Archive for the ‘Uncategorized’ Category

EHR in the Cloud

Friday, November 6th, 2009

Electronic Health Record in “the cloud?”  Honestly I can’t imagine it anywhere else.

Disappointingly but true to form, most healthcare practice management systems are bundling their EMR/EHR capability into their products.  Many of them continue to emphasize the “shrink-wrap” locally-deployed model to keep revenues flowing.  EMR in a proprietary system?  Yes, of course.  EHR?  Ludicrous.   EHR implies interoperability, and a complete unique dataset independent of practice management systems.

The doctor or hospital intake and practice system may indeed be instrumental in creating the initial demographic and procedural linked data, but the EHR belongs in the cloud.  Why?

  1. It doesn’t belong to the care provider – read up on HIPAA.  It belongs to the patient and their agents.
  2. It needs to reside in a place anyone can access, given prior authorization or “break the glass” emergency credentials.
  3. It needs to be impervious to local datacenter disasters.
  4. It needs to be highly secure.

Other than #4 above, which can be addressed via HIPAA-compliant data security and access technologies anyway, there shouldn’t be any argument to the EHR in the Cloud.  But the U.S. Government money set aside to encourage EMR/EHR proliferation is targeted to care provider organizations.  With an offset of tens of thousands of dollars per physician/provider to buy new EMR practice management systems, the money is in local systems infrastructure.  And that’s what got us into this mess in the beginning.

Patient, own your EHR.  Physician, heal thine own practice management system.

Sourcing Content from the Cloud

Friday, October 16th, 2009

Sourcing content from the cloud rather than from your own server and application software opens up a large can of nightcrawlers.  Besides the copyright and fair use issues, besides the security and intellectual property issues, there are major performance and reliability issues.  Not to mention, the apparent lack of control.  Can you imagine someone two degrees of net separation away, creating content into your institution’s public presence?

Why would anyone want to do this?

Hello Cloud!

Wednesday, October 14th, 2009

I’m just wrapping up my configuration work on the services.  In the traditional provisioning model this would have taken weeks, and I’m only going on my second day.