On 23 Apr 2005, at 3:25 AM, Adrian Midgley wrote:
I am not convinced we always address the collection of problems and opportunities from the right aspect.
I prefer to think about _automation_ rather than just an EMR, and about tools for tasks rather than a whole system. I know that re-usable code and integration of different pieces is harder in practice than in theory, but ...
I also believe we have not considered the use of the computer and network as a Knowledge Source for medical/healthcare practice sufficiently, and some distance remains, in England although it is decreasing, to the establishment of an ecology of people making a living, and technical resources aligned to FLOSS.
Looking at the opinions published by the US Leapfrog Consortium, and
reviewing my memories of the development of UK General Practice software
over some decades, the prescribing system seems to be the first clinical
tool to be of obvious value.
This implies the presence of a register - a list of who is a patient/was
a patient (but does not absolutely _require_ it, or require it to be
complete).
The Connecting for Health group (a fellow traveller to the Leapfrog group) is working as we speak to deliver just this type of index. They call it the "Record Locator Service". Their most recent technical overview ("Linking Healthcare Information" published in February) is available in pdf on the project home page at:
http://www.connectingforhealth.org/
The RLS observes a distinction between "knowing where a record is located" and "knowing what is in the record".
The OpenHRE project is following the RLS specification.
[wr]
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