I was invited to give a lecture to the International Masters Programme in Health Informatics at Karolinska Institute, and we recorded a video of the entire lecture, in total around 3.5 hours. The last part is about iotaMed, our open source project for a “new and improved” electronic health care record, which is knowledge support, [...]

Now we’ve arrived at the last of the solutions in my list, namely “Opening the market for smaller entrepreneurs”. There are a number of reasons we have to do this, and I’ve touched on most of them before in other contexts. The advantages of having a large all-in-one vendor to deliver a single system doing [...]

Around 1996 I was part of the CEN TC251 crowd for a while, not as a member but as an observer. CEN is the European standards organization, and TC251 is “Technical Committee 251″, which is the committee that does all the medical IT standardization. The reason I was involved is that I was then working [...]

The quality of our IT systems for health-care is pretty darn poor, and I think most people agree on that. There have been calls for oversight and certification of applications to lessen the risk of failures and errors. In Europe there is a drive to have health-care IT solutions go through a CE process, which [...]

Forcing a large application into small independent parts that have to communicate with each other using minimal interfaces is always a good thing. Large monolithic applications go “fat and lazy” when there is no requirement to keep them split up. Also, the effort to expand and maintain the applications go through the roof. We know [...]

Ah, finally we arrive at solutions. The first in the series is the elephant in the room: issues. Why do I say “elephant in the room”? Because when a doctor examines and treats a patient, he thinks in “issues”, and the result of that thinking manifests itself in planning, tests, therapies, and follow-up. When he [...]

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 [...]

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 [...]

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 [...]

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 [...]