Tech Giants Push Open Standards for Health Network

securitas writes "The New York Times' Steve Lohr reports that 'Eight of the nation's largest technology companies, including I.B.M., Microsoft and Oracle, have agreed to embrace open, nonproprietary technology standards as the software building blocks for a national health information network.' Microsoft, IBM, Intel, Oracle, Accenture, Cisco, Hewlett-Packard and Computer Sciences have formed the Interoperability Consortium to build a health information network proposed by the Department of Health and Human Services (HHS). The network is the first step in moving from paper to electronic patient records and sharing health data between doctors, researchers, insurers and hospitals. Mirrors at IHT and CNet News.com with additional coverage at IDG/ComputerWorld Australia."

Comments

Control and privacy.

[Anonymous Coward]

Well we like technology. We like services that make life easier for us. Now how about the privacy, and control issues raised?

Microsoft - Open Standards - ???

[BigAlexK]

That's all great, but Microsoft seem from history to have a corporate psychological flaw whereby on the rare occasions they try to support open standards they cannot help themselves trying to manipulate and distort that standard to their own devious ends.

MS should truly be proud of themselves if they manage to avoid that this time.

Re:Microsoft - Open Standards - ???

[Anonymous Coward]

they try to support open standards they cannot help themselves trying to manipulate and distort that standard to their own devious ends. MS should truly be proud of themselves if they manage to avoid that this time.

Web standards - although they were (are?) a member of W3C and helped form and ratify standards, their browser does not fully support these standards, nor do they intend to upgrade it to do so. In addition, none of their web-sites are encoded to these standards (run the W3C validator on any of their web-pages; it is obviously more than Microsoft ever bothered to do!).

Java - Microsoft basically co-opted the Java language and capitalized on Sun's Java work to extend their dominance. They were eventually sued by Sun and Sun won. In a fit of pique, Microsoft stopped supporting Java at all and have since been promulgating their own Java replacement (.NET).

TCP/IP - Microsoft has consistently ignored recommendations in the original defining documents for TCP/IP protocols to make sure that their software appears to perform better than others. Their latest OS's co-opted Kerberos by defining some optional parts to make sure that it broke exisitng Kerberos implemetations and then resisted releasing any implementation details that would have allowed existing systems to fix it.

The only thing that Microsoft is truly proud of is their ability to play foul and get away with it! Their inclusion in this particular group just about guarantees that no standard will emerge except Microsoft's and that such a standard will only work well with Windows!

"Insurers"?

[CrystalFalcon]

The network is the first step in moving from paper to electronic patient records and sharing health data between doctors, researchers, insurers and hospitals.

This was completely mind-boggling to me, until I realized we're talking about the big ole US of A.

If a commercial enterprise that was supposed to be working in my interests got access to my medical data here in Europe, there'd be fucking hell to pay. Heads would roll.

Can't see why you keep putting up with it.

Re:"Insurers"?

[ScentCone]

Assuming, of course, that you have health insurance. Some 50 million Americans do not. Some 8 million of those are children.

There is not a single person, facing a serious medical situation, that cannot walk into a hospital get immediate treatment. That costs us all a fortune, of course, when it's used for more routine matters, but it's there. The original post refers to an undertaking that will hugely, hugely reduce the overhead costs in providing health care. That will help stem the rising tide of insurance costs, and will allow more employers back into the position of offering coverage as part of their compensation plans. If we can cut down on the billions of dollars that go into frivalous lawsuits and damages, we can go a long way to bringing the per-person costs of these services back into into line with what the average person can afford. As a doctor what his malpractice insurance costs, and why - and then you'll see where all that cash goes.

Re:"Insurers"?

[ScentCone]

Bullshit. Cite one reliable source for that

It was a July poll done by the German weekly Die Seit. The number was actually 30%, which is different than I recall, and perhaps the attitude has changed since July, now that Bin Laden has more overtly proclaimed his group's role in that. Not pulled out of my ass, though - CNN's talking heads spent half an hour rolling their eyes at this, of course, but there it was.

