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Tech Giants Push Open Standards for Health Network 233

Posted by michael from the eschewing-proprietariness dept.
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."
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Tech Giants Push Open Standards for Health Network More

Tech Giants Push Open Standards for Health Network

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  • About time ... (Score:4, Interesting)

    by malcomvetter ( 851474 ) on Thursday January 27, 2005 @01:47PM (#11494076)
    Finally ... now maybe health care systems won't rely on dial-up as their primary method of sharing information from facility to facility.

    Amazingly enough, health care is probably 5-10 years behind in IT. The optimistic note: Health Care IT can learn from the mistakes of the 90s (which they were thinking about implementing next quarter- honest) and with movements like this, perhaps they can finally adopt proven standards.

    • It's not amazing (Score:4, Insightful)

      by sczimme ( 603413 ) on Thursday January 27, 2005 @01:57PM (#11494202)

      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).
      • While the latest and greatest tech could be extra-helpful, it also has the potential of having the most amount of bugs. Who here would like the lasik machine have a buggy software/hardware? Who here wants the MRI machine to describe a problem that is not there? OR miss a problem that is there?

        While I am all for rapid expansion - some fields need to take it nice and slow - the medical field needs to utilize tested and re-tested hardware/software as it is literally life and mission critical!
        • Your examples are embedded systems, not the IT infrastructure that is addressed here. Embedded medical devices are subject to FDA review.

          I used to write and debug C for a medical device company.

        • Re:It's not amazing (Score:2, Informative)

          by Adian ( 104160 )
          As someone who as worked in the within the Medical establishment, the issues you are talking about are more vendor specific. The equipment used in Lasik cases and others have been thoroughly tested, because of the fact they have to be so precise. Calibrations on these machines are often conducted before every use, or on a very regular basis. As far as MRI's diagnosing problems, that's not the case. MRI's take the pictures, and the Radiologist then interprets the MRI results. So, human error is the co

    • and why is this? (Score:4, Insightful)

      by ecalkin ( 468811 ) on Thursday January 27, 2005 @01:57PM (#11494215)
      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.

      • Most young doctors today are probably trying to pay off enormous education loans and pay for current liability insurance, if they are not bailing out of the profession altogether. They probably have to cut every corner out of necessity.

        Somehow, the Star Trek-y benefits of allowing a doctor in a vacation spot in, say...Thailand, being able to pull up my medical records on a whiz-bang high-tech system are balanced by the concerns of unauthorized or even malicious use of such records. Could such malicious use
        • Could such malicious use ever happen???

          Yes, if you were diabetic, had severe allergies, etc., and someone wanted to kill you and make it look natural/accidental.
      • I have done computer work about 15-18 medical offices...

        No you didn't. How do I know? You said "hippa". Health Information Portability and Accountability Act. HIPAA.
        • No you didn't.

          Yeah, it's possible he did.

          Installing computers doesn't mean you have to know what HIPAA stands for. It's very possible the poster heard someone say "hippa" was the reason they were upgrading, while he was dropping ethernet, or upgrading to VOIP, or even installing a MS Office upgrade on PCs. Does he need to know what "HIPAA" stands for to observe the decreptitude of their PCs, ethernet, phones, or software? No.

          Hell, I filled TPS reports at IBM for nine months, and I *never* found out w

      • Re:and why is this? (Score:2, Informative)

        by chithead ( 853769 )
        Similar situation here, They feel that they should be paid for the healthcare service they provide. Nobody is reimbursing them for dealing with your crappy insurance. I am the IT department for an independent pharmacy and my hardest task has been convincing the 50somthing-technophobe-owners that it really is a good thing. At present we spend 10% of time and effort on the patient and 90% dealing with 3rd party problems.

    • Re:About time ... (Score:5, Informative)

      by Rei ( 128717 ) on Thursday January 27, 2005 @01:58PM (#11494224) Homepage
      5-10 years? You're being too kind. As of when I left Terre Haute Medlab in the late 90s/early 00s (I forget exactly when), they were still required to transmit their data via bisync modem. It was one of those "We could have saved a lot of money just by burning CDs and driving them a couple hours away if they had allowed us" situations.

