Andrew Patterson <[EMAIL PROTECTED]> wrote:
> 
> > The benefits of participation would need a social marketing campaign.
> > But GPs agree to participate in the CARDIAB programme, don't
> > they? I think what I had in mind was a next generation platform
> > for CARDIAB or something very like it.
> 
> Tim,
> 
> Sorry, I wasn't really up on what CARDIAB did so I didn't
> immediately see the connection..
> 
> But you are right that it could be used to populate a
> fair bit of the chronic disease data. I'd still argue that consumers
> would want a bit more out of a PHR than that. What about
> an accurate up to date list of _all_ my medications? A record of
> _all_ my encounters with coded diagnoses? All my PSA results
> for the last 10 years. I don't think any of this information would
> be captured in any chronic disease program like CARDIAB (and
> also - I'm a healthy male - I don't think I'd be enrolled in
> a program like CARDIAB but I still might be interested in having
> a PHR).

Yes, a PHR (personal health record) needs to go beyond the CARDIAB data items, 
but they would be a start. Could be a bit more ambitious in the first instance, 
perhaps.

Officially you probably should not be in CARDIAB which is designed for 
high-risk patients but that doesn't mean that your risk of CVD won't be reduced 
even further if you get your BP down from 120/80 to 110/70 and your total chol 
down from 4.9 to 4.2 - there's no magic threshold below which no benefit 
accrues (obviously, only up to a point, as very low BP may be a risk factor for 
other things).

> My GP is the one that has the master copy of
> all that information - I don't pay them enough to force
> them to type it in again into my PHR, I don't have the medical
> experience to enter it in myself accurately, and HCN has no
> interest in automating the whole process. I don't really see what
> the driver is that will change any of that..

Re-keying data won't fly. But I thought that key results were already being 
streamed as HL7 messages to CARDIAB via Argus Connect? And if HCN won't play 
ball, then legally there is nothing stopping third parties from extracting the 
data from GP's databases which are contained in HCN products (with both GP and 
individual patient consent, of course). But co-operation by HCN and other 
software vendors would be nicer. I must say that the absence of any open 
plug-in architecture in HCN or any other GP clinical information systems is an 
issue - it stifles innovation and trammels many potentially very useful public 
health and preventive medicine programmes.

Tim C
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