The Dutch government has been trying to get something like this for
years; parliament is asking every new minister why the promised heaven
has not yet arrived, only to hear that more consultants are needed. I
have been to hearings of our parliament and I can tell you such events
are extremely informative and make you loose any hope that something
good will come out of this soon; there are just too many stakeholders,
and no so-called "problem-owner"s except you. Simple questions asked,
for which there often is no answer is:
- who owns the information?
- are you allowed to change information which you own?
- should docters pay for the right to enter information in this
system, or be paid for the service they provide if they enter
information?
Instead of trying to change the world you may run a small wiki (I run
Twiki) server on your home machine where you just store the
information you collect, and enter your information while you are
having a consult through your iPhone! When you leave the room you ask
your docter whether what you have entered is a correct view of this
situation ;-}I think this will solve the major part of your problem,
and maybe it opens the eyes of the medical establishment.
Doaitse Swierstra
On 2 jun 2009, at 11:18, wren ng thornton wrote:
Tom Hawkins wrote:
At the core, the fundamental problem is not that complicated. It's
just storing and retrieving a person's various health events:
checkups, prescriptions, procedures, test results, etc. The main
technical challenges are database distribution and patient security.
Both are fun problems, and our friends at Galios continue to show how
effective Haskell is at building secure systems.
Any thoughts? Ideas?
Actually, it's a lot more complicated than that, albeit not for
"technical" reasons. There's a great deal of legislation about what
can and cannot be done with medical records: who can have access to
them, under what circumstances, how they can be transmitted, stored,
etc. This is more than just boilerplate code--- clinics can be
audited to prove proper handling and can loose their licenses or
worse for improper handling of records. Additionally, the requisite
formats do require a lot of boilerplate code since the protocols
were defined back in the paper age and medical legislation moves at
the speed of mountains.
I worked briefly on an open-source database project for managing a
medical clinic's records (so, not even for dealing with the public
in any way). The technical feat isn't that difficult, as you say,
but the human engineering involved can be quite complex--- and the
human programming will have major effects on the design, in order to
forbid invalid or unacceptable behavior. It's not a project to
undertake lightly or without corporate funding.
Medical record management is a market that has very low penetration
from the F/OSS movement, which in turn places a burden on smaller
clinics, so I'm all for anyone who's willing to invest in an open
solution :)
--
Live well,
~wren
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