      But yeah, the paper situation really needs to be resolved. A site that I know from my current job is looking into a system where interviewers conducting research on patients will use tablet pcs with the forms on them. The data is automatically entered from the digital forms into the database, where it can be shared cross site with appropriate access restrictions. No need to have two people enter the data to insure data entry correctness, or anything like that (although you may still want two raters).

      Back at Terre Haute Medlab, they had an office of a dozen or so people whose job it was simply to type in to the system printouts of records spit out from a different system. In short, the data was going from the doctor and the patient, to paper records, to a digital record, to a printed record, to a digital record again, which was then transmitted via bisync, often multiple times if there was an error in the batch, each transmission taking overnight... oy, it was just a complete mess.

      If you wonder why healthcare costs are so much in the US, you have to at least consider things like this a contributing factor.
      • If you wonder why healthcare costs are so much in the US, you have to at least consider things like this a contributing factor.

        Personally I think the main reason is the malpractice insurance that docs have to pay. For most it is upwards of 50% of their Gross pre-Tax Income. This may be some, but if so it is miniscule.

        • Re:About time ... (Score:4, Insightful)

          by Rei ( 128717 ) on Thursday January 27, 2005 @02:17PM (#11494439) Homepage
          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.

        • Re:About time ... (Score:5, Informative)

          by BWJones ( 18351 ) * on Thursday January 27, 2005 @02:18PM (#11494454) Homepage Journal
          Personally I think the main reason is the malpractice insurance that docs have to pay.

          This is certainly part of the problem. Let me give you an example: My mother (a physician), used to love delivering her patients babies. It was one of the high points of her practice. Then one day, we were going over her budget for the practice and we discovered to our horror that every baby she delivered was costing her $200 because of insurance and other costs. Note: she has never been sued either. So, we made the business decision to stop delivering babies. But here is the real galling thing: She has to maintain an insurance trailer that goes down a little every year, until the last baby she delivered turns 21!. Is it any wonder they tried to discourage me from going into medicine? Is it any wonder that physicians are abandoning medical practices left and right in this country? There are also other regulatory issues physicians have to deal with that would boggle the mind. No other business in the US has to deal with these issues to the degree that physicians do.

          • "Is it any wonder they tried to discourage me from going into medicine? Is it any wonder that physicians are abandoning medical practices left and right in this country? There are also other regulatory issues physicians have to deal with that would boggle the mind. No other business in the US has to deal with these issues to the degree that physicians do."

            Yup, that's what happens when bean-counters for HMO's, and lawyers take over the practice of medicine.

    • Display * where SS# is Null ...

      Oh, you mean this isn't an Immigration Service project?

      Never mind, then...
      • Actually, this would also dredge up us tinfoil hat folks. Neither my health insurance company nor any of my health care providers have access to my SSN. (Because I make a stink and refuse when they ask for it.)

        We'll know if the system is being abused though, if INS shows up at the offices of thirtysomething white lawyers in North Dakota and start asking questions.

    • Re:About time ... (Score:4, Funny)

      by Waffle Iron ( 339739 ) on Thursday January 27, 2005 @02:05PM (#11494323)
      Amazingly enough, health care is probably 5-10 years behind in IT.

      I would say they are further behind than that. The incredibly poor communication between providers and insurers is one of my pet peeves. Transactions often take many months to clear, and involve numerous cryptic paper printouts, and often must be mediated by patients with no clue as to what the codes mean. Just how hard can this be?

      More than once a doctor or hospital in a PPO network has started hounding me over an unpaid balance that the insurer was supposed to cover. They called me up and tell me that I should coax the insurer to pay up. I'm usually a calm person, but this was just too much. *They're* the ones who entered into a contractual agreement with the insurance company when they joined the network. *They're* the ones with multimillion dollar mainframe systems who can communicate with the insurer's multimillion dollar mainframe systems. Why the hell do I need to get on the phone to try to fix their data interchange problems? Do they have kindergardners running their IT operations?

      The couple of times I've had to use this rant on their pesky bill collectors, it seems to have worked. The charges mysteriously got settled.

