On Sat, 2003-06-07 at 18:15, David Forslund wrote: > >Federated - each component of a patient record is stored where created > >and all components are joined by a unique pateint identifier. > > This is not my definition of federated. There can be a hierarchical > federation as we > discuss in our AMIA 2000 paper on MPI.
After reviewing this work I stand by my 20,000' view (definition) of federation. While there is a hierarchical, peer-to-peer and modified hierarchical approach (of PIDS implementation)......they all accomplish the same thing.....identifying a specific patient across multiple systems. This is/can be used to tie healthcare related bits (parts of an EHR) together. > A local hospital could contribute their data to a consolidated record without > it being where there every day data is stored. Sorry, I missed your point here. > So when your primary healthcare provider changes, what happens? I get my EHR in XML [hey, we need to define this still ;-) ] and in printed format. > Who pays for the copy to be put into your master patient record? Just like always, the patient. Maybe in indirect ways. > Is your healthcare provider the same as your health record manager? Not necessarily as a person...but as a medical practice, yes. > I think there are big benefits. It may not be possible to send data from > your point of care to your primary healthcare provider. Not expressed yet....but I contend that all future systems should/must be able to accept stand format documents as input. This may cause research problems but an implementation should have the ability to search any standard document format. > It may be possible > to send it to a local consolidation point. One can search from there. > Check out our AMIA 2000 MPI paper. It discusses the pros and cons of > different kinds of federation. Again, we have a totally different point of view. Your approach looks at how we can "discover" data in an automated way. My approach looks at how we can store, in a consolidated manner, any healthcare data associated with a particular individual, in a central repository. Regards, Tim
