Discount airfare scotland. Last minute airfare deals. Low price airfare. Airfare. Discount airfare….

The other reason for silos is centralization… if data is spread around the internet, it’ll be slow at best, and likely unreliable as hell, leading to inconsistent data depending on which set of servers happen to be reachable.

I’d start with just a simple legislative REQUIREMENT that read-only access be mandatory for personal data stored by any corporation, with appropriate restrictions for law enforcement, privacy, security, etc.

–Mike–

Its a bear of an idea but the incentive might lie with government and private industry to improve service quality, efficacy, and cost-effectiveness for treatment prescribed versus cost-management for treatment delivered. A unique user account could simply be a number-based account (similar to a Swiss bank account) within each silo (and different for every silo) that would ensure complete anonymity for patients, and at the same time permit anonymous aggregation of data and statistics by healthcare providers, insurers, government, and industry.

Come to think of it – why shouldn’t government, education, transportation, and financial services work the same way?

I agree, any step in the right direction is a good step.

Your comment that it’s “maddening that a patient record as simple as a freakin’ ASCII text file,” is where we have to go. And where we will go. If it starts out as silo integration based on open architectures, it’s a good first flanking maneuver.

Once the practice becomes commonplace, then it makes sense to try to “improve” the practice with the rest of the reforms we all want, like filling this stuff out once, and having it maintained by the Doctors who name the conditions we’re suffering from, and who actually have the best CLUE as to what’s going on.

Its maddening to me that a patient record as simple as a freakin’ ASCII text file that gets appended and copied everywhere could probably save thousands of lives per year, and millions of dollars… just won’t happen anytime soon. We’ve got intertia and a ton of laywers who will chop on any little mistake to discourage innovation in the US… so it’ll have to happen elsewhere first, then arrive here when it’s so freakin’ obvious to everyone that we have to change it.

I don’t expect it to get better for a very long time, but hopefully it will before I get too old to remember all the things that have happened to me…

Small changes at the outside, with the big picture in mind… flanking maneuvers are key here… a frontal assault WILL FAIL.

–Mike–

I love the ideas of the patient using some sort of PDF file or even strong the data on the internet somehow (most medical offices have internet access at their reception desks for insurance verification). It saves time, money and would make the patients happier (they wouldn’t have to sit in a waiting area reading People Mag with a bunch of sick folks)

The comment about the compatibility problem is a big one, but if it could be overcome it could save the system oodles of money that could be used more effectively,

Doc, if you are ever up in SLO, I would be happy to show you how archaic the whole thing is (patient intake, billing….) in a small town medical system.

Excellent points. That could be a very good first step.

Our machine essentially turns paper into PDFs and adds taxonomy to those files so that they make sense to humans later on.This also supports the extensibility for machines to share data in a standard format unassisted.

That’s what I don’t want to lose: the metadata that supports the PDF(s). Otherwise I think it creates another set of problems, in that the PDFs have to be handled (sorted, stored, etc.) by a human being, which again opens up the sort of error-prone processes that electronic medical records are supposed to alleviate.

I think you make an excellent point about going around these beaurocracies. That’s probably the only way to create change in our lifetime. Do you have any thoughts about patients adopting an open platform, therfore pushing the doctors and technology companies to adopt that platform? Also, would you, as a consumer of healthcare, have any interest in being proactive about maintaining the baseline data that would be required to make such a platform viable?

Doc-

Proprietary formats and platforms are a huge problem in our industry. I haven’t taken my concept any further than our product because it would probably take an act of congress (literally) for developers to budge from their silos.

There has to be a creative way to make being closed a disadvantage, and it could very well be led by patients, or patients and doctors. I don’t personally believe it can be led by technology folks, although there will need to be enough adoption by tech folks to create that tipping point where you’re “damned if you don’t.”