    • Health Care IT can learn from the mistakes of the 90s

      Yeah, I work in healthcare IT and we're not waiting until 2009 to start updating our code for Y2K! Unlike the rest of people in IT who waited until the last minute.

  • Where's Apple? (Score:4, Funny)

    by Foozy ( 552529 ) <jbrown&thrupoint,net> on Thursday January 27, 2005 @01:47PM (#11494077) Homepage
    After all, an apple a day keeps the doctor away...

  • Typo in Submisson (Score:5, Funny)

    by jaymzter ( 452402 ) on Thursday January 27, 2005 @01:48PM (#11494090) Homepage
    Somehow Microsoft got into the same sentence as non-proprietary
    Please correct and resubmit
    • Somehow Microsoft got into the same sentence as non-proprietary Please correct and resubmit

      Funny, but remember MS's theory of "embrace and extend" which they do to many, many "open" standards that they can then effectively "close" after they get established.

    • "Somehow Microsoft got into the same sentence as non-proprietary"

      I think it might have been the "we'll give you vast amounts of money and not look too closely at the results if you just sign-up to these few conditions" that swung it.

      After all, supporting some US-medical XML schema isn't going to allow any of their Word users to escape. Especially if it's a government IT project (i.e. it'll never be finished, so no need to worry about what it will do)

  • Control and privacy. (Score:3, Insightful)

    by Anonymous Coward on Thursday January 27, 2005 @01:48PM (#11494091)
    Well we like technology. We like services that make life easier for us. Now how about the privacy, and control issues raised?

  • Interoperability and sharing... (Score:5, Interesting)

    by PornMaster ( 749461 ) on Thursday January 27, 2005 @01:50PM (#11494117) Homepage
    Interoperability and sharing are all kinds of nice for the interchange of information, but what happens when a third-party developer comes up with something that can also plug-in, so it gets access to the data, but has some kind of big open hole in other parts of its code, so everyone's records are available to anyone?

    Without resorting to a paranoid rant about huge databases where authorized people have access to my personal data... what about the unauthorized?

    For some reason, I don't see a security framework coming down the line that is *good*, consistent, and enforced by the system as a whole.
    • Your best bet there would be the draconian (and appropriate) penalties associated with violating the HIPAA [hhs.gov] rules, with which medical, IT, and insurance people trifle at their peril.

      Believe me, you screw up on that end, and it's huge fines and/or jail. Federal time.
    • This is a major problem in the hospital environment. As soon as you limit a doctor to seeing a patients record you cause problems. But you can't just let every doctor see it. The moment the doctor needs to see it and they can't is the moment the system fails. The doctor is not going to go through all the trouble it would take to request access and provide the reasons why they need access. A lot of doctors don't know how to work a mouse much less request security access to records. They will continue u
      • The system we use here has a concept known as "breaking the glass." A doctor who tries to view a record to which he normally wouldn't have access can (with confirmation) "break the glass" and see the record anyway. It sets off all kinds of alarm bells for the administrators, but if the situation was justified then it's all good.
        • We have the same kind of thing. They can request to override the security with the press of a button and its all logged and emailed that they did so. But the problem we encounter is that the doctors feel they shouldn't even have to do that. Another problem is that to just show that a note or set of notes are there is a breach in privacy. For example, just knowing that a particular patient has psych notes in their records is bad enough, you don't even have to show the note. So that stuff must be hidden.
    • Certainly that won't happen. Those computer companies just care too much about people to be that careless.

      I mean, look how they treat their employees and consumers now. *shudder*

      I wouldn't be surpised if the next time I go in for a dental check up I wind up a different sex and with only one eye and leg when I come out.

    • Re:Interoperability and sharing... (Score:4, Interesting)

      by Rei ( 128717 ) on Thursday January 27, 2005 @02:12PM (#11494396) Homepage
      You think this isn't already an issue? I for one welcome any upgrades to the system - it's bound to be a lot more secure and have a lot less human eyes on the data.

      At a job I used to work at, there was an officefull of people who really didn't need to be there if the system had just been designed properly to begin with. Each of them looked at huge amounts of personal data every day as they typed it in from one system to another. Then I, as a software developer, had access to all of it when trying to write scripts to ease access to this data. We transmitted it to several places, each of which probably had similarly inefficient and human-intensive systems. No encryption was used at any stage that I'm aware of. I mean, seriously, how is it going to get worse?

