On Thu, 25 Nov 2004, John Leo Zimmer wrote:
This is another aspect that the HH and WV need to get uptodate on. The capabilities you mention have been defined in ASTM E-1384 Structure and Conent of the Electronic Health Record and the VA has implemented parts of the documented capabilities but we havent yet gotten into all of the capabilities that may need to be inserted into VistA to provide the behavior noted. Part of it may be dealt with in the ObGYn/Peds configuration being worked on Nancy's project and other parts may be part of the "Office VistA" project of CMS. Its not yet clear that many of the parties are even aware the ASTM standards and what they mean let alone investigated how the VA may have implemented these concepts within VistA. Thats one line of effort that needs to be organized so that folks are building on existing architecture and extending it so that it has maximum generality. A number of us here at UW are working at getting these these capabilities documented in a general way so they can help this line of effort. We are working with Nancy and her project as a specific foil to this end. I look forward to additional ideas on keeping this all in synch.
Ok, For a diversion from the heavy lifting going on over in vista-open-source... And for something to think about while digesting the turkey...
I am a <<family>> doctor, ok? VistA has never seemed particularly family oriented to me. (Perhaps because most veterans do not bring Mom and all the kids along for their health care.) So, how might we address the task of capturing and using (for pleasure, profit and the good of mankind) a patient's family ties?
I do not mean existing next-of-kin fields. I want structured linkages among patient records. For example, when one of four children comes in for immunizations, the system might be able to present more than just Johnnie's record and <<his>> currently needed shots. I want to be presented with the fact that MaryAnn missed her last polio update, and that Daddy is probably past due for a tetanus booster, three years ago. And it might be good to know that grandpa is past due for his colonoscopy.
It is the sort of thing that could get out of hand very quickly, of course. But the ability to treat family groups rather than just individuals is one of the few things that keeps me convinced that I am doing some good in the world.
OK, so the question is what would one add to VistA's patient records to allow such linkages within patient records? I don't want a kludge, but something elegant.
Thanks to all, JohnLeoZ
Healthcare, a human right.
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