-----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 David Forslund wrote: > I'm trying to understand what these reference view points have to do > with getting the data between organizations. > In a single care place, the data for the patient may have to come from > multiple locations to be available to build > a diagnosis. The MRI may be done at a facility 40 miles away, the Lab > test may be done across town, but all > of this needs to be available to a physician to make a diagnosis and > treatment plan, whether the patient is at the point > of care or not. To manage a continuity of care system (which doesn't > exist in the US), one must be able > to rather freely move information around. This doesn't happen if the > various systems can't or won't talk > to each other. The idea of a "virtual patient record" is to avoid > precisely the issue of information showing up > at a doctor's office which you no longer visit. In the US, it is very > hard to get a patient-centered view of the > treatment of a patient. The only examples I know of are where a > patient creates their own chart and carries > it with them between providers. Other than that, the patient never has > their medical record. It is scattered > amongst the various points of care that a patient has to deal with. It > is the movement of data from one care provider > to another (or the virtual movement) that requires multiple information > systems to communicate with each other. > > I don't think we are in any disagreement, just different viewpoints on > the same situation. > > Dave
Hi Dave, Your example is a very good. However, the practical point of view is that unless you can get people in the US (or anywhere else) to accept a universal health care ID number (politically and technically impossible) you will not be able to build a valid federated / virtual patient record. If you cannot guarantee that you have searched everywhere that patient the may have been seen then how can you have confidence in the validity of the data in front of you as a clinician? - From a pragmatic stand point the patient MUST be presented with a pain/pleasure relationship [ http://www.zaadz.com/quotes/view/36462 ] that encourages them to assign custody of their EHR to one location. All EMR summaries should feed into the EHR via a PUSH type transaction. The receiver should still be able to verify that the data is going into the correct patient record (EHR). As a patient I should be able to tell my podiatrist that my EHR is held at Dr. M.Q. Jones' office and my patient ID is XYZ098. My podiatrist could then send a summary of my visit to my GP. If my GP (or other downstream users) needed more details they could track back the summary to my podiatrist. This is very much the workflow that has worked (for the most part) for many years. The primary care provider is the consolidated record holder and that record can accept and store virtually any type of data (it's just a folder) even it if isn't 'computable' it can still be stored as a document etc. of course it would be helpful if everyone used a coded, computable standard format (let's pick openEHR version 1.1) but that isn't going to happen for a long long time. My 2 cents....... Tim Cook -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.4.3rc2 (MingW32) Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org iD8DBQFEI1AiMOzvb7luwR0RArXnAKCT8W+R+lBR3fFxi1NiHVXcABs7fgCggGAz hwHluEjH7ZzIr6wvK9WTZ54= =gwF/ -----END PGP SIGNATURE----- [Non-text portions of this message have been removed] Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
