Tuesday, April 28, 2009

Electronic Medical Records Horror Story

The writer, an asthma patient, describes a near death experience in hospital. All the doctors and nurses were too busy working with a clunky computer system to treat him. The asthma nearly killed him.
The writer works in IT and he talks about data models and message models and other technical stuff. In simpler words, this is an example of the don't know squared problem. The medical people don't know, that they don't know what they need. It's a typical situation. The customer wants "it" computerized but that's as far as his thinking goes. The vendors do their best and present the customer with a vast written specification, 100's of pages, which only makes sense to the vendor who wrote it. "My eyes glaze over" (MEGO) . Eventually the spec is signed, so the job can proceed, even though the customer still doesn't understand it. If the resulting system isn't too too bad, it goes into service.
I had thought that the medical business would have come up with a workable system by now. Manufacturing has SAP, Engineering has Orcad, administrators have Office. Each system has been in use for 10 years or more and is basically satisfactory. Sounds like the medics are not there yet.
And this story doesn't get into security issues. An electronic medical record system based on Windows computers hooked to the public internet will be totally vulnerable to high school hackers. Your medical records will be "accessed" by anyone who cares; employers, insurers, private investigators, the ex-wife, bill collectors, cops, lawyers, parents, children and god knows who else.
Neither did the author talk about portability issue. For the system to be worth much, records entered by your doctor, at his office, should readable at the hospital should you later get hospitalized. Or at the next hospital after you move. Without the fiercest sort of federal supervision, competing vendor's systems will be unable to read records created or edited on other systems.

2 comments:

Unknown said...

Thanks for shearing The story, I think its great and helpful presentation I like your good service.I always appreciate your post.I’m really amazed with your posting skills as well as with the layout on your blog site.
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Dstarr said...

Alex, Thank you for the kind words.