Peering into the (ehealth) fog of war …

At one point in time, a long time ago (around 2000), I wondered if centralized, government maintained electronic health records was the way to go.  In defense of this position, my arguments revolved around the notions of efficiency and control, in that it was easier for systems to be monitored, maintained, and updated if they were all in one place.  But, as anyone with a technical background could point out, there are significant technical issues behind such a strategy.  It would seem that some people agree: "German doctors say no to centrally stored patient records".

What I find interesting is the proposed "counter" solution:

As an alternative, the German private doctors’ body is suggesting the use of encrypted USB-sticks. These could be handed over to patients and would carry all relevant patient data, including digital images such as radiographs or CT-scans

Wow.  I haven’t heard a call for the use of physical based media in quite some time.  Personally, I thought that this line of thinking was disappearing as the feasibility of cloud computing increases and slowly becomes a realistic option.  In all fairness, there are a few other very interesting points raised by the group representing the German physicians.

  • Allow hackers to try to and crack the USB system in order to prove that it can be made safe
  • Make patients more aware of what information is collected and stored

After reading this article, I get the distinct feeling that as of 2008, we’re staring into the "fog of war" as no-one is certain as to what strategies or solutions will ultimately prove successful.  Might be interesting to start documenting what ideas people think will work or not work.

From my involvement in this industry in North America, I got the distinct impression that a strategy that mixes personal and public records was emerging.  Basically, health care organizations and governments (depending on their level of involvement in the delivery of care) would maintain an electronic record that is stored and available to authorized parties of the "system" (be it regional or otherwise).  Patients would then maintain some sort of "personal health record" that they can control.  The organizational records are often deemed to be the "electronic health record".  Maybe it’s me, but the title, "electronic health record" seems to have a more legitimate or official connotation than "personal health record".

It will be interesting to see what strategy(s) emerges.

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