Senate Bill Calls For Open Source Electronic Health Records 170
An anonymous reader optimistically writes that new legislation has been introduced in the Senate that would call for a nationwide adoption of electronic health records built on open source. The bill does not seek to supplant proprietary alternatives, but instead to either augment or offer a cost effective alternative. "'We need advancements in health information technology across the board to improve the quality of care Americans receive,' said Senator Rockefeller, Chairman of the Senate Finance Subcommittee on Health Care. 'To make this happen, we need universal access to affordable and interoperable health information technology — from small, rural health clinics to large, urban hospitals.'"
Hurray for Google Health! (Score:2, Insightful)
I remember not long ago reviewing the medical bills from my Dad's bout in the hospitals. There were charges for everything from phones to cable to aspirin to blood. Most people look and probably just shake their head then sign on the bottom line. I was overly curious and started to ask questions. The answers were all over the map. My favorite was the 700 dollars for blood. The billing person said that I wouldn't be charged for it if I agreed to donate blood that weekend. It took three tries on her part befo
Test it with the military first (Score:5, Insightful)
Re:Test it with the military first (Score:5, Interesting)
Dude, I hear where you're coming from but I just for the life of me can't believe anyone wants to trust their health history to the tender mercies of computers and the internet--the same entities that routinely reveal hundreds, sometimes thousands of people's IDs, credit card and bank info for days or weeks at a time to passing thieves.
And can you imagine what it will be like to correct inaccuracies??? We've all been to that movie with banks, utilities, etc. and it's a total nightmare. Imagine if your medical treatment rested upon timely resolution of computer errors. Good luck with that.
I am a survivor of serious medical malpractice. I can assure you doctors lie--and lie very convincingly--to protect one another's butts, not just on the witness stand but on medical records that follow you for the rest of your life.
I am deadset against computerized medical records. My information has been computerized against my will and without my permission and is shared, again against my will and without my permission, with every doctor and their office staff in the vast network owned by our local hospital. In this day of HIPPA I, ironically, have no privacy anymore about what I choose to share with my doctor--it's shared for me, the wheat and chaff alike. I start out any relationship with medical personnel behind the eight ball--all without my permission or control.
I no longer tell my doctor anything except the bare necessity of what he needs to know to treat my current ailment. My doctor is nothing but a conduit for information to my insurer, whose only desire is to deny me care, and the hospital network which nearly killed me and then smeared me with lies. My doc is a very nice person but I can no longer trust him, thanks to computerized records over which I have no control. I avoid medical care whenever possible because I value my privacy. At any rate, my medical care is now hopelessly compromised by the inaccuracies on my records.
=Smidge=
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Would it help if you could choose what is shared and what is not?
I like the idea of making sure my doctor knows everything about me he can when making a diagnosis. I believe most of them are competent and not acting out of greed. If I get screwed by one, as you have, censoring out the idiot would be nice.
But looking at how many blood tests I have had over the years in physicals, and how many other things have built up in 3x years, I think there's a body of evidence a doctor could use. I also want them to kn
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"Would it help if you could choose what is shared and what is not?"
As someone who has not experienced malpractice but spent a lot of time with doctors-HELL NO.
I wan't my medical records HARD to get. I can't think of a situation where rapid access to your records would be needed. Not to say that there might not be certain situations.
But do you really think the ER is going to look up your name (if they have it), find your record and spend the time looking at it before they treat you? And heaven forbid if t
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But do you really think the ER is going to look up your name (if they have it), find your record and spend the time looking at it before they treat you? And heaven forbid if the file is the wrong one or their is some important inaccurate information (and there always is).
I do. I always look up a patient's medical record when I admit a patient. Why? Because, almost invariably, when I ask the patient a question about their medical history, they will either forget to mention something or will just tell me to "look in the damn chart." It also helps me to formulate a battery of questions to ask when I end up seeing the patient.
Does that mean that the medical record is accurate? No, of course not. And that's why I always ask the questions to confirm. Usually I'll say something
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Maybe some people have seen that providers using EHR rather than hardcopy records have been shown to reduce the instances of fatal medical errors, and prefer the (AFAICT, pur
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There is no black market for your medical history. Nobody gives a crap.
I am confident my healthcare will be better if, no matter which hospital or ER I go to, my doctor can have immediate access to test results, X-rays, and other useful information. I don't carry that information with me when I travel, and I sometimes get sick when I travel... this will save lives.
