Comments on: Untangling the Electronic Health Data Exchange http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/ Chronic Disease Management • Technology • Strategy • Issues and Trends Mon, 15 Mar 2010 19:40:15 -0600 http://wordpress.org/?v=2.8.2 hourly 1 By: Dr. Matt http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/comment-page-1/#comment-12214 Dr. Matt Tue, 22 Sep 2009 02:32:07 +0000 http://e-CareManagement.com/?p=288#comment-12214 This is likely not THAT important, and basically supports the good works of the author. 1) if you really don't want top down and want PERSONAL health records, make it able to be made by the patient and privately held. 2) make it in HTML. If it is in HTML, then the different sections can be demarcated with and written by anyone and read by anyone. If it is held by the patient confidentiality is moot. If it is from the patient it is a primary source. 3) Neither 1 NOR 2 are incompatible with the author's views. This is likely not THAT important, and basically supports the good works of the author.
1) if you really don’t want top down and want PERSONAL health records, make it able to be made by the patient and privately held.
2) make it in HTML. If it is in HTML, then the different sections can be demarcated with and written by anyone and read by anyone. If it is held by the patient confidentiality is moot. If it is from the patient it is a primary source.
3) Neither 1 NOR 2 are incompatible with the author’s views.

]]> By: Andrew Needleman http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/comment-page-1/#comment-11735 Andrew Needleman Sun, 11 Jan 2009 20:32:01 +0000 http://e-CareManagement.com/?p=288#comment-11735 David, thanks for your thoughtful analysis of this issue. This is a great example of the issues that we face with healthcare data transmission and storage standards. I heartily agree that I couldn't care less which standard is adopted as long as one is adopted for each use case. Until we work together to bridge the gap between these standards and many other standards, the benefits of electronic medical records and other software systems will be handicapped. Even the "worst" standard for each use case winning would benefit the greater good, as it would save a tremendous amount of money and effort. This money and effort could be used to create software and services to help people live longer and healthier lives. David, thanks for your thoughtful analysis of this issue.

This is a great example of the issues that we face with healthcare data transmission and storage standards.

I heartily agree that I couldn’t care less which standard is adopted as long as one is adopted for each use case.

Until we work together to bridge the gap between these standards and many other standards, the benefits of electronic medical records and other software systems will be handicapped.

Even the “worst” standard for each use case winning would benefit the greater good, as it would save a tremendous amount of money and effort. This money and effort could be used to create software and services to help people live longer and healthier lives.

]]> By: Linh C. Nguyen, MD, MS, MMM http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/comment-page-1/#comment-10279 Linh C. Nguyen, MD, MS, MMM Sat, 21 Jun 2008 13:57:51 +0000 http://e-CareManagement.com/?p=288#comment-10279 David: I like your analysis of current standard. Nevertheless, USC's MMM program taught us the same theory "the best marketing, distribution, and power relationships to make implementation work." I believe Healthvault is showing this through their recent conference in Washington. I may be wrong, but I thought HL7 v2.4 has been used by 94% US IT. V3.0 is more popular now in Europe and gaining popularity in US. HealthVault adopts all standards (XML, HL7, CCR, CCD, etc). If Google Health mainly adopts CCR, are they behind? Next, does Google Heatlh allow bilateral interface (I believe they do with Medem)? Some said not. Afterall, I believe the trust is leaning toward Microsoft at this time, supporting by their privacy policy when compared to Google Health's privacy policy. Best Regards, LCN David:

I like your analysis of current standard. Nevertheless, USC’s MMM program taught us the same theory “the best marketing, distribution, and power relationships to make implementation work.” I believe Healthvault is showing this through their recent conference in Washington.

I may be wrong, but I thought HL7 v2.4 has been used by 94% US IT. V3.0 is more popular now in Europe and gaining popularity in US. HealthVault adopts all standards (XML, HL7, CCR, CCD, etc).

If Google Health mainly adopts CCR, are they behind? Next, does Google Heatlh allow bilateral interface (I believe they do with Medem)? Some said not.

Afterall, I believe the trust is leaning toward Microsoft at this time, supporting by their privacy policy when compared to Google Health’s privacy policy.

Best Regards,
LCN

]]> By: David C. Kibbe, MD MBA http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/comment-page-1/#comment-10258 David C. Kibbe, MD MBA Fri, 20 Jun 2008 12:04:44 +0000 http://e-CareManagement.com/?p=288#comment-10258 Dear Dave: Thanks for your comments. Yes, I agree that many times the best product doesn't win the race. The best standard doesn't get implemented. But I don't think that's happening here, in part because both the CCR standard and the CCD use the content and tagging of the CCR standard. Perhaps HL7 will eventually control the standard, because they have the money and the power. But I still think that market forces will dominate the technical issues, particularly now that Google, Microsoft, and other consumer brands are in play. DCK Dear Dave: Thanks for your comments. Yes, I agree that many times the best product doesn’t win the race. The best standard doesn’t get implemented.
But I don’t think that’s happening here, in part because both the CCR standard and the CCD use the content and tagging of the CCR standard. Perhaps HL7 will eventually control the standard, because they have the money and the power. But I still think that market forces will dominate the technical issues, particularly now that Google, Microsoft, and other consumer brands are in play. DCK

]]> By: Dave Rearick, DO, MBA http://e-CareManagement.com/untangling-the-electronic-health-data-exchange/comment-page-1/#comment-10257 Dave Rearick, DO, MBA Fri, 20 Jun 2008 11:55:52 +0000 http://e-CareManagement.com/?p=288#comment-10257 Although I am in the same camp as Dr. Kibbe and Vince, I believe both are ignoring the fact that in almost all business endeavors the eventual winners are not the ones with the best product; it is usually those with the best marketing, distribution, and power relationships to make implementation work. It took me 20 years as a clinician, and 15 years as a physician executive to learn this lesson. For example: It is the hospital administration and/or the managed care industry (who can devote 40 hours a week, $$$$, people and time to their efforts) pushing their agendas that will win over an unorganized provider community (that meets only before or after office hours). For any significant project, these are the "industry experts" and this is their business and they will devote the planning and resources to get their way. Normally, end users don't have this level of committment. It is how the world works. Welcome to business. Dr. Rearick Although I am in the same camp as Dr. Kibbe and Vince, I believe both are ignoring the fact that in almost all business endeavors the eventual winners are not the ones with the best product; it is usually those with the best marketing, distribution, and power relationships to make implementation work.

It took me 20 years as a clinician, and 15 years as a physician executive to learn this lesson. For example: It is the hospital administration and/or the managed care industry (who can devote 40 hours a week, $$$$, people and time to their efforts) pushing their agendas that will win over an unorganized provider community (that meets only before or after office hours). For any significant project, these are the “industry experts” and this is their business and they will devote the planning and resources to get their way. Normally, end users don’t have this level of committment. It is how the world works. Welcome to business.

Dr. Rearick

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