Archive for May, 2010

That was a rough ride

Monday, May 31st, 2010

Finally, we’re past the summing up of the problems in current health-care record systems. It was long, depressing, and admittedly quite boring at times, but oh so necessary. I hope you’re all in a suitably despaired state of mind to crave some solutions to all this misery, but first let’s see what we endured. I […]

Ode to a printer

Saturday, May 29th, 2010

We’re always complaining about stuff not working, but I just want to say how happy I’ve been, and still am, with our HP Laserjet 2300 DTN. Sounds like a commercial, doesn’t it? Anyway, as I replaced the drum today, I checked the numbers. We got it in the summer of 2003 and it’s never failed […]

OSX, FreeRadius, Netscreen, and me

Saturday, May 29th, 2010

Oh, wow, this was crazy. What I needed to get done is to have a Juniper SSG-5 firewall (which runs Netscreen OS 6.2) authenticate users from the FreeRadius server that runs by default in OSX Snow Leopard server (10.6.3). And I needed the SSG-5 to differentiate depending on groups on Open Directory on the OSX. […]

Problem: too much secretarial work

Friday, May 28th, 2010

Since current electronic health-care record systems are largely text based, there is a large amount of text to be written after each encounter. In Sweden, doctors generally dictate the entry after each encounter, and a secretary then types it out. The same procedure is used for referrals, reports, and letters. Brevity in notes is definitely […]

Problem: closed interfaces

Wednesday, May 26th, 2010

Current electronic health-care systems are built as monoliths. They are constructed and sold as all-in-one solutions, largely because of the failure of care provider organizations to successfully manage collections of smaller, more specialized systems. This failure is caused by two factors: The failure of the smaller vendors to cooperate and produce simple methods of supporting […]

Problem: confidentiality

Monday, May 24th, 2010

Electronic health-care records must implement and respect confidentiality settings, such that certain care givers will not be able to view information that the patient may not want them to. There are many aspects to this problem, such as if the doctor should be able to break these confidentiality barriers in emergency situations, if the existence […]

Problem: too much text

Friday, May 21st, 2010

This post is part of a series detailing the problems of current electronic healthcare records. To orient yourself, you can start at the index page on “presentation” on the iota wiki. You will find this and other pages on that wiki as well. The wiki pages will be continuously updated. Current electronic health-care record systems […]

Problem: no searcheability

Wednesday, May 19th, 2010

This post is part of a series detailing the problems of current electronic healthcare records. To orient yourself, you can start at the index page on “presentation” on the iota wiki. You will find this and other pages on that wiki as well. The wiki pages will be continuously updated. Since current electronic health care […]

Problem: no current status

Monday, May 17th, 2010

The entries in our electronic health care records as they are currently built, only give us a chronological list of measurements and changes of the patient’s condition and investigations and treatments applied to him. A number of these steps naturally result in a change in the status of the patient, such as becoming less ill […]

Problem: no archiving

Friday, May 14th, 2010

Patients naturally progress through life by accumulating some diseases and becoming cured from other diseases. The accumulated diseases are what we call “chronic diseases”. Typical examples are diabetes, rheumatoid arthritis, vascular disease, hypertension, etc. Other, temporary, diseases are for example: bone fracture, most infections, myocardial infarctions (except for the underlying vascular disease), and an increasing […]