Monday Jun 04, 2007

Where should the Heathcare systems go?

Recently while having a look at the HL7 BC at the open-esb I felt that there are several issues and challenges that are not yet solved in this domain.

From a philosophical perspective too if we look at, the globalization is happening at great speed and we need interoperability amongst the standards for accessing a patient's record who is diagonalized for a particular disease to be treated at a different geo-political location. Why I m talking about political here is to emphasize the disparate systems via which the patient records pass and heterogeneous health care and insurance systems we have in different geo-political regions.

The following list is not complete. This is only a start for looking at the things. :-) . I might be writing you more if we continue to do work.
Have a look and give your feed back.

  1. Arden Syntax, which is a language for encoding medical knowledge. HL7 adopted and oversees the standard beginning with Arden syntax 2.0. These Medical Logic Modules (MLMs) are used in the clinical setting as they can contain sufficient knowledge to make single medical decisions. They can produce alerts, diagnoses, interpretations, and contain a quality assurance function and administrative support. An MLM must be run on a computer that meets the minimum system requirements and has the correct program installed. Once this is provided, the MLM can give advice when and where it is needed.

  2. The HL7 Clinical Document Architecture (CDA) is an XML based markup standard intended to specify the encoding, structure and semantics clinical documents for exchange. It is based on the HL7 Reference Information Model (RIM) and the HL7 Version 3 Data Types,

  3. Interoperability with Clinical Data Interchange Standards Consortium (CDISC)


2 and 3 seem to be pervasive in the Health care domain. Supporting these things would certainly enhance the marketability etc.. Apart from above if we were to be leaders we need to do have the following to with interoperability amongst these protocols in mind (Why interoperability ??? --- for flexibility and transforming one kind of data to the other kind offering seamless transfer of data from one system to another system. This has potential of One kind of record to be looked from another kind of system without the user being switching from one kind of domain to the other kind). Have a look at Open Healthcare, Good European Healthcare Record (GEHR) and Electronic Health Record (EHR) and Electronic Medical Record (EMR).

Without inter-operable EMRs, practicing physicians, pharmacies and hospitals cannot share patient information, which is necessary for timely, patient-centered and portable care. There are currently multiple competing vendors of EHR systems, each selling a software suite that in many cases is not compatible with those of their competitors.Office of the National Coordinator for Health Information Technology (ONC), works to address interoperability issues and to establish a National Health Information Network (NHIN) in US. Under the ONC, Regional Health Information Organizations (RHIOs) have been estabilshed in many states in order to promote the sharing of health information. US Congress is currently working on legislation to increase funding to these and similar programs.



About

I was part of Sun R&D in Java CAPS and later Glassfish ESB. I moved from R&D to Consulting. I am currently working as a Solution Architect in Oracle Consulting Services (India). I was sharing my experience w.r.t. Java CAPS and other technologies during Sun period. Now in Oracle world I share my experiences with Oracle FMW product line as well as other Oracle Technologies and products.

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