Helping to Eliminate Mistakes in Medical Treatment (Part 1)

Loren Mack is a design architect in xDesign who creates strategic and tactical designs for the Service Oriented Architecture/Business Integration group at Sun.

I love design; especially when I get to work on something that can make a difference in the lives of everyday people. My latest project is just that: an interface design for a health care tool. It's not a nerdy tool like I normally get to work on, rather it's a tool for health care folks to use to ensure that when I (or you) go to the doctor, the doctor knows who I really am. This kind of information can prevent a blood-type mismatch or having a kidney donated, when I was really supposed to have my toenails trimmed. The cool thing is that this kind of design also can make a difference for every day folks; a group I don't usually impact directly.

The problem that we're trying to solve is keeping the records of a person's various medical treatments connected to each other. Several different systems all have a unique record of a patient that's pertinent to the system-owner's service (the doctor, pharmacy, or hospital). And even though there are really smart people putting information into these systems, well, mistakes can be made — things like hitting the wrong key, misspelling a name, transposing a SSN, that sort of thing — small mistakes that can have a large impact.

A colleague of mine had the same first, middle and last name as another girl, who went to her high school. Coincidentally, they also had the same birthday, one year apart. Unfortunately for them, they also went to the same primary care physician, which they weren't aware of until the other girl's medical charges showed up on my colleague's insurance. This kind of confusion over identity could cause a problem for one or both of them for anything from blood-type to allergies.

So, when I go to my doctor and I need an antibiotic, she should know from previous visits and my health care records that I'm allergic to penicillin. When I go to the pharmacy to get my prescription filled, their records of me would ideally be linked to my doctor's records and I won't get any substitutions for the prescription that would cause me to, say, die of anaphylactic shock.

Comments:

That sounds like a great application. Despite ballooning costs, the medical field has been very slow to adopt IT improvements and make caregivers more efficient.

Are there any special privacy protections you have to implement to comply with HIPAA or other regulations?

Posted by Joshua Ledwell on August 08, 2007 at 06:10 AM PDT #

Joshua - Thanks for your question!

Essentially every transaction is recorded. Any access, along with CRUD (Creat Read Update Delete) functions are written to a transaction log, and those logged transactions provide the auditing levels necessary for complaince.

This, and requiring user authentication for using the tool satisfies the regulations, keeping in mind the users are authorized to view basic patient data for their specific data processing tasks (things like names, addresses, SSN, and identifying data like blood-type).

What's not included in these patient data are things like specific diagnosis, treatments, etc. - things that should \*only\* be accessed by their doctor. This level of authentication is enforced by the individual systems which comprise the back-end data sources.

The back-end and user-interface for this tool simply help to link the records from these systems together (think master index).

I hope I answered your question. Thanks again!

Posted by Loren Mack on August 16, 2007 at 07:56 AM PDT #

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