Tuesday, October 7, 2014

Interoperability and the Messiah...

In a recent NYT article ("Doctors Find Barriers to Sharing Digital Medical Records"), a frustrated physician said that "he hopes interoperability comes sooner rather than later", see article here: http://mobile.nytimes.com/2014/10/01/business/digital-medical-records-become-common-but-sharing-remains-challenging.html?smid=nytcore-ipad-share&smprod=nytcore-ipad&_r=0&referrer=

It seems as if interoperability is becoming the new Messiah that many people are hoping for... but let's face it: interoperability will not come any time soon! Why? Simply because the current law in most countries enforces healthcare providers to not only provide care, but also provide long term archiving services for the medical records they created when they took care of patients. That's what makes patients data fragmented and scattered across the various healthcare providers and other facilities patients have visited in their life. No data sharing or information exchange mechanism is going to solve this issue because it's not technological. Rather, it has to do with data flow dictated by the overall constellation of healthcare stakeholders and definition of medico-legal records residing solely  in the hands of healthcare providers.
The fact of the matter is that despite of huge efforts towards sharing and exchange of patient data carried out around the globe in the past decades, true interoperability that gets the complete health history of an individual at any point of care is still nonexistent!
Therefore, it's time to think outside the box:
>> It's time to revisit those presumably axioms that fixate data fragmentation and induce fragmentation of the entire healthcare sector.
>> It's time to change the current law and free healthcare providers from the archiving task that is not the essence of their role and specialty, i.e., providing care.
>>It's time to give rise to new entities in the health arena, which will be trusted by all current stakeholders but yet be independent of all of them.
>>It's time to give rise to trusted third parties (TTP) who will be the sole record keepers by a new law, with responsibility to sustain individual lifetime health records.
>>It's time to shift paradigms into a custodian model where multiple and certified custodians are trusted by all parties and only regulated by the new legislation.
This is a complex problem because data flow has been shaped so far by the current law. But despite the complexity, the solution is very simple, and its simplicity is the best indication of its inevitability. Let's act now!

Monday, April 21, 2014

Focus Theme on Health Record Banking is published in Methods

I've recently edited a Focus Theme on Health Record  Banking in the the Methods of Information in Medicine Journal. My editorial paper is titled "It’s Time for Health Record Banking!" Here is its abstract:
This Focus Theme aims at describing the Health Record Banking (HRB) paradigm, which offers an alternative constellation of health information exchange and integration through sustainability of health records over the lifetime of individuals by independent and trusted organizations. It also aims at describing various approaches to HRB and reporting on the state-of-the-art HRB through actual implementations and lessons learned, as described in articles of this Focus Theme.

Other papers in this Focus Theme include: