Administrative data exchange is built right in. I can’t imagine what you mean by non-scalable.
Err uhh… excuse me but HL7 works with any EHR anyone chooses to use and allows interoperability between HIS and clinical systems no matter what system is in use.
Why is that even a goal? Isn’t security and data quality more important than imaginary ownership?
So a plumber needs to make sure all his notes are owned by the person who hired him to do some work?
It’s not designed to be a panacea. It’s designed to allow timely and accurate data exchange between healthcare provider information systems. That’s the only issue it solves so how to hire better nurses will need a better solution than HL7.
Of course there is. Your primary care physician should be doing that for you already or have they failed to implement HL7 and are still working on paper?
Which is what HL7 solves but providers keep giving excuses as to why they choose not to implement an HL7 interface on their systems.
How is your local doctor not having a modern clinical system the fault of HL7?
Yeah, because AWS has never been hacked right? Pull the other one buddy.
“It’s free”
Disingenuous - the packages to add support for HL7 are expensive add-ons for existing systems
“HL7 v3 messages are based on an XML syntax”
The message structure itself is simple, implementation and deployment are complex (which I’m sure you know)
“I can’t imagine what you mean by non-scalable.”
I mean (as I stated in my original comment) that setting up point to point integrations between every single one of the hundreds of thousands of providers in the US alone is a task that would take centuries and is completely unfeasible. Point to point doesn’t scale
“Why is that even a goal? Isn’t security and data quality more important than imaginary ownership?”
And here is where your true colors show.
“Imaginary ownership?” Its MY fucking data. Personal, vital, and paid for my by ME. The whole point of integrating systems should be to allow for transparency and ownership pf medical records BY THE PATIENT.
HL7, as I said earlier, is a way to integrate billing systems by linking clinical systems with billing systems. Its not designed to improve patient outcomes or allow for transferability and ownership of medical records. Which is why its a good solution to the wrong problem.
And, in the context of the original article - completely inappropriate for a single-payer health system like the NHS
“So a plumber needs to make sure all his notes are owned by the person who hired him to do some work?”
Such contempt for the patients and medical system - I truly hope you are retired or no longer working in the field.
And I’m tired of educating you. You are being purposely disingenuous and obtuse. Have a wonderful day in your EHR sales job (enjoy it while it lasts).
Feel free to attempt to make that case. Everyone that’s tried it on me has failed, because they used “oh, Amazon and Google are big and well known, and you aren’t, so therefore they are smarter and better than you” as their base premise, which is an easily disproved fallacy.
It’s illegal to store protected health information on other people’s computers* unless you have a B.A. (business associate contract) with the provider, and computers outside the US are not subject to US law, so you’d be extremely stupid to move HIPAA/HiTECH PHI to a cloud with any non-US computers in it.
Amazon, I believe, will sign a BA and restrict your data exclusively to US servers, so probably others will also. But the service is too pricey for most small single-office shops, and large multi-site operations processing PHI can build out their own clouds to provide lower cost, higher reliability, better security and disaster recovery and (perhaps most importantly) direct control of data without middlemen. So it’s just a sort of middle niche that find it worth the effort.
* “the cloud” is marketspeak for “other people’s computers”.
That depends entirely on the system and administrators should consider any system without an HL7 interface to be a non-starter. Again, this is not an issue with HL7 but rather the clinical system chosen by the provider.
Not at all. My team of 4 banged a custom one out for a Meditech system in less than 4 months which includes coding, testing, and implementation.
With the advent of SSL based VPN systems, it’s really quite easy in Unix, Linux, Windows, and even MUMPS. You basically just request a configuration file. Also, your argument of “every single” is ridiculous on it’s face. Most clinics and hospitals will have a handful of connections to a few local providers. Hospitals can easily act as clearing houses between counties and the clinic therein. So, even for out of state data, you would just need a connection to the local county hospital clearing house or failing that to the office of the last PCP for a given patient.
Seems to me what you said is that it doesn’t integrate administrative data. But in any case, it actually is designed for clinical data first and administrative data second. By providing accurate and timely clinical data it does indeed provide for better patient outcomes.
What the heck does the number of payors have to do with exchanging patient information between clinical systems?
Is it? Is the transcription of a surgery involving the conversation between two doctors your information? Is the adjustment to the bill provided by the contractual agreement between a hospital and an insurer yours? Are the doctors private notes concerning the mental disposition of the patient owned by the patient? No, I think you have an idea of what a medical record is but little understanding of all that can be involved in it.
Let me know when you have something of value to educate me on other than uninformed F.U.D.
You have a point of view based on a technocratic clinical based software vision.
Clearly we disagree on this, although your examples of what may be in a medical records are (IMHO) red herrings that don’t belong in that record. That may be what records include in the US for-profit system, but I’ll remind you that no other country in the world has chosen to follow that path and, as I said before, the original discussion was about the NHS in the UK (about which you seem to know very little).
I’ll let other people reading this thread judge whether I was the one who’s uniformed and spreading FUD.
I deal with NHS IT every day. It’s provided by Capita, and it’s fucking horrible. The main bit of software I use crashes if you log into it whilst looking at it funny. The whole thing is a squamous hellscape of repurposed enterprise software, legacy databases running on Access for fuck’s sake, convoluted Excel nightmares, string and spit.
Hah, Wells Fargo mortgage used Excel macros and VBscript for their letter generators. I only know because someone offered me a job working for them and I asked what technologies they used and that was the answer. I said no thanks. Scary stuff.
It’s amazing what old, crappy tech some very large companies still use. To be fair, upgrading can be a daunting task, and if it ain’t broke, don’t fix it. Plus it keeps that old guy who looks like a wizard who has jars of toenails in his basement and knows COBOL working.