  • Minor points (Score:4, Informative)

    by sczimme ( 603413 ) on Thursday January 27, 2005 @01:50PM (#11494118)

    Microsoft, IBM, Intel, Oracle, Accenture, Cisco, Hewlett-Packard and Computer Sciences have formed the Interoperability Consortium

    This part of the summary (lifted from the article, apparently) mentions "Computer Sciences"; the company is actually Computer Sciences Corporation [csc.com].

    As an aside, the printer-friendly (i.e. less cluttered) version of the CNet link is here [com.com].
    • if I'm not mistaken, isnt CSC really DynCorp (the DOD Contractor)? Somewhat interesting to see them on the list with all the other companies.

      • if I'm not mistaken, isnt CSC really DynCorp (the DOD Contractor)? Somewhat interesting to see them on the list with all the other companies.

        CSC acquired DynCorp a couple years ago. They (CSC) do a lot of DoD work but are heavily involved in healthcare, too (among other things) [csc.com].
        • ah, thank you, I did not realize the other areas they were involved in. I work in DoD Contracting myself, and so of course have run into DynCorp, but I cant say I knew much about them beyond my occasional run-ins.
    • CSC hires a LOT of developers in India. [csc.com]

      "Where are your patient records today?"

  • I for one... (Score:5, Funny)

    by fizban ( 58094 ) <fizban@umich.edu> on Thursday January 27, 2005 @01:51PM (#11494122) Homepage
    I for one welcome our new open, nonproprietary technology standard overlords.

  • Microsoft - Open Standards - ??? (Score:3, Insightful)

    by BigAlexK ( 398239 ) on Thursday January 27, 2005 @01:51PM (#11494129)
    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.

  • "Insurers"? (Score:5, Insightful)

    by CrystalFalcon ( 233559 ) on Thursday January 27, 2005 @01:52PM (#11494146) Homepage
    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.

    • Uhhh, I bet that even in Europe, your health insurer gets access to lots of your medical data right now, for billing information. They don't get your charts, but they know about any procedures, visits and prescriptions that they're paying for. They don't just sign blank checks....

      • No, they don't (Score:3, Interesting)

        by CrystalFalcon ( 233559 )
        They do not have access to the hospital data, period. I can't see why this is such a hard concept.

        Hospitals are financed mostly by taxes and in part by private insurances. At no point will I allow the hospital to communicate any information directly to an insurance company, or vice versa. All such information passes through me. And I am free to lie about what I want, but I am also accountable for such lies, should I choose to change anything.

        Anything other order is unthinkable.

        • Re:No, they don't (Score:2, Interesting)

          by kingpin2k ( 523489 )
          You've piqued my interest. Does this mean that you're on the hook for services you consume at the hospital until such time as you receive reimbursement from the insurer? That's excellent. The third-party payment system is a joke, and it has turned on-demand healthcare into an entitlement for which the proverbial "they" always pay. If you're saying what I think you're saying, I like that a lot better.
          • If I understand what you are implying here, you are talking about how HMOs will "deny" the hospital permision to perform services such as surgery.

            If so, please note that this is HMOs only and not the other types as I understand it. This is also the meaning of HMO - Health Management Organization. If you have a different type of health care such as a PPO (Preffered Provider Org) you do not have to worry about the HMO having a say. (One reason why I have an PPO instead of an HMO, costs a bit more but is w
          • but that's how it mostly works, yes. The hospital bills me, I am reimbursed by the insurance company, minus a small fixed amount which I don't know the U.S. term for.

            There may be other systems but this is how I know it from where I live.

            This only applies when seeking private care (95% not necessary) or needing a hospital bed, though. If it's an ordinary visit, I pay a small fee when entering the hospital, and the rest is paid through taxes. Many European countries don't have the entry fee, either.
        • Here in the USA it is usually (but not always) the doctors that submit the insurance information. They submit what was performed, but do not submit the details such as charts, exactly what meds (they will say "pain killers" but not which ones). It is akin to what you see on a car maintainence bill or credit card statement.