Your little rant about the fact that doctors make mistakes is entirely unrelated to this. With paper or digital records, they will still make mis
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From a privacy perspective, I can understand - but only to a point. It seems hubris to me when someone presumes to decide what information their doctors "need" access to in order to provide the best treatment for them.
In principle, you could say that it's your righ
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> What if the information you wanted withheld was critical, but you simply don't have the background or knowledge to know that it's critical?
If there is missing information that is critical then any responsible doctor should be capable of recognizing that - they will be in the same position as any doctor with no information and should ask questions and order fresh tests. You're right that this may cause delay and perhaps result in some slight increase in risk. However it also gives patients the chanc
I want the records public. (Score:2)
Doctors may sometimes lie, but random people lie very often. What do you think your date will say if you ask about diseases or hidden health problems?
I'll gladly give up my health info to the world in exchange for getting the same info about other people. Dangerous hazards, like sick people, need warnings.
This is more important than listing where sex offenders live. This is more important that listing where asbestos has been dumped. If I catch drug-resistant tuberculosis and HIV from you, I'm going to die r
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Actually, Smidge is a medical doctor.
Doctors can't treat themselves, you know.
Re:Test it with the military first (Score:5, Informative)
The VA was and other federal agencies already were the "test". From TFA: The Health Information Technology Public Utility Act of 2009 will build upon the successful use of "open source" electronic health records by the Department of Veterans Affairs as well as the "open source exchange model," which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative.
Re:Test it with the military first (Score:5, Interesting)
Nothing in the summary provided in TFA of this bill suggests it does anything to increase healthcare providesr access to "anyone and everyone's" records. What it does to is provide funding to cover provider costs of converting to use electronic (as opposed to paper) records systems, and seeks to make those systems interoperable with eachother and with billing systems, so that in the circumstances where information sharing is allowed (and, often, necessary) it now can be acheived at lower long-term costs and with greater accuracy. And, perhaps as importantly, even when sharing between providers isn't the issue, the accuracy and completeness of the records readily at hand to physicians during the course of treatment within, say, a single hospital will be improved, preventing avoidable errors.
Insurers, rather than providers, tend to be the ones that do that.
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I'll believe it when I see it. Until we actually see Medicare requiring that all patient records be stored in a standardized, patent-free, open interchange format, we're going to have the same mess we do now, only in a few years, some of those messes will be open source messes.
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No, when you have an open source app used by some hospitals, it will be trivial for closed source companies to reverse engineer the open formats, but also trivial for them to write apps that import data from that format but don't support exporting data... just like proprietary app vendors have done with dozens of other open standards in the past. Without laws that require hospitals to use software that provides both import and export support for open standards, we aren't really any better off than we are n
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"...it now can be acheived at lower long-term costs and with greater accuracy."
Are you kidding? The electronic records will suck as bad as the paper ones. Probably worse considering the input to create the record, the time to input the data, and the limitations of any format.
I believe it would increase errors because "everyone trusts data"...
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Hence the benefit.
You thought it was to benefit the patients?
You realize this is a for-profit industry and government, right?
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Your records already do follow you.
You will still have to repeat tests, as no one wants to be liable for someone else's mistake ("they did the test wrong, and you should have caught it, now my dick fell off").
If you have serious issues that would necessitate specific treatment, or that would counterindicate standard treatment for trauma or other emergencies, then wear a MedicAlert bracelet.
It's a hell of a lot more accessible and reliable than any digital record ever will be. It works when the network's do
I don't see this happening any time soon (Score:2, Insightful)
If you force open source, you'll quickly bring to the forefront every security issue in the code, which will be a HIPAA nightmare.
Moreover, I don't think the industry is ready to give up all its little proprietary secrets. A lot of places are reluctant even to give out the documentation on their database schemas, let alone any serious amount of source code.
Open interchange of information, on the other hand, is a big necessity and has been happening for a long time now.
Re:I don't see this happening any time soon (Score:5, Informative)
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If you don't mind me asking, which package are those companies using? It sounds like it's the same as mine. If not, I'd be inclined to believe most claims processing software is garbage. Ours certainly is, even though it's known for being the best available.
