but this does not require a national EHR! this requires local systems integration, which is already commonplace in many health trusts.
my own experience tells me that even when a doctor has access to recent test results, they prefer to get their own because they have to stake their reputation on the diagnosis they give and want up-to-date information to base that diagnosis on.
regarding drug addicts, they are driven by their addiction to acquire drugs or money for them and we should probably look at stopping them from mugging the elderly before we worry about them getting double prescriptions. While neither of these scenarios are pleasant I don't think a national EHR will effect the treatment of drug addicts at all.
I suppose my point is that we (in the UK at least) have poured millions of tax payers money into the National program for IT for the NHS and it's had hardly any positive impact on patient care and outcomes. Someone should ask the doctors what they need to do a better job rather than cooking up yet another government IT scheme heralded as the "one true way". Sadly promising the NHS reform is one of the best ways to win votes for British politicians and as such we'll continue spending money and messing about with it much to the frustration of the people who work in the front line of patient care.
having worked in patient care software for the NHS for the last seven years with many other vendors and 3rd party systems. I can honestly say that national program for IT is largely useless (from a clinical perspective). The project has been cut back so many times that all it amounts to now is a patient master index that contains no clinical information (e.g. a big list of names and addresses). Useful clinical data is locked in departmental systems where no-one can get access to it because no decent minimum national standards exist for storage and transmission of data from one system to another. Issues around data privacy have not been addressed, some recommendations have been made but none of which cater for what is to be done with the bulk of clinical data in legacy systems and how this data is practically going to be migrated.
great idea, but it does not work well in practice. The most vulnerable patients are the ones you are most like to injure with the wrong medication or similar. These vulnerable patients include the very old, the very young and the badly injured. These people are often not able to be their own medical book keeper.
It's best to limit access by role *AND* location thus making sure that staff at the reception desk (even doctors) cannot open sensitive records on such public terminals
what does a national EHR do for the doctor and the patient that a local GP system doesn't already do?
Most people having this discussion have not considered this. Try listing the benefits and penalties and then decide whether you'd spend your cash putting it in place.
While you consider this... note the following:
Most people do not migrate, they are born, live and die in the same place. So local systems work well for these people.
Emergency medical staff do not have time to correctly identify a patient in order to find the correct medical record for them on a central system in an emergency. This requires quizzing the patient and for the most part, if the patient is well enough to tell you who they are, they are well enough to tell you what they are allergic to and their existing medical conditions, if not, then you're flying blind no matter what.
Would it not be better for the government to spend their time setting a standard for data exchange between the existing local systems? The closest thing that exists to this is called HL7 but it's so slack and non-standard in every implementation I've seen that it's no more useful than generic XML.
you are assuming that an EHR can be delivered to the emergency care professional in a form that actually helps them in an emergency. The key to this is patient identification which is hardest when your patient is sufficiently injured to be unable to tell you who they are, this coincidentally is also when they are least likely to be able to tell you about their allergies. In short, if your patient is able to tell you enough information about themselves to safely ID them in your EHR, my bet is that they can mention their "thingymycin" allergy. Where the patient is not conscious you have to go a long way to beat a bracelet attached to their arm with this detail on it. (no I don't work for medic-alert or similar, I'm an IT professional that spent the last seven years working on EHR systems)
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I can't say that this is how it works here, but I only have experience of health care systems in the UK where local electronic patient records exist.
but this does not require a national EHR! this requires local systems integration, which is already commonplace in many health trusts. my own experience tells me that even when a doctor has access to recent test results, they prefer to get their own because they have to stake their reputation on the diagnosis they give and want up-to-date information to base that diagnosis on. regarding drug addicts, they are driven by their addiction to acquire drugs or money for them and we should probably look at stopping them from mugging the elderly before we worry about them getting double prescriptions. While neither of these scenarios are pleasant I don't think a national EHR will effect the treatment of drug addicts at all. I suppose my point is that we (in the UK at least) have poured millions of tax payers money into the National program for IT for the NHS and it's had hardly any positive impact on patient care and outcomes. Someone should ask the doctors what they need to do a better job rather than cooking up yet another government IT scheme heralded as the "one true way". Sadly promising the NHS reform is one of the best ways to win votes for British politicians and as such we'll continue spending money and messing about with it much to the frustration of the people who work in the front line of patient care.
having worked in patient care software for the NHS for the last seven years with many other vendors and 3rd party systems. I can honestly say that national program for IT is largely useless (from a clinical perspective). The project has been cut back so many times that all it amounts to now is a patient master index that contains no clinical information (e.g. a big list of names and addresses). Useful clinical data is locked in departmental systems where no-one can get access to it because no decent minimum national standards exist for storage and transmission of data from one system to another. Issues around data privacy have not been addressed, some recommendations have been made but none of which cater for what is to be done with the bulk of clinical data in legacy systems and how this data is practically going to be migrated.
great idea, but it does not work well in practice. The most vulnerable patients are the ones you are most like to injure with the wrong medication or similar. These vulnerable patients include the very old, the very young and the badly injured. These people are often not able to be their own medical book keeper.
It's best to limit access by role *AND* location thus making sure that staff at the reception desk (even doctors) cannot open sensitive records on such public terminals
what does a national EHR do for the doctor and the patient that a local GP system doesn't already do? Most people having this discussion have not considered this. Try listing the benefits and penalties and then decide whether you'd spend your cash putting it in place. While you consider this... note the following: Most people do not migrate, they are born, live and die in the same place. So local systems work well for these people. Emergency medical staff do not have time to correctly identify a patient in order to find the correct medical record for them on a central system in an emergency. This requires quizzing the patient and for the most part, if the patient is well enough to tell you who they are, they are well enough to tell you what they are allergic to and their existing medical conditions, if not, then you're flying blind no matter what. Would it not be better for the government to spend their time setting a standard for data exchange between the existing local systems? The closest thing that exists to this is called HL7 but it's so slack and non-standard in every implementation I've seen that it's no more useful than generic XML.
you are assuming that an EHR can be delivered to the emergency care professional in a form that actually helps them in an emergency. The key to this is patient identification which is hardest when your patient is sufficiently injured to be unable to tell you who they are, this coincidentally is also when they are least likely to be able to tell you about their allergies. In short, if your patient is able to tell you enough information about themselves to safely ID them in your EHR, my bet is that they can mention their "thingymycin" allergy. Where the patient is not conscious you have to go a long way to beat a bracelet attached to their arm with this detail on it. (no I don't work for medic-alert or similar, I'm an IT professional that spent the last seven years working on EHR systems)
you need to try SuSE, it indeed ticks all of these boxes (or is that boxen) *shrug*