          Hospitals here are not financed by taxes and in part by private insurance, they are primarly financed by the patients and the insurance bills. Very few tax dollars go to hospitals for
      • Correct, I just took out a medical insurance policy and by signing you gave the insurance company FULL access to you medical records related to any claim you might have. They can't go digging years back but they can see what they are paying for. If you participate in Clincal Trials or Government programs a lot of folks can see your data. HIPPA didn't close ALL the loopholes.
    • The whole point of this is to cut down on the stupefyingly expense paper chase that people in both medical and insurance have to go through just to get a patient cared for (without the patient having to pay cash on the spot). Health insurance companies, by definition, already know everything there is to know about their customer's use of the insurance company's resources (read: money, as paid into by all of the insured, and as used by some of the insured).

      Deny the insurance companies an appropriate hook
    • So... the insurers in Europe will pay bills without seeing any information about the procedures, etc.? They certainly are trusting over there...

    • Re:"Insurers"? (Score:3, Interesting)

      by the_rev_matt ( 239420 )
      Because insurance companies donate heavily to political campaigns and any attempt to change things is met with overwhelming pr campaigns.

      On example, back in the early 90's there was a ballot initiative in California to institute some mild insurance industry reform. Supporters managed to raise a few hundred thousand dollars to promote the initiative. The industry spent well over twenty million dollars on a campaign that basically said 'this initiative is anti-American, it will destroy the state economy an
    • You want your insurer to pay for it right? Why wouldn't your health insurance have access to your medical records? They need it to be able to asses your case and what benefits you are entitled to. I suppose you plan on just calling them up and telling them how much they owe? You sign lots of stuff when you get insurance, one of them gives the insurer limited access to your medical records. When a procedure is done, that information needs to be sent in a secure manner to the insurance company so they ca

  • Hipocrisy (Score:2, Informative)

    by rbarreira ( 836272 )
    Some of those are also the ones who are propelling trusted computing [wikipedia.org]...

  • HL7 (Score:5, Interesting)

    by Kainaw ( 676073 ) on Thursday January 27, 2005 @01:55PM (#11494177) Homepage Journal
    Anyone who has worked on IT in the health field knows about HL7. It is a free protocol for sharing any and all medical information. As of version 3, it has become XML compliant to allow programmers to use XML parsing tools to read/write data. I don't understand why there is such a need to make a new protocol for sharing health data when one already exists and is in use with most EMR systems.
    • Probably because there are so many systems out there that generate hl7 messages but don't actually follow the protocol correctly. Hell we are still getting version 2.1 messages and the hospitals still manage to screw those up. Getting them to correct them is impossible because they don't control the sending system. Some other company does and to get them to do anything is like moving a mountain.

      • Re:HL7 (Score:3, Informative)

        by Kainaw ( 676073 )
        Probably because there are so many systems out there that generate hl7 messages but don't actually follow the protocol correctly.

        I agree with you there, but that isn't a problem with HL7. It is similar to another project I worked on - website readers for the blind. The website reader could handle HTML if it was properly coded. However, most people do not follow the HTML standards correctly. Actually, most HTML WYSIWYG programs produce invalid HTML when pages get a little complicated.

        I don't assume th
      • HL7 v2 was a problem precisely because the standard was imprecise and full of "other" fields (named Z-segments if I remember correctly).

        V3 is a different beast entirely. I'd have a hard time naming another spec with the same level of rigor and documentation.
    • Why? Because there's currently no mandate that such systems must run on Trusted Computers.

      And how are they going to impose Trusted Computing on us if they don't first start with mandates in and by the government?

      -
    • I don't understand why there is such a need to make a new protocol...

      The article didn't mention a new protocol. And the HHS Department is pushing HL7 heavily, so if the companies are working with HHS then I'm sure the "nonproprietary technology standards" the article talks about includes HL7.

      But there are lots of gaps in HL7 that need to be filled, and it's only the medical message transmission protocol anyway.

      For those curious, check it out [hl7.org].
    • any and all medical information

      Really? Is DICOM a part of HL7? I thought they were distinct...?

