Miscellaneous-B

Summary

It’s mine, just like my financial records, and I’ll take responsibility thanks. I don’t need a large, nation-wide shared records system rolled out, I just need to be given a copy of the records and a (choice of) place to securely store them; I’ll share my records with you, if I choose. I’ll pay for the service, but if it’s deemed a “good thing” for us all to have lifetime EHRs by the government of the day, I’ll gladly accept a subsidy, perhaps with an incentive tied to sharing the data in a de-identified manner for research purposes. I don’t expect it to be too expensive (US$1.80 per GB-Year of storage used with S3).

I want…

1. to be able to contract with a 3rd party for secure online access to my records (HTTP + SSL with client and server certificates).
2. to be able to authorise others to submit new records to my repository (eg my GP, Sullivan Nicolaides for my blood tests, etc) – I’ll be the editor/moderator.
3. to provide a summary of my essential details for use in an emergency (blood type, allergies, etc), freely accessible to any authorised health care provider.
4. a full audit trail of access to my information — in case I decide to care about the privacy of even the semi-public summary, I want to know who accessed it for my law suit.
5. my GP, for example, to be able to view my record(s) in their web browser when I visit him/her, but not to be able to download the data (I can always email it if I want to).
6. key recovery available using n (>1) trustees (here’s how)
7. my GP to keep their own records; I’ll choose a GP who will upload a consult summary just as I choose a home loan provider with no ongoing fees.
8. a patient-centric solution.

What’s missing? On the tech side we have HTTP, SSL, easy AJAX for fancy browser interfaces, and the Atom Publishing Protocol. We need companies to supply the storage package, and to establish relationships with the pathology labs and HCN (Medical Director) et al. to enable easy upload. Finally, we need some standard formats for the records themselves. This is the hard bit, but no harder than would be required in a centralised/top-down approach, and we could instead just start with a microformat approach and migrate to the fancy stuff later.