Brian Bray wrote:
>
> The more I think about EMR, the more I think of a document for each
> patient. No database or middleware needed ;-)
The beauty of this "solution" is that it satisfies the patient's need
for privacy. The "document" can easily, emphasis easily, be under the
patient's control via encryption, whatever. Is there any way to sell
EMR directly to patients? I think there is, and in fact there are many
websites that currently purport to do just that. They're not open
source, though.
The problem is physician access. Having been tarred with the brush of
the VA (heaven forfend!), I feel slightly uncomfortable mentioning it
again, but physician access has been totally knocked by VistA. The
"best of breed" systems installed in other hospitals are just that:
dogs. They need to go to the pound ASAP.
But something that patients control over the web, is immediately
accessible (with the correct permissions) over the web. And it neatly
finesses all legacy systems (even VistA).
You just have to ask yourself: how much do we really need to know about
patients? Do we need images, or just reports on images? Can we get
away with 90% historical data. Mike Roizen's editorial in the NEJM
seems to suggest that we can.
John Gage
