On Sat, 2003-06-07 at 16:56, Tim Cook wrote: > On Sat, 2003-06-07 at 13:43, David Forslund wrote:
> > Records today aren't available when they are needed even within a given > > hospital. I don't know how to consolidate across international boundaries > > let alone between two hospitals across the street from one another. They > > don't want to do it. Consolidation in a region doesn't rule out > > federation on > > a larger scale. I think consolidation in a region makes good sense with the > > caveat given below. The consolidation may take the form of a secondary > > caching server to ensure the data has high availability. > > WOW! Are we ever in different worlds. I'll come back to this. <s> Maybe I should start with definitions, in context of healthcare records just to see where we are? This might be part of the divide. Federated - each component of a patient record is stored where created and all components are joined by a unique pateint identifier. Consolidated - each component (or copy of the component) of a patient record is transmitted to a master patient record. Your first sentence about records availability is the problem we're looking to solve, isn't it? Consolidation across international (if I may narrow that to language) boundaries is certainly an issue. Hopefully if I am in a foreign country I can find a physician that speaks my native language to treat me. If not, I likely have larger problems than getting those documents translated, though they can still be stored in my record. In any case (in my little dream world here) the consolidation occurs because I instruct any healthcare provider I see to place a copy of their findings in my master patient record hosted by my primary healthcare provider. Your last statement about consolidation and caching is what led me to do the definitions. I'm not certain where there is any benefit in a combined federated/consolidated environment. Later, Tim