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It's all MUMPS / M / Cache underneath. MUMPS [thedailywtf.com] is old - the programming language is the OS is the database:
To give you an idea of what MUMPS is all about, following is an abbreviated list of features pulled straight from the MUMPS FAQ:
CASE SENSITIVITY: Commands and intrinsic functions are case-insensitive. Variable names and labels are case-sensitive.
COMMANDS: may be abbreviated to one letter, case-insensitive. Includes commands such as IF, ELSE, GOTO, WRITE, and XECUTE [which is my personal favorite, it allows arbitrary execution of code contained in a variable]
OPERATORS: No precedence, executed left to right, parenthesize as desired. 2+3*10 yields 50.
DATA TYPES: one universal datatype, interpreted/converted to string, integer, or floating-point number as context requires.
DECLARATIONS: NONE. Everything dynamically created on first reference.
LINES: important syntactic entities. Multiple statements per line are idiomatic. Scope of IF and FOR is "remainder of current line."
LOCAL ARRAYS: created dynamically, any number of subscripts, subscripts can be strings or integers. Stored in process space and expire when process terminates.
GLOBAL ARRAYS: arrays that start with a caret symbol. Stored on disk, available to all processes, persist when process terminates. This is M's main "database" mechanism.
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There are different vendors and layers on top, but it's all the same underneath. VistA [vistapedia.net], the VA system is the underlying MUMPS open-source system that has been forked into many versions around he world
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Wow, I wouldn't have though there were so many languages that way. The system we use was written in a similar language:
http://en.wikipedia.org/wiki/PL/B [wikipedia.org]
I know there are several dialects of BASIC out there, with database extensions, too, but they all (like Databus) use ISAM files.
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It's really not a long article... you could have spent a couple minutes reading it and finding out that this is only providing for Open Source *alternatives* to conventional proprietary EHR systems. Most importantly, it's providing funding to safety-net clinics who want to implement open source EHRs; most of the existing funding for EHR implementation available to safety-net clinics practically requires them to choose a solution that is CCHIT certified, and you *know* that costs $$$. Not even VistA (the p
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If you force open source, you'll quickly bring to the forefront every security issue in the code, which will be a HIPAA nightmare.
PSSSST. The "P" in HIPAA stands for "Portability", not "Protection" or "Private"
-Rick
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Yeah, so they just have to record when they sell or lose your medical records, or if they are stolen.
-Rick
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If you force open source, you'll quickly bring to the forefront every security issue in the code
You say that like it's a bad thing...why would that be a bad thing? What sort of "HIPAA nightmare" would it be...a nightmare for health care administrators? Hell, that's their JOB they shouldn't whine about it. The whole of corporate America had Sarbanes Oxley foisted upon them and were told to "suck it up". If public companies must scrutinise their operations with a fine-toothed comb I'd expect no less from the medical system.
Medical information management systems perform a vital role involving sensiti
Good place to start (Score:5, Informative)
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I work for a company who's EMR software was started as exactly that: an image archiving program. It then added procedure records, report printing, patient demographics, and eventually billing and statistics. I'm trying to convince the boss right now to release the early versions of the image archiving program under a commercial-friendly open source license, so that we might be able to take advantage of some of this government hype.
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Depending on the intended use of the image there are several standards out there for capturing, transmitting, and archiving imaging data. If you have some free time you might want to try looking up DICOM (Digital Imaging and Communications in Medicine). DICOM images are typically stored in a PACS (Picture Archiving/Communication System).
Alternatively, if you are talking about building up an electronic health record, you could create a CDA (Clinical Document Architecture) document for the encounter with the
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And for what it's worth, there are already plenty of open source medical imagi
A person should own their health record (Score:5, Insightful)
The information should legally belong to the patient, and health care providers and government should be required to create a system whereby the health records follow the person for life, regardless of jurisdiction or health care provider.
So the records would live in an independent information infrastructure, not owned by any particular health care provider.
And of course open standards would be needed to ensure interoperability of info systems that dealt with the records.
Re:A person should own their health record (Score:5, Interesting)
If it really belongs to the patient, the patient should be able to tell others to purge his records, so it will not follow him for life if he so chooses.
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A patient's medical history may be about the patient, but it is the doctor's tool. It allows the doctor pass information to future doctors who care for the patient. Some of the stuff in the record may not be flattering to the patient, but it's there to protect the doctors from making avoidable mistakes forseen by previous care givers and to create a context for diagnosis and treatment. Allowing the patient to "edit" their medical history would be a huge mistake.
