5 ms·

I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Going a little further, th

by ip26 4y ago

I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Going a little further, this was appealing in part to avoid simple medical errors & oversights. Losing the record, mixing up records, incomplete history, and so on. Eliminating medical error is incredibly valuable but doesn't show up as "productivity".

sokoloff 4y ago
This is amusing as, 10 years ago, my wife (a decade-plus under 60, even now) showed up to a consultation with a doctor who remarked that she looked very good for someone over 60 and who suffered from a series of conditions that she did not have but showed up in "her" medical records.
- conductr 4y ago
  My wife is in 30s but has had a lot of women's health stuff going on the last decade. We stay completely within the same "healthcare network" of hospitals precisely because they actually use the same system and all doctors can access it (obviously we like the providers as well!) But even for basic procedures we could save a little on like lab work or imaging by going out of this network we've learned it doesn't really work as promised. It's still hard to get your records to stay together unless they're in the same company's database is what we've learned.
  - lotsofpulp 4y ago
    We do the same. My wife sees tons of suboptimal healthcare delivery due to lack of doctors having the necessary information. In our current area, it is easy to find doctors they use mychart and interface with local hospital, so if we were to end up in the hospital, our medical history is immediately available.
  - robertlagrant 4y ago
    Yes. All the systems are set up this way. The problem is: how do you allow departments to retain their fiefdoms in a world of centralised data? The answer is to spend a fortune on management consulting.
    - yurishimo 4y ago
      Or nationalize the documentation infrastructure. This is not a problem in the developed world. i give my doctor my tax ID and they can see my entire patient history, all of my medication, and relevant notes from other providers.
      - klyrs 4y ago
        That won't happen in a federation like US or Canada, sadly. The states (provinces) would have to either agree on an infrastructure (hah!) or agree to give that power to the federal government (OMG lol).
      - hotpotamus 4y ago
        I work in EHR as of this year. About a week into the new job, one of the older software engineers made a comment about how what we do should really just be a function of the federal government. I was like, "but wouldn't we be out of a job of they did?" And he said, "sure, but we'll probably be dead by the time they figure it out anyway".
        dashundchen 4y ago
        If you're in the US, the federal government actually created one one of the most widely used EHRs and set of clinical applications in the world, called VistA. It was made for the VA but is used outside of it. https://en.m.wikipedia.org/wiki/VistA https://en.m.wikipedia.org/wiki/VistA It's actually public domain and open-source. Unfortunately the VA is in an ongoing project to replace it with Cerner Millennium.
        robertlagrant 4y ago
        A project that's not going well. VA system might be MUMPS based, but it's very good, as you say. The big issue from my EHR-adjacent vantage point is that all the money is in making giant, entrenched EHRs, whereas the future should be in lighter-weight services that conform to standards, and competition is between those services. That way you could gradually slice off VA functionality piece by piece, and have a successful, more efficient, gradual migration.

by ip26 4y ago

sokoloff 4y ago

This is amusing as, 10 years ago, my wife (a decade-plus under 60, even now) showed up to a consultation with a doctor who remarked that she looked very good for someone over 60 and who suffered from a series of conditions that she did not have but showed up in "her" medical records.

conductr 4y ago
My wife is in 30s but has had a lot of women's health stuff going on the last decade. We stay completely within the same "healthcare network" of hospitals precisely because they actually use the same system and all doctors can access it (obviously we like the providers as well!) But even for basic procedures we could save a little on like lab work or imaging by going out of this network we've learned it doesn't really work as promised. It's still hard to get your records to stay together unless they're in the same company's database is what we've learned.
- lotsofpulp 4y ago
  We do the same. My wife sees tons of suboptimal healthcare delivery due to lack of doctors having the necessary information. In our current area, it is easy to find doctors they use mychart and interface with local hospital, so if we were to end up in the hospital, our medical history is immediately available.
- robertlagrant 4y ago
  Yes. All the systems are set up this way. The problem is: how do you allow departments to retain their fiefdoms in a world of centralised data? The answer is to spend a fortune on management consulting.
  - yurishimo 4y ago
    Or nationalize the documentation infrastructure. This is not a problem in the developed world. i give my doctor my tax ID and they can see my entire patient history, all of my medication, and relevant notes from other providers.
    - klyrs 4y ago
      That won't happen in a federation like US or Canada, sadly. The states (provinces) would have to either agree on an infrastructure (hah!) or agree to give that power to the federal government (OMG lol).
    - hotpotamus 4y ago
      I work in EHR as of this year. About a week into the new job, one of the older software engineers made a comment about how what we do should really just be a function of the federal government. I was like, "but wouldn't we be out of a job of they did?" And he said, "sure, but we'll probably be dead by the time they figure it out anyway".
      - dashundchen 4y ago
        If you're in the US, the federal government actually created one one of the most widely used EHRs and set of clinical applications in the world, called VistA. It was made for the VA but is used outside of it. https://en.m.wikipedia.org/wiki/VistA https://en.m.wikipedia.org/wiki/VistA It's actually public domain and open-source. Unfortunately the VA is in an ongoing project to replace it with Cerner Millennium.
        robertlagrant 4y ago
        A project that's not going well. VA system might be MUMPS based, but it's very good, as you say. The big issue from my EHR-adjacent vantage point is that all the money is in making giant, entrenched EHRs, whereas the future should be in lighter-weight services that conform to standards, and competition is between those services. That way you could gradually slice off VA functionality piece by piece, and have a successful, more efficient, gradual migration.