It's not amazing

[sczimme]

Amazingly enough, health care is probably 5-10 years behind in IT.

It's not amazing, really: healthcare as an industry is often both very very conservative and rather frugal. The combination results in an atmosphere of sticking with what works because a) well, it works and b) the new item(s) will cost money and might not work (see a)). It's actually not a bad viewpoint much of the time because it discourages upgrading for the sake of upgrading (i.e. with no clear and necessary benefit).

and why is this?

[ecalkin]

Medicine is behind because of the doctors. I have done computer work about 15-18 medical offices and the doctors seem to have a 'this shouldn't cost me any money' attitude towards technology. In a lot of (but not all) the offices, things were not updated/replaced until the gun of hippa was placed to their heads.
Apparently, the ability to get more accurate records, better customer satisfaction, faster data retrieval, etc, doesn't seem to matter. It's like a lot of the doctors take out as much money as they possibly can in their pockets *now*, and do very little reinvesting for the future.

Re:About time ...

[Rei]

Actually, malpractice is miniscule. For a percentage of doctors, it is a significant percentage of their income (not for all doctors; some have it much worse than others). However, "doctor salaries" are just a portion of total medical costs themselves (for example, have you ever seen how much an MR scanner costs simply to buy, let alone maintain?); you're looking, consequently, at a percentage of a percentage of a percentage of total costs being in malpractice. The net result? Malpractice costs amount to around 2% of total system costs.

Most of medical costs are in overhead, and what I described is precisely that: serious, bloated, unnecessary overhead.

Excellent idea, but the wrong process.

[Anonymous Coward]

I formerly worked in health care IT, and consulted to Microsoft last year as they were ramping up to this.

The whole time I worked with them, there were several prevailing concerns:

1) They focused completely on the technology and suffered from an understanding of the health care/health insurance domain.

2) They failed to understand the history of IT in the health care space. There were several times I was tempted to scream "its been done already."

3) Hospitals and insurance companies have invested millions in pharmacy systems, CIS systems, and other domain specific systems, yet Microsoft was convinced these companies would switch just because the technology was "better."

Health care desperately needs talented companies and people to assist with its IT needs, but software companies forcing solutions on them without understanding the domain does nothing to solve the problems.

Asking important questions about health records

[invincerator]

I've read all the posts on this topic but it seems like many important questions and comments haven't been made about the implications of having national health care records.

• Why would doctors and HMOs put money into a national system if it makes it easier for patients to jump to another provider? Maybe that's why it takes national leadership to make this happen.
• How would updates to your health record get disseminated to other hospitals and clinics? How often? You have to assume there will be multiple data stores, not just one central one. And, remember, bad data could kill you.
• Shouldn't patients be able to carry their records with them for emergency rooms or new doctors? What's the best way to carry that record because don't I already have to carry my health insurance card whereever I go?
• How do you authorize certain people to see your medical record but not others?
• In an emergency room situation, a portable record (on the patient) with drug allergies, current prescriptions and medical history could save your life. Isn't that worth it to make it part of the standard then? How does an unconscious patient grant authorization or does she have to? Can EMTs unlock an on-person record if needed?
• Exactly how does a national health record improve the quality of patient care, instead of just enriching or giving more control to third parties such as government and insurance? Is improved care the #1 goal of this initiative?
• Controls and standards aren't just needed at the data level (think database) to ensure security and privacy. Aren't they needed at the "view" level also? What if a doctor is on one terminal in a hospital and they walk to a different one? How fast should the view lock up? Should the first view of your record close if the doctor opens a second view of that record on a second terminal?
• How can we guarentee that patient records are made sufficiently anonymous when researchers are using records en masse for statistical analysis?
• Who gets the money for usage of the records for research ... or are they free?
• Should you get a royalty if your record is used as part of a study? Do you have a right to know which studies your record was used in?

I could go on but I won't. As you can see, this isn't just about data, like the HL7 standard. It's about a heckuva lot more.