Seriously, how could a patient be better serve
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Seriously, how could a patient be better served by giving their insurance company a censored view of their medical history?
Fixed.
-Rick
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Do you seriously believe that doctors take the time to actually READ the records? They already complain about the time that record keeping takes.
If they did then I wouldn't have to repeat the same information to ever nurse and doctor that I see in the same office, much less after I am referred to another doctor.
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It doesn't belong to the patient. You can ask the Doctor/clinic to correct mistakes, but the Doctor actually owns the IP of your medical records.
notes regarding bad patients (Score:2)
The patient...
stole narcotics and syringes from our office
bounced a check
tried to rape our receptionist
is psychotic; he misreports many symptoms
fails to take his medication
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The information should legally belong to the patient...
Well, the way it is set up in the USA, it will either take making medical records being exempt from most IP law, or big changes in IP law to get to the point you are wanting.
Basically, you 'own' the 'facts' in your medical records, but the records themselves are the Doctor's IP. It's difficult to explain in a way that actually sounds rational or reasonable.
For example: *note: I am not an M.D., but work with me here!*
Let's say I am a M.D.(general practitioner), and you come to me with a rash. I(or more likel
Why open Source not open Standard? (Score:5, Insightful)
I don't see why it matters who implements someone's electronic health records (open source, Joe's Software Shack, Bill's Multi-National Software Emporium, etc.)
But what the Government should work on (and it's their job to do so) is making sure there is a single open standard format for the records, so that they can be used and transfered between providers with different systems. Otherwise electronic documents can easily end up worse than paper.
Re:Why open Source not open Standard? (Score:4, Funny)
But what the Government should work on (and it's their job to do so) is making sure there is a single open standard format for the records, so that they can be used and transfered between providers with different systems. Otherwise electronic documents can easily end up worse than paper.
Agreed. Definitely a job for ISO!
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In Ontario, the government has done this. All EMR software that is certified (and clinics therefore are eligible for government subsidies when they buy it) must import/export patient data using a very detailed XML schema.
In theory, at least, a doctor could export from one software package and import that XML file into a new package. EMR packages can store additional data, which can be exported in generic sections of the XML, but all standard data should be simple to transfer.
Oh yes, and doctors/clinics get
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The standards for the data already exist. HITSP [hitsp.org] However adoption of the standard is optional, and healthcare IT is very very slow to update technologies. Most system to system healthcare messaging is currently done in HL7 V2.x which is a pipe-delimited text format and while new XML based standards exist, adoption of them has been slow and spotty, at best.
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I don't see why it matters who implements someone's electronic health records (open source, Joe's Software Shack, Bill's Multi-National Software Emporium, etc.)
Because you're talking about highly sensitive data, and it's reasonable to know just what is happening with it. A doctor's office can't just hire Joe's Software Shack to whip them up an EHR; they need certain guarantees that the data is secure (HIPAA final security rule). To this end, there's a certification program... but of course, it's quite pricey to get certification, so only the folks making lots of money off of proprietary systems have done so.
Health care is expensive in this country. We all know
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The problem is not a lack of standards, the problem is getting providers to actually use the standards that are there right now.
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The last time I had access to a full specification was when I was working for a company that was a member of the HL7 working group a few years back. It really shouldn't be as difficult as it was (still is?) to get a full spec.
Doomed to fail... (Score:2, Funny)
Re:Doomed to fail... (Score:5, Funny)
as Microsoft just announced Doctor's Office 2009.
Yeah, but it won't be released until the second half of 2010.
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Yeah, but it won't be released until the second half of 2010.
And it won't actually be usable until SP1.
(Duck and run.)
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Yahoooey!
I've pre-ordered it already 'cause I heard it was built using the Railroad Tycoon game engine and Leisure Suit Larry code!
Now I can not only bill like a Doctor, but can play 'Doctor' while I do it!
Health IT Federal Advisory Boards (Score:2)
Dodging the bullet (Score:3, Interesting)
Your medical records should be PRIVATE.
Even if they now store your data in 'free software' it still means you are now less free.
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Your medical records should be PRIVATE.
Even if they now store your data in 'free software' it still means you are now less free.
