On 25 Nov 2002, Heitzso wrote: ... > Our branch needs to query and report against distributed data sources,
Heitzso, There have been many attempts to solve this problem. Depending on your relationship with the data source sites and what you need from them, different solutions come to mind. > My fantasy is that the same is applicable down to the health provider > in that health provider records [appropriately scrubbed or > confidentiality filtered] are where you will see an outbreak first. Most(all?) existing open-source health systems can do this. David Forslund's OpenEMed (or a closely related component), if I recall correctly, have already been deployed by the government (CDC?) in a network of emergency rooms for exactly this application. Of course, the OIO system can probably do it a little easier :-). Also, the "automatic anonymization" feature is part of the OIO system's design. > So health provider records become a primary data source that may be > combined upstream into geo/regional data stores, that are then > queriable as a federated system. I _assume_ such a system would be > applicable to a health provider in that information needed to aid a > patient might be obtained from such a data source. What you describe is technologically quite easy. The politics may be quite hard, however. > As an odd example, my mother (real life) contracted Guillain Barre > Syndrome from a flu shot recently and just got out of the hospital > (she's able to walk, but barely). Yesterday I heard of another GB > case from this year's flu shots. But when my mother first went to > an emergency room she was turned away. It wasn't until she lost the > ability to walk that she was correctly diagnosed and treatment started. I hope she is doing better now? > I wonder whether access to large federated data stores of recent > symtoms and diagnosis would have caught her GB on the first ER visit? This is hard to achieve. If the decision support computer is better than the doctor, it makes sense to let the computer make decisions (e.g. order some tests). On the other hand, if we are not convinced that the computer is better (than the doctor) - and force the doctor make the final decision, the machine can still end up making decisions (e.g. EKG machine with automatic analysis). Best regards, Andrew --- Andrew P. Ho, M.D. OIO: Open Infrastructure for Outcomes www.TxOutcome.Org
