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Showing posts from January, 2013

Why Direct makes sense for Data Delivery to an EHR Hub

Who precisely are you sending that message to?
There is a little recognized problem in using legacy HL7 over VPNs to deliver data (lab results, image studies, reports, etc). The orderer is in the message regardless of whether you are trying to send to them or not. The CC list is in the message regardless as well. The attending, the primary, etc. all there but maybe not who you are routing to. Who are you routing it to?

How is this a problem?
In today's modern world of Software as a Service (SaaS), many of the EHRs get data delivery through a common gateway for many practices. If you route a message to a single practice with a locally installed EHR, then when the data source (e.g. hospital or an HIE as its proxy) sends a message to the practice, the practice endpoint and the EHR endpoint are one in the same. There is no confusion about who the message is for. When the EHR serves multiple practices is where we get the confusion. The endpoint of the practice is a spoke off of the E…

eRegister and Get Rid of the Clipboard

The Real Use Case for Personal Health Records (PHR)
I have been at this, HIE game, for a few years or so now. And when I go out and meet new people, I get the typical, "so, what do you do" question. Once I tell them and give a little explanation of what it means, about half of them have a follow-up question. There is only ever one follow-up question and it is always the same question "so, are you going to get rid of that clipboard of paperwork that I have to do over and over again every time I go to see a doctor".

The fact that I only get one question from general consumers and it is always the same question tells me one thing. This is what matters to them. This is how they see their information making it from them to their provider today. This is what they want to eliminate by using HIE or a PHR.

In essence, I see the HIE and PHR as one in the same. The HIE, in a fixed repository model, is a collection of "views" of the patient. We have a primary care v…