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Comment by pstuart

2 days ago

Seems like a wonderful win/win opportunity to have the software be FOSS but enable small businesses to provide hosting/support/customization.

The biggest win of all is if we had an open/extensible/maintainable data exchange format so that we could eliminate the need for paperwork. How many times must we fill out the same information, and then require the providers to keyboard it in?

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pstuart

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nradov  2 days ago

There are in fact multiple data exchange formats published by standards development organizations including HL7 (V2 Messaging, CDA, FHIR), DirectTrust, NCPDP, DICOM, and X12. Some such as HL7 and DirectTrust are very open, others may require a paid licensing agreement. Usage of some of those standards is mandated by CMS interoperability regulations and/or ASTP (ONC) Health IT Certification requirements.

Beyond the wire formats, in order to eliminate the need for paperwork provider organizations also have to participate in data exchange networks. These include TEFCA, Carequality, eHealth Exchange, and some smaller regional HIEs. It all works fairly well when used correctly but many provider organizations continue to waste administrative effort and abuse their patients by failing to take advantage of the available technology. Like in many cases the necessary functionality is already built in to their EHR/PMS software but they simply don't turn it on or train their users.

anjel  2 days ago

Wasn't that in fact apropriated, launched and funded in the US under the Obama administration?

  • pstuart  2 days ago

    I recall various tech/data initiatives during that admin and my search came up with this: https://www.cms.gov/newsroom/press-releases/hhs-announces-ne...

    I don't work in healthcare but I do use their services and every intake interaction is the same paperwork dance, so it doesn't seem to have impacted providers themselves.

    There's another element that needs address as well, which is the controlled dissemination of one's medical history. It should be easy peasy technology wise, with the only blockers being political/entrenched players sabotaging it.

  • nradov  2 days ago

    You are perhaps thinking of the HITECH Act of 2009? The Obama administration didn't directly fund any open-source healthcare software. There were billions in federal grant funding available to provider organizations to purchase EHR software that met certification criteria for a certain level of interoperability and clinical functionality. This really accelerated the growth of commercial EHR vendors like Epic, as well as some smaller vendors that used FOSS within their offerings.

    https://www.hipaajournal.com/hitech-act-meaningful-use/