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12.07.2008:... Challenges to improving health care information systems...

They may not be what you expected...

The last time I went to an emergency clinic, I was impressed by the fact that, rather than sit and tell my life story to the nurse or doctor, I could sit at a terminal and type all of that information into their system without wasting any of their time. Sounded good to me.

And then the Nurse Practitioner asked me all of the same questions before offering me treatment. So much for "modern technology."

When I hear officials talk about improvements to US' health care, and modernization of information systems and sharing data between organizations so that this kind of "type it again, Sam" scenario doesn't have to be repeated multiple times by or for every patient, I find myself pessimistic.

Here's why: every medical organization, from the mom-'n-pops to the conglomerate-sized providers, has a database and information system that they've either implemented on their own or bought from some software/hardware vendor and then tweaked it to their "personal" needs.

And they've fallen in love with what they've done, just as virtually all programmers fall in love with their programs and user interfaces.

It's really hard to tell them "that field needs to be changed to a different size and linked to this other field which you haven't even implemented" so that all of the health services organizations can get access when needed!

They'll hate you for that.

So, I'm wondering... as part of all of the wonderful health care plans, do you have anyone working on how standards will be created and promulgated throughout the entire industry so that all of my medical records can be quickly updated and made available to any organization or company I choose to work with on my health?

Will you need a "medical data-sharing czar" to make companies come into compliance with "standards"? Who will set or debate or agree on the standards, let alone make sure they're implemented in such a way that nobody ever has to complain, "sorry, we don't have that information... please fill in this form"? What security measures will be provided so that no identity theft can happen using the data?

Interesting problem, eh? Looking forward to hearing it addressed...