Tuesday, April 29, 2008

Coordinating Less; Accomplishing More

On April 28, Government Health IT published an op-ed piece with my consent and participation. It was based on a longer and more spontaneous blog entry at this site. It had its roots in my wish to see more focus and immediate wins in areas that will raise the larger questions.
In this op-ed piece, I said:

"One hopes a smaller set of high-priority items will emerge that can be adopted across the health care sector. I believe about 12 of the core services are must-do high priorities, and many others could be set aside for future consideration."

I was commenting on the bewildering array of features and functionalities described in the Gartner NHIN I report. These features are actually more bewildering because each use case in turn added features and desiderata that may or may not be congruent with the larger NHIN list. The simple fact: there are a lot of things that would be nice to have, but the list of things we must have in a "Version 1.0" world may be fewer in number and complexity.
For each, I the pdf document linked above cross-references the relevant NHIN reports. Summarizing in a few words, the 12 core services are:
  1. Data delivery
  2. Look-up
  3. Matching
  4. Summary patient records
  5. Integrity
  6. Choice
  7. Audits
  8. Identity
  9. Authentication
  10. Management
  11. Security
  12. De-authorization
These may be the wrong items, and there may be differing priorities, but this writer at least believes starting with some of the NHIN terms - using these terms and supporting their evolution over time through thoughtful study - seems like one approach.


Blogger Dr. Deborah Peel said...

The key concern the public has for the NHIN did not even make your list: patient control over electronic health information.

This is the right to health information privacy which has been the foundation of the practice of Medicine since Hippocrates--and is reflected in very privacy-protective state laws, common law, tort law, Constitutional law, and the physician-patient privilege.

Strange how this Administration has systematically de-regulated so many industries and eliminated so many consumer protections. The disastrous effects of systemic de-regulation are now exploding into view.

If you like what de-regulation of the financial industry did to your job and 401K, you will love the effects of de-regulation on your electronic health records.

Today the US has very primitive health IT systems that were designed for data mining by millions of covered entitles and millions more business associates that in turn sell personal health data.

Today, with no trust in the President or Congress, Americans desperately need proof that the healthcare system and healthcare institutions are protecting their rights and interests, not stealing and selling sensitive personal data and endangering jobs.

CCHIT is a bunch of foxes designing hencoops--the chickens will never trust the results.

Deborah C. Peel, MD
Founder and Chair, Patient Privacy Rights

November 23, 2008 4:19 PM  

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