Seref Arikan schreef:
> Hi Berth,
> Please let me add my set of questions to yours, for I have not been 
> able to figure out the overall scheme of the discussed setup. Maybe 
> its my fault, and I apologize in advance if I've missed the answers in 
> the discussion or on the web.
> What is the extend of Google's or Microsoft's offer to these 
> hospitals? Both MS and Google give me the impression that their offer 
> is about personal healthcare records. The extend of functionality they 
> will offer is important, because it can either be a complementary 
> functionality that will allow the patient to use his/her initiative to 
> transfer data to allowed parties, like the next GP or hospital, or it 
> can be a complete alternative to whole idea of national healthcare 
> information systems, which is unlikely in my opinion.
Hi Seref, I am not sure what the extend is. I don't know many details. I 
believe that there will be in Alkmaar a sort of cooperation between 
OpenEhr and Google or Microsoft. This, I conclude from combining 
information that comes to me.
The situation at this moment is: In the Netherlands there are (according 
my information) hardly hospital wide medical information-systems. Most 
hospital-systems are administrative.
This is because in a hospital clinicians often work in small business 
groups with all their own data-store. They pay hospitals for having a 
place to work, and other services.
Some services in hospital, like, f.e. laboratorium, are used by all 
clinicians, and have their data hospital-wide on a hospital-system.
/(However, in academical (university) hospitals, this is completely 
different. Most hospitals in the Netherlands are not connected to 
universities.)/

Now, the government does no longer accept this, and is in the opinion 
that there must be medical information systems, not only hospital-wide, 
but country-wide. They even set up a very expensive study- and design 
group NICTIZ, which in 7 years is to come with a product that maybe 
could be good 7 years ago, but it is not anymore today.
Like banks, insurances, shops, supermarket, even police and government, 
they offer Internet services. If there is a country-wide medical 
information system, the patient needs too his connectivities and 
responsibilities in this system. The NICTIZ system as far as is designed 
does not offer this. In fact it is a very old fashioned system, typical 
for the last century.

This is where Google and Microsoft come in. They fill in the information 
gap in many hospitals, they give responsibilities to the patient, the 
have Internet connectivity, they use most modern technical architecture 
(cloud), they offer an API for third parties to connect to, and large 
companies like these are well equiped for 24/7  99,999% uptime and save.

The only thing the Dutch government has to do is make service 
level-aggreements on where to store data, how to backup, which 
security-levels, etc.

The govenrment is not yet that far, they see it as a political blamage 
to give up NICTIZ, it costed hunreds of millions, in 7 years, and 
produced nothing that is yet working. The hospitals however, they don't 
have the risc of blamage, but they have an information gap.
You know what they say in the Netherlands about sheep: if one is over 
the bridge, others will follow, something like that.

It could go fast.
> What about the legal consequences? For example: I can remember being 
> told my multiple sources that it is not legal to store healthcare data 
> of a UK citizen outside of UK. Will the mentioned solution be located 
> in USA? Are there similar legal constraints for discussed setup?
There is a lot to say about legal consequences, for example, copyright, 
who is the owner of the data but on the other hand, the patient will be 
responsible for what to store, and by whome visible, that must be a big 
relief. It maybe makes things in legal perspective simpel.
However, this is only what I think and read, and I am not an expert in this.

Bert
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