.604-621.

As Bernard said, this stuff isn't new, but it's so damn hard, no one 
has accomplished it yet in all its 'glory'. In fact, every discussion 
I have about it exposes more about the range of meanings in any 
individual's mind about what it even *is*. If you know the fable 
about the blind men and the elephant, you'll get the idea.

And as for open source, I'm not sure that's such a wise idea. I want 
the tightest security system possible.

As to how to proceed to solve the difficulties [Steve Wilson's 
question], probably in modules. Create the most beneficial projects 
first. Show that the 'system' can be trusted. Show that the patient 
and their families are respected in the process. Keep the bloody 
public research interests out of it until the primary purpose issues 
are solved. Frankly, if that one thing happened, there could be much 
quicker progress, but they keep wanting population data way beyond 
what is necessary. Governance is critical to all of this.

Nehta is focusing on standards. Heck, just getting vocabulary 
consistent would help. They're getting there. They are also working 
on messaging standards.

Good luck!
[who has been on panel after panel and meeting after meeting on this stuff]

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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