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Gillian Braunold wrote:
> Melbourne on ethics issues in shared records etc.
I suspect many people are on the wrong track with the idea of shared
records.
Accepting for the moment that the NHS in the UK - Scotland first, but
England following - have largely abandoned the idea of medical
informatics in favour of replacing the difficult task of moving around
pieces of paper with the easier one of moving around pictures of pieces
of paper, it remains possible in principle to make records which have
some internal structure and present meaningful specific information.
Indeed, QoF has caused many specifics to be recorded in specific fashion.
The problem of what people are supposed to be able to get from shared
records has had less airing than I'd have expected, but my impression is
that most people interrogating a record set they did not make and do not
maintain are after answers to particular questions.
eg
Is the patient diabetic? Yes || known not to be (date)|| not known to be.
List the drugs the patient has had.
Mad?
and so on.
The task of specifying ways for one computer to ask another computer
such questions, and an answer to be received and handled is a
significant one, but it is well understood and uses routine engineering.
It does of course work far better with an Open SOurce approach than a
closed one, but closed groups have managed it in their own little
bubbles of the information foam[1] we struggle through.
Identification and so on is an easier security task than the one the NHS
set itself some years ago, with a deadline IIRC of rather fewer years...
In the same way,handling an incoming assertion of something is
well-scoped and routine.
I mistrust those who abandon a hard but reliable course of action in
favour of something fanciful and requiring much consultancy, and in this
area, I've not seen anything that suggests I'm wrong to do so.
[1] more of a foam than a coud, as yet and with many people trying to
make more froth and then skim it.
- --
A
http://defoam.net
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