A week or so back I needed to put some stuff in storage as we’re moving house. Apparently my fine heirlooms are not conducive to selling the place, I was told. The storage facility I choose was pretty local and had the look of the scene from the end of the Raiders of the Lost Ark where the Ark of the
Covenant is placed. Anyway, I got talking to the staff and they were pretty happy to admit (almost proud) that they stored both healthcare and legal records there. I must have an honest face.
The place itself did not have the room to have direct access to each box, instead what they did was note where a box was in the stack and then bury that stack behind other more frequently accessed stacks of boxes. I asked what happened when they lost a box and the guy on the forklift rolled his eyes and said “You don’t want to know.”
This is all well and good until you consider that occasionally its important to access medical history in a hurry. What if there’s a hold up on a diagnosis? Or a clinician needs to give drugs or treatment for an acute condition where there’s the possibility of interfering with previous meds. I know what my luck is like with admin mishaps and these are not odds I want when my (or your) health is at stake. We’re assuming that the admin from your GP went smoothly and the request for retrieving your record was made against the right box in the first place.
At this point I could go into the waste that this kind of data being tied up in paper represents when you might want to look at a population to see what effects medicines, the environment and upbringing might have on health. The fewer paper records you look at the more the doubt is about figures that come out some the more studies need to be done. In other words, it costs a country (us) in money and lives to keep medical records on paper.
I was involved in the project to try to solve this problem in the UK the first time round. It had partial success would be one way to describe how it went. Now the UK health secretary, Jeremy Hunt, has announced a second attack at the problem. A less monolithic one hopefully, one less dependant on the pain that mega SOA architectures built on heavy weight HL7 brings. It is possible to build for health data sharing a different way based on what projects need as opposed to what government ministers wish for as a legacy. See what the Oxford MMM project is doing in this area.
We now have new ways to tackle this problem based on the ease of exposing data over lightweight APIs – maybe a bit much for a surgery but an NHS Trust IT department could get their heads round it. Big Data in healthcare means we’re not tied to huge SQL DB suppliers or having to have health data as a strongly typed with HL7 any more where that’s not needed. OAuth 2 and SAML means we can share, track and trust access tied it to staff identity.
Anyone for a high speed messaging / API governance tool that can understand health care protocols, auth tokens AND talk to backend data services? Intel Mashery for Healthcare Information Exchange.