As opposed to how "free" you are when someone making $8/hour has to run your entire, plain-text paper chart to and from the front office, nurse's station, doctor's office, and file it back in the medical records room?
Yes, your record should be private. It's far, far easier to control access to an electronic chart than a paper one.
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Yes, your record should be private. It's far, far easier to control access to an electronic chart than a paper one.
Agreed.
What I don't get is why do we need the Senate to pass a law for something private hospitals can perfectly do on their own, if it is as economical as you argue.
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Its economical in the long-term and reduces errors. However, there can be a very high initial cost, and the "safety net" providers which this bill targets (which may provide services largely, or even exclusively, under public programs which often limit reimbursement to the lower of actual costs, standard rates, and charges to third parties) don't tend
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It's far, far easier to control access to an electronic chart than a paper one.
umm... no?
"private" records kill people (Score:2)
Nobody dares to ask a potential boyfriend/girlfriend/spouse to provide all health records. It's not romantic.
Even if you did ask, you couldn't know if you got all the records.
Ommisions mean you get incurable and/or fatal diseases. Assuming you don't just die, you are less able to find somebody else without lying about your new disease.
Omissions mean that, one fine day after you've started a family, you discover that your spouse was hiding a genetic heart condition that will kill most of your kids (and spous
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I would hope for public access to non-personal details...
Long, uphill fight to get there. Frankly, I don't see it happening anytime soon.
I agree with you, and your noble sounding reasons, It will be a huge IP mess. (Intellectual/Imaginary Property-not playing sides here)
The hard part is going to be tracking changes for use in malpractice cases.
While difficult, I don't see that as the 'hard' part. See above.
Medical Records in the USA are currently a can of IP worms.
Quick, easy example:
Assume I am a M.D. with my own 'office' and practice. If I retire/move on, and decide to sell my 'practice', your medical records are part of my IP I inclu
Why I don't want this (Score:3, Insightful)
If we end up with an "open source" medical record, and a central, unified medical history becomes available to every doctor that treats me, then they are going to know things I do not want them to know.
For instance, I have a history of amphetamine abuse. I'm past it, I beat it, I'm feeling much better now, thank you.
I do not want a doctor refusing to give me a drug to help me focus because he's afraid I'll relapse. Or not giving a weight loss drug for the same reason.
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This is not about a "central, unified me
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We're moving towards government provided health care. You won't get to decide what treatments you are eligible for anymore... At least not unless you're paying cash.
Re:Why I don't want this (Score:5, Interesting)
"You won't get to decide what treatments you are eligible for"
And this differs from the current private insurance system in what way?
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I'm not sure how this is 'interesting' or 'insightful'. You can currently choose whichever insurer you want, and you can choose based on what they cover. You can also purchase supplemental insurance if, for some reason, you feel you're trapped into a particular plan by your employer.
The only thing you can't do is pick after you already need the treatment... But then if you could do that it wouldn't be 'insurance', now would it?
If you can't afford anything at all right now, I don't know how you think you're
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Agreed, but why deny treatment when you can just block the treatment from being approved in the first place? (Provenge)
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"If you can't afford anything at all right now, I don't know how you think you're suddenly going to be able to afford it when the government is taking your money to pay for it for you..."
Of course the devil is in the details but why do you assume that the everyone will be paying the same?
"So it differs from the current system, where you're insured to the level you're comfortable with. Instead you'll have a system where decisions about your health are made in context of the general population rather than in
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Which is, really, exactly the case now with "insurance company provided healthcare" -- you and your doctor don't decide what treatments you are eligible for unless you are paying cash now.
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If you don't like what your insurance company deems you eligible for, you can switch to another plan, or another provider. Even if you're in a situation where you can't, the competition pressures insurance companies to be more open to covering things.
Also, private insurers may have a profit motive for deciding what to cover, but typically no political motive...
Most importantly, and staying in the context of this discussion, you can decide to withhold your medical history from a doctor to get a fresh opinion
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For instance, I have a history of amphetamine abuse. I'm past it, I beat it, I'm feeling much better now, thank you.
And nobody should cast judgment on you pertaining to employment prospects, credit worthiness, medical insurance, how "decent" of a person you are or whatever. Kudos on getting past it--I know people who still battle with that addiction.
