Senate Bill Calls For Open Source Electronic Health Records

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.'"

Comments

Test it with the military first

[HasselhoffThePaladin]

They should implement this in the military first as a test. It's always the biggest pain in the ass to hand-carry your medical and dental records when you undergo a permanent change of station. Of course, paper backups would be a great idea in the initial stages.

Re:Test it with the military first

[Smidge207]

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=

Re:Test it with the military first

[DragonWriter]

They should implement this in the military first as a test.

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

[DragonWriter]

What is the benefit of this system? When healthcare providers have easy access to anyone and everyone's records they'll jack up the prices to everyone but the 'ideal' patients.

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.

When healthcare providers have easy access to anyone and everyone's records they'll jack up the prices to everyone but the 'ideal' patients.

Insurers, rather than providers, tend to be the ones that do that.

Good place to start

[orclevegam]

After talking with some people in the medical field, it seems like an excellent place to start would be in the medical imaging records. Just about all the advanced imaging equipment out there saves the images to a "standard" format that's about as standard as a MS Word file. Every manufacturer has their own custom version of the "standard" that's incompatible with everyone else, and regularly updated, thus ensuring a constant (and broad) income stream.

A person should own their health record

[presidenteloco]

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

[characterZer0]

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.

Why open Source not open Standard?

[mdf356]

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?

[DoofusOfDeath]

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!

Re:Why open Source not open Standard?

[elBart0]

The standards for the data already exist. HITSP 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.

Re:I don't see this happening any time soon

[profplump]

From what I've seen they're reluctant to give out the schema because they don't have decent documentation and they're embarrassed by the DB. I support several companies that do claims processing using a system that uses fixed-record-length ASCII tables as the DB. The schema is defined only by an ordered list of column types -- you have to calculate the offset for each bit of data. And the column types aren't enforced -- you can put any type of data you want in any field -- the types just specify a field width. And don't even get me started on the lack of foreign key checking.

Re:Doomed to fail...

[rackserverdeals]

as Microsoft just announced Doctor's Office 2009.

Yeah, but it won't be released until the second half of 2010.

RTFA

[DragonWriter]

Why not use the one our tax dollars have already developed?

Why not RTFA?

VistA is the VA's EHR system.

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.

Current State of Medical Records

[mc1138]

I used to work as an outsourced IT support guy, and a lot of my customers with medical offices. A lot of them used EMR systems, and a lot of them were all proprietary, clunky, full of bugs and issues, and just general pains in my ass. Now, a system that forces uniform standards, would allow, for data to be easily transfered from a PCP to a specialist. However, the mere thought of implementing any of this, makes me very glad I'm no longer in that job as it would be an absolute nightmare.

Re:Why I don't want this

[ClosedSource]

"You won't get to decide what treatments you are eligible for"

And this differs from the current private insurance system in what way?

Call for Standards, not Open Source

[spotchka]

What they are calling for is a set of standards (i.e. What is a Medical Record?), not an open source solution. Once they can define exactly what comprises a medical record and standardize it (ANSI, HL7, etc.), the open source community usually takes care of itself.

Poor understanding of IT jargon by a politician's office...what a shock...