      I think you're wrong about the "any and all".

      • HL7 vs. DICOM (Score:3, Informative)

        by oliphaunt ( 124016 )
        I thought [DICOM and HL7] were distinct...?

        And as I'm sure you know, there are different flavors of DICOM produced by different vendors. Last time I checked, Siemens DICOM doesn't play nice with GE DICOM. Yes, there are standards, but they're GOVERNMENT standards, not customer standards. They all have loopholes big enough to drive a truck through, and the vendors exploit these loopholes to lock customers into a one-vendor package.

        If you are a Siemens sales guy, which one is better for you- a Siemens
        • Um. Okay.

          The customer needs to be informed, yes. You can't blame the vendor for this one. And you can only blame the government if they interfere with the choices the vendor would make - which is only true for like VA hospitals, and the like.

          IHE (Integrating the Healthcare Enterprise) tests exactly the things you talk about (during their Connectathon, and other times), and the results are public, aren't they?

          The vendors do what the vendors do. If their products aren't right for the customer, they're
  • technology standards for sending health data across the network and sharing information, when appropriate, among doctors, hospitals, insurers and researchers.
    I seem to have missed the point of this. There's already a standard for the data/information: HL7. As long as all systems can read and write it, does there need to be "technology standards"?

  • Vista ! (Score:3, Interesting)

    by Mad_Rain ( 674268 ) on Thursday January 27, 2005 @02:00PM (#11494245) Journal
    The Veteran's Administration Health Care System has an excellent [va.gov] electronic record-keeping system, and can be found even as an open-source [sourceforge.net] format. I'm hoping that they build off of the OpenVista project, and have some standardization across health-care organizations, so that the patient records are more easily transferrable and readable by the providers.

  • Freedom Of Information Act (Score:5, Informative)

    by amdg ( 614020 ) <amdg.mac@com> on Thursday January 27, 2005 @02:04PM (#11494318) Homepage

    I've been following this story for some time now. For me, the cool thing about this quasi-open-source project is that it will be built using source code that was released to the public thanks to the US FOIA (Freedom of Information Act) [google.com].

    This software was built years ago by the Department of Veterans Affairs for its hospitals and clinics. Similar commercial software is easily sold for over US$1 Million. I would love to see more software developed by the US government with taxpayer money released into the public so that the open source community can benefit. If you know of any government software that could be useful, file a FOIA request! (Assuming of course that it does not violate national security, yada, yada.)

    For more info on this software and other open source stuff going on in the healthcare world, see these links:

  • Doesn't the establishment of this type of venture just beg for a HIPPA violation?
  • Proprietary noninterop has been one of the nonnegotiable ways that personal medical info has remained private. Before we switch over to the vastly healthier system of unimpeded flow of medical info among medical people, we need to protect that info from unauthorized "sharing". Our copyright on our personal information must prohibit any transfer of our info outside the transaction within which it was provided by us, unless expressly authorized - which authorization is nontransferable, unless itself expressly

  • As a Hospital IT Professional (Score:5, Interesting)

    by 314m678 ( 779815 ) on Thursday January 27, 2005 @02:25PM (#11494566)
    I can tell you that this is great news. Our hospital currently has myriad legacy systems running on dinosaur mainframes all linked together buy buggy interfaces which sometimes resort to screen scraping.

    Let me give an example of one of our systems, a text based system, with functionality similar to telnet, when I used it for the first time I noticed that it was slow to open, so I put a ethereal on it and noticed that to connect it sends 8MB of info every time you connect. Approximately 20,000 packets, each with every permutation of two ASCII chars.

    We deal with crap this daily. For another program we are forced to use a non-standard telnet client that takes 100% of the CPU regardless of the machine you are using.

    Open standards that could link admitting, clinical and financial hospital systems will save billions of dollars and probably a few human lives. Additionally, this will allow small software companies and open source coders to make applications that can be widely used. Ive been working on a multi million dollar project the last few months where an aspect of it was completely screwed up because one software vendor uses a non-standard interface that they will not allow us to access directly, as a result, our users have to settle for diminished functionality.