That said, strictly speaking from a medical delivery perspective, that such information, as "embarrassing" as it appears to be, could indeed be medically relevant. Seeing as the decisions made by medical professionals can have life-and-death consequences, wouldn't it be bes
a day and a fee? for electronic records??? (Score:2)
Patients should be able to have full access to all records pertaining to them on demand from any medical facility in a timely fashion (in an electronic system, within 1 business day would be charitable), and at no more cost than a nominal administration fee
That's offensive. Better: all records should be on the web within 8 hours of creation. Some *.gov website would do nicely, especially since I might forget the name of my old doctor or he might go out of business. I don't want to search 666 different places for my records!
Make it public and permanent, possibly with portions hidden by court order. Let me add a rebuttal whenever I wish.
Current State of Medical Records (Score:5, Interesting)
Jay Rockefeller sucks. (Score:2)
He's all good with advocating that everyone else can live with his crap while he can sit back and cash in on his great grandfather's robber baron stock. Yeap, stand up guy. I can't wait till he's out of office.
Free data format is far more important (Score:2, Insightful)
Having a standardized, non-proprietary, free data format is much more important than "open source."
However, there's more to medical records program than a data format. You also need your code to be audited and easily auditable. Open source gets this free. "Free to see but not to use in a production environment" licenses also achieve this goal.
massive under taking for an open source project (Score:2)
Contact Your Senator! (Score:3, Interesting)
This is one of the key things me and my local linux user group recommended.
http://www.healthreform.gov/communityreports/new_jersey/new_jersey_08002.html [healthreform.gov]
Contact Your Senator and show your support!
http://www.senate.gov/general/contact_information/senators_cfm.cfm [senate.gov]
Our summary was:
* create/maintain/update a fully free and open source electronic health record system
* mandate their electronic health record system to be taught in medical and nursing schools
* mandate an open and freely implementable patient record communication standard
* mandate a national medical identification number and prohibit the use of and storage of Social Security Numbers in any health care system
Call for Standards, not Open Source (Score:3, Insightful)
Poor understanding of IT jargon by a politician's office...what a shock...
Interoperability First, Open Source Afterward... (Score:2)
Speaking as a CS postdoc working on a National Library Training fellowship, I have to stay the best bet is to start small and start fresh. There is a ton of praise about VistA, the VA system, but it is built on old storage technology and may not support the kind of analytics needed for quality improvement. Also, there is a lot of information captured in notes, which is free text and not really helpful in terms of decision support and continuity of care.
I think a good place to start would be a couple of thin
Why electronic? (Score:3, Insightful)
I don't understand all these buzz about electronic health records. The roots of health care crisis are that doctors charge you $500 for seeing you for 2 minute w/o doing anything else and hospital charges thousands for lying on their bed for one night of "observation." Those are probably caused by lack of doctors and hospitals as well as, over zealots about quality and ridiculous malpractice insurance costs due to ridiculous high malpractice claims.
It does not seem to be caused by the need to pull out your chart by a $20/hour assistant.
It just seems like marketing gimmick trying to treat a non-existent cause. Can the patients just take their charts around like patients in many places of world are doing?
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Yes. If this were the nineteenth century, a patient could just take their charts around to different doctors by hand in a manila folder.
Firstly, I think we are running out of "manila" :-)
More importantly, there is currently an inherent excuse for lousy misinformed care by the "team" of doctors that maintains a person. I didn't get the memo. It was in a manila folder somewhere and it didn't get to me.
In the future, an obvious mistake made by a physician that could have been easily avoided by a quick scan or
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First, 90% of patients don't need a team of doctors working together. Usually, one doctor just needs to know what other doctors have you seen recently and what illness do you have. That can be described by the patient briefly, as it is working in the rest of the world now. Again the patients (or the parents) need to learn about their illness and tell the doctor. This society is overdependent on somebody taking care of you, whereas in the rest of the world, you are expected to take care of yourself as much a
Existing open source PCHR (Score:2)
Can't believe nobody has mentioned Indivo yet. http://indivohealth.org/ [indivohealth.org]
"Indivo is the original personally controlled health record (PCHR) system. A PCHR enables an individual to own and manage a complete, secure, digital copy of her health and wellness information. Indivo integrates health information across sites of care and over time. Indivo is free and open-source, uses open, unencumbered standards, and is actively deployed in diverse settings, in particular our own Children's Hospital Boston and the Dos
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That's because this is entirely about EHR systems, not PHR systems.
