[LINK] The "health" record security model

Karl Auer kauer at biplane.com.au
Sun Nov 11 22:24:30 AEDT 2018


On Sun, 2018-11-11 at 20:28 +1100, David wrote:
> On Sunday, 11 November 2018 18:12:05 AEDT Karl Auer wrote:
> > Regardless of all that, the first thing that must be discarded in
> > any design is the "emergency room scenario".
> I imagine the ED scenario is probably the one which is most
> justified.  If the patient record held nothing but current status
> regarding allergies, medications, & critical health conditions, and
> the medical practice holding the patients records, it would surely be
> useful. In any common scenario the patient or their agent will be
> perfectly able to interact with the medical staff.

I disagree. And this is why a statement of aims is needed :-)

The emergency room scenario is freighted with emotion, unstated
expectations, time criticality, life-and-death decisions at their most
extreme. It might be politically exciting to announce, but in practice
a new system will only add to the load on THE most adrenalin-pumped,
overworked, pressured and tired health professionals in the business.
And being new it will probably let them down. It is NOT a good
candidate for a first excursion into a workable health record :-)

And it implies that one goal of the system, in it's first iteration, is
support emergency room decisions. That's like building a new widget
with the goal of being able, from day one, to use it in Formula One
racecars. Ambitious, but pretty much doomed to failure if it's anything
more complicated than a decal.

More to the point it is not a broadly useful thing to support. The vast
majority of medical providers are not emergency room staff. The vast
majority of patients are not in emergency rooms.

I think there are probably better candidates, but we are seriously
jumping the gun. There are much higher-level aims that need to be
defined.

I reckon a good guiding light would be "to directly improve the health
outcomes of people receiving medical treatment in Australia". That
would shut out all the crap about law enforcement, the ATO, Centrelink
and commercial interests.

Complex systems need to be described in very simple terms at the top.

Regards, K.

-- 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Karl Auer (kauer at biplane.com.au)
http://www.biplane.com.au/kauer
http://twitter.com/kauer389

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