    If encryption is built into this standard it will be a step ahead for HIPPA protection and most systems just send everything, (passwords too) in plain text. I for one, look forward enthusiastically to open source hospital applications made possible by open standards.

  • The biggest problem with all these ventures is that nobody has found the genius to devise a system of keeping your medical records away from prying eyes. While the mounds of paperwork are expensive and slow, at least it is difficult for a prospective employer to get his/her hands on your medical records and decide not to hire you because you have high blood pressure and may risk costing the company. Or worse, insurance companies who decide that because you took an AIDS test a few years ago, you statisticall

  • should read: Consulting Giants Push Open Standards for Health Network.

    BTW: have fun with hungry-hungry-HIPAA [hipaa.org]!

  • The biggest obstacle to this is doctors. That's not necessarily their fault, though.

    This is going to require huge amounts of infrastructure, IT and human, to accomplish. It will take huge amounts of money and time. If you've ever wondered why the medical system is so far behind the IT curve, this is why. Also, add on to that the general resistence the medical community has, especially doctors, to change and it adds up to one heck of a hard mountain to climb.

    You might say, "doctors, resistant to change

    • Re:The biggest obstacle to this is doctors (Score:4, Informative)

      by Torqued ( 91619 ) on Thursday January 27, 2005 @04:47PM (#11496168) Journal
      It's not just the doctors... it seems to me that many healthcare providers (doctors, pharmacists, nurses, etc.) don't like having their workflows messed with. It is much quicker and easier for any of the above mentioned professions to pull a pen out of their pocket and scribble something on a piece of paper in a chart than it is to find a workstation, log in, and then several mouse clicks later, finally be at a screen where you can type in your note, click on your orders, etc.

      The problem with most EMR (electronic medical record) systems that I have seen is that on the front end, they don't end up saving you any time. The actual data entry into a computer will frequently take more time to enter than if you had scribbled it in a paper chart.

      Where you really reap the benefits is more on the "back end" of the process through electronic processing of orders - potentially reducing errors, improved billing/payment procedures, data analysis/mining that can be used to identify quality improvement opportunities (such as improved utilization of resources or decreasing infection rates), etc.

      In my experience as a nurse, there is some limited benefit on the "front end" for when you're giving patient care such as lab alerts; graphs showing trends of lab values, vital signs, etc.; and being able to actually read the physician's notes! :) But, the reality is that it often takes longer to compose your patient documentation on a computer than with pen and paper.

      Adding to this problem is issue that the healthcare industry keeps asking the providers to "do more with less", but then they want to introduce some computer systems that take more time to use.

      There are other issues such as the nursing shortage, the fact that the average age of a nruse is in the mid-40's, and that the aging baby boomer population will soon start to place a crushing load on the healthcare industry as they begin experiencing the onset of chronic disease such as hypertension, heart disease, diabetes, etc.

      Also, I have been involved with healthcare information systems for the past several year, and the user interfaces and system configuration tools need a LOT of work! You can put all the nifty infrastructure in place that you want, but if you can't configure an acceptable, efficient workflow and user interface for the user, the system will either fail miserably or be poorly/inappropriately utilized.
  • OK, try and tell me it isn't related to BG's recent donation of $750m to vaccinations [slashdot.org]!

    Damien
  • Remember when Healtheon, Jim Clark's disaster, was going to do this with a proprietary system that put them in the middle of every health care transaction? At least this is an open standard.

  • A bigger problem than standards (Score:2, Interesting)

    by Anonymous Coward
    The huge problem of sorting through extreemly complicated db groups has always caused delays in the roll out of health care software. The most reliable db in use so far is Oracle. If there was some standard in query language things might be different. Migrating data from one db to another has caused huge headaches for implimentation with MS gui driven aps.

    The client aps are all written so that one implimentation can use MS sql or the db software of choice. My wife works with business process testing and fu

  • Anyone find it odd that WebMD (who owns the nations largest insurance claims clearinghouse that uses about 8 differnt formats from ansi4010 to nsf+) Does want to get in and help build a standard?

  • Asking important questions about health records (Score:3, Insightful)

    by invincerator ( 739412 ) on Thursday January 27, 2005 @05:43PM (#11496967)

    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.

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