Finally, funding for non-proprietary solutions (Score:3, Informative)
I'm irrationally excited about this proposed legislation. I work for a safety-net clinic, and we basically have a mandate to get onto an electronic system by 2012 or our reimbursement levels go down. Unfortunately, the funding currently available all but requires CCHIT-certified solutions... which are all expensive proprietary works, built to run on Windows servers, yadda yadda. Color me unreassured by their promises of safety.
I just hope they make the funding available in time for us to be able to choose an open source solution. This is so very needed.
Would GPL code be allowed under this bill? (Score:2)
The text of the bill does not yet seem to be visible, but the Rockefeller press release suggests that open source means code that does not limit use or distribution. One could argue that GPL2/3 imposes material limitations on use and distribution and thus would not qualify under the bill.
The GPL's position under the bill may not be helped by the use of the words "free" rather than "open source" by many deep in the GPL community.
Re: (Score:2, Funny)
This whole thing reminds me of this absolutely classic Dilbert...
http://tijil.org/gallery/v/dilbert-eunuch-c.jpg.html [tijil.org]
/. Mods: Flashing Blue Lite Secial! only at +3 (Score:2)
Yes, you do understand the confusion here. Or at least recognize that everyone is not using the same script/page here!
Perfect timing, right on target, and yes, the linked comic is funny!
Well done, and thanks for the laugh!
*crosses legs, and nervously looks around for a chainsaw wielding nurse*
Re: (Score:3, Informative)
Yes, it could be. This bill provides funds for certain providers that would cover the cost of implementing and maintain EHR systems using open source software for up to five years, with a potential for another 5 year renewal.
The idea is to (1) assure that the providers can afford the cost of implementing EHR by putting up federal funds, and (2) simultaneous
Re: (Score:2)
This bill provides funds for certain providers that would cover the cost of implementing and maintain EHR systems using open source software for up to five years, with a potential for another 5 year renewal.
The idea is to (1) assure that the providers can afford the cost of implementing EHR by putting up federal funds, and (2) simultaneously to get the maximum public benefit for the buck by only providing those subsidies where the iplementation is done using OSS, and providing support for interoperability workgroups, and doing a number of other things to promote standards.
Well, almost. There is quite a bit of funding available for (safety-net) clinics to implement EHRs. Unfortunately, it all has strings attached that make it virtually impossible to implement an non-proprietary solution. This legislation seeks to address that imbalance (for very good reasons as you've stated).
Re: (Score:2)
Re: (Score:3, Insightful)
Isn't an EHR just a file format? That goes for both the files and the interfaces.
No, it's not. An EHR (a good one) is an intricate interface to a complex database containing text, statistics, images, and receiving data from a variety of systems including labs, pharmacies, and imaging systems. EHRs contain a lot of built-in structures for the data they contain, for auto-coding, decision support, drug-drug interaction, etc.
Then there's the whole user access/permissions/security component, too... you need to make as sure as possible that only the people with a need to see the information
RTFA (Score:5, Informative)
Why not RTFA?
FTFA: The Health Information Technology Public Utility Act of 2009 will build upon the successful use of "open source" electronic health records by the Department of Veterans Affairs as well as the "open source exchange model," which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative.
Re: (Score:2)
2. The technology that VistA was developed on is *very* antiquated, and makes most developers cringe. In fact, it's nearly impossible to find MUMPS programmers anymore, and the entire project is stagnating horribly. The computer industry has simply moved on. There are 100
Re: (Score:3, Informative)
This bill doesn't, from the summary, mandate anyone to have anything "open" to anyone else. It only provides funding to purchase open source EHR systems, but you'd think on Slashdot, of all places, people would readily distinguish between an "open source" electronic health records system and "open" health records.
Re: (Score:2)
No, I'd figure on /. I'd get arguments about health records just being more information that wants to be free.
Re: (Score:2)
I've got two dollars that says you didn't RTFA, since you're talking about something entirely different.
This bill will put forth funding for the implementation of OSS EHR systems in medical clinics, particularly safety-net clinics that can't currently get funding for non-CCHIT (i.e. non-proprietary) systems. It doesn't open anyone's record, or require anyone to use Open Source; it just requires the gov't to put some money toward building out OSS solutions.