Although a series of consumer information technology products such as word processing programs, search engines, social networks, email systems, mobile phones and applications have penetrated into all aspects of modern life, clinicians seem to find themselves in an era without the Internet The development of the electronic medical record system that lags behind requires doctors to be in a complete and professional environment to complete their work tasks ... In fact, information technology in the field of health care is not fundamentally different from information products in other industries. The technology of customer relationship, web application and secure cloud data storage widely adopted by the industry can be fully applied to the pharmaceutical industry. It is believed that after proper preparation process, some innovative products will be launched quickly, opening the era of post-electronic medical records.
There seems to be a widespread misconception in the pharmaceutical industry that information technology systems in the medical and health field need to be complicated and highly specialized. This has led to the rising cost of information technology, the burden on doctors has increased, and technological innovation has stalled. Doctors are increasingly restricted by the various documents and communication products used in their work, and the functions of these products are often decades behind those of other documents and communication products that people use daily.
Although consumer information technology products including word processing programs, search engines, social networks, e-mail systems, mobile phone applications, etc. have penetrated into all aspects of modern life, clinicians find themselves as if they have returned to the era of no Internet , They often need a complete and professional environment to complete all kinds of work tasks. Over the past few years, the United States Federal Government has vigorously promoted the development of medical informatization through the National Office of Health Information Technology Coordination (ONC), providing an information foundation for accountable medical care, patient safety, and health care reform. However, now that work needs to continue to take a step forward, it is necessary for us to integrate electronic medical records into a dynamic, cutting-edge, and constantly improving information infrastructure, rather than stuffing all the health care and workflow processes into the already restricted Electronic medical record operating system.
There are common misunderstandings in traditional electronic medical records
It was pointed out that some electronic medical record manufacturers often promote a wrong concept, that information technology in the medical and health industry is fundamentally different from industry and consumer information products, and its purpose is to protect prices, monopolize market share, and prevent new competitors. Enter this industry. For managing complex and complex tasks in the healthcare industry, current tools should have a way to become more high-quality, safe, low-cost and fast.
In fact, the information technology in the earliest medical and health fields is at the forefront. In 1966, the OctoBarnett laboratory at the Massachusetts General Hospital in Boston, USA developed the earliest efficient programming language for electronic medical records. It was called the Massachusetts General Hospital Universal Multiprogramming System (MUMPS). The personal computer uses only 16KB to run multiple terminals that support electronic medical records. However, after nearly half a century, most electronic medical record manufacturers have little innovation, and they have not even introduced the most recognized modular structure today, resulting in a series of functions such as product performance upgrades, innovative use of data, and interactive operations between software. Are difficult to achieve.
The lack of technological innovation reflects the reluctance of some electronic medical record manufacturers to let the data they collect circulate, and even opposes the openness of information data. This attitude ignores the need for dynamic and vertical observation of individuals or groups in the medical and health field, and has affected the progress of the medical industry in electronic information infrastructure for decades. The business model adopted by these electronic medical records companies controls all data as trade secrets, rather than openly applying the data to innovative clinical uses.
At present, many academic medical centers have imported data into open source systems that do not rely on manufacturers, so that they can carry out population-level data analysis and management on their own, and can share the results in multiple places.
Commercial electronic medical records are derived from the medical management system, that is, the medical charging system. Later, in order to meet the needs of patients' safety flow, the manufacturer added the function of the document module and the input of medical orders. Despite the proliferation of electronic medical record vendor portals in the past few years, there are currently more than 700 manufacturers producing 1,750 types of certified products, but their systems are still separate. Since each electronic medical record product operates independently, beneficial innovation work also has its own way in the market and is difficult to unify. In addition to this, several companies that occupy a considerable market share are still using outdated methods.
Medical information technology needs revolutionary innovation
The healthcare information technology market requires revolutionary innovations, which will promote patient participation, communication and medical collaboration, thereby improving the health of the overall population at a lower cost. Just as consumers choose all kinds of online products, doctors should choose and manage medical information technology products like Facebook as a social network, Twitter as a microblog, Google as a search engine, and iTunes to play music. Only a small portion of information technology that is not highly relevant needs to be highly specialized, and most of it is not protected by patents.
Privacy safe storage is such an example. Many industries, like the medical industry, rely heavily on the security and privacy of data. If you attach a strong privacy policy that complies with the regulations, such as local or cloud storage provided by EMC and Amazon is very suitable for the medical industry. In contrast, every electronic medical record used today relies on local information technology teams to support it, or in small offices relying on medical staff to maintain it. This situation often leads to large variables in data security.
Secondly, there is nothing special about the communication between doctors and patients. It is possible to use existing safe and flexible products and protocols. For example, a project called "Direct Project" initiated by the US National Office for the Coordination of Health Information Technology, whose goal is to promote a secure communication system based on the SMTP protocol (a simple mail transfer protocol with decades of history) in the medical industry usage of. This project provides an example for general technology to be incorporated into the healthcare industry in an open, standard, and integrated manner.
Once again it is the documentation tool. Many other industry document processing tools and other software that supports task-based group processing are far superior to electronic medical record systems. As a simple example, many electronic medical record document processors cannot complete spell checking. Other industries use highly improved project management software to process complex processes, and can also use advanced tools such as Teambox, Basecamp, and Huddle to record extended interactive processes.
Another point is that although the analysis methods for managing individuals and people are often unique to the healthcare industry, downloading, mapping, maps, and data analysis tools are not. Some tools are also free and open source resources, such as Google Maps and R statistics package. Although other tools such as ArcGIS and SAS are protected by patents, they have a common programming interface that integrates various workflows for users in different industries. The cost of all these tools may be only 1% of the commonly used electronic medical record system.
The era of electronic medical records after the development of new products
The special feature of medical information technology lies in the content of medical regulations and clinical decision support system. However, software systems based on regulations are not protected by patents and can also be purchased. Because electronic medical records are not designed to integrate with third-party applications, each manufacturer must develop its own rule system to restrict users, and it must also specify the rules repeatedly.
Although some data used in the medical industry is unique to the medical field in terms of storage and use, there is no particularity in achieving data sharing among multiple electronic systems. For important data, banks and airline reservation systems have solved this problem at the global level. The data systems of these industries started out as individual soldiers, forming thousands of different data structures in various complex systems, but developers eventually gave these systems a high degree of functionality and real-time interoperability. In addition, in many industries, whether based on Oracle, SQL or Hadoop, the basic data storage and data reading systems are mostly standardized.
Although the human-computer interaction between doctors and patients requires deep personalization to support complex and special medical workflows, the interface itself can be created using flexible and patent-free tools.
The foundation of information technology required in the field of healthcare is the core components of medical data types, standardization of medical workflows, and related knowledge (such as practice guidelines, decision support tools, and care plans). With these architectures, existing free and flexible software can support the automation of biomedical processes. Many merchants have adopted large, cross-industry platforms to support customer relationships, web applications, and secure cloud data storage. This method can be applied to the medical field.
Medical information technology vendors should use modern technology whenever possible. Clinicians should no longer be restricted by electronic medical records that reduce their efficiency and stifle innovation. The new company will provide a series of the best interactive replaceable technologies, several of which are being developed under the auspices of the National Office of Health Information Technology Coordination. These technologies will be optimized to bring information technology to the healthcare industry. progress. I believe that after proper preparation, these products will be launched quickly, which marks the advent of the post-electronic medical record era.
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