On 2003.06.13 14:44 Tim Cook wrote:
On Tue, 2003-06-10 at 04:43, Thomas Beale wrote:
> agree with all this; the big question in my view is to do with data
> governance, and infrastructure ownership/guardianship.


<snip> > (something more like HMOs that stretch around the globe?)

I know you are all tiring of my US family physician centric point of view. <g> But it really seems to work now for paper and the less you change the way people work (initially) the better the acceptance. With less than 10% penetration this is a primary concern here.

If my EHR is too large to fit on a CD, USB stick or any other portable
media.....then when I checkin/register with my new physician I tell
them
who my previous physician was and they request a copy of my record in
the magical stan

Hey . . . this list is supposed to let us dream a little without risking exile to corporate Siberia :-)


Would it be any consolation to know that when I do consulting, it's 60% "leading horses to water?" I can certainly emphasize with Tim's view. Same situation with developing websites as it is healthcare software.

I tend to look to presently established business practices that provide a useful means for segue to a new system. In my state, for example hospitals report monthly statistics to the dept. of health. It's a good process to learn from when pondering these ideas related to data sharing.

In Mexico, which is mostly "cash and carry" medicine I have no idea how a migration would work, but I suspect it would only happen between crony doctors at first - if at all.

In the land of OZ (Australia), where American insurance companies will pay for surgeries, it may be a different story still. I'm guessing . . .

--Richard



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