Should Personal Wellness Data Reside Inwards Silos?
Over the past times few weeks, I've been engaged inward a conversation amongst an intelligent grouping of people most whether personal wellness information (PHI) should reside inward disparate "silos" (repositories) that create non communicate amongst ane another, or whether standards should endure adopted that "bust" the silos past times merging the information into a mutual warehouse (centralized database) that spans multiple unrelated healthcare organizations, agencies as well as practices.
Some argued that silo-busting centralization has benefits that include narrowing the number of places the information reside, improved auditability, as well as the mightiness describe as well as written report access attempts as well as actual reads (i.e., "access/read tracing") to a greater extent than effectively than private computers.
Others (including me) argued that silos bring existent value, equally long at the PHI they incorporate tin endure readily as well as securely shared amidst "trusted partners," a model which I telephone phone "controlled silo-crossing." I proposed a new as well as cost-effective means to create this through a federated, node-to-node, publisher/subscriber model we've developed, which is described at this link as well as elsewhere on this blog. Using this method for controlled silo-crossing provides major benefits, including the following:
Two entities are public wellness agencies and research (academic) organizations. Two others are Health Information Exchanges (HIEs) as well as the National Health Information Network (NHIN). They all request PHI from multiple silos to, for example, position world wellness emergencies through biosurveillance (e.g., unsafe medications as well as medical devices, pandemics, bioterrorism, etc.), equally good equally to educate evidence based practise guidelines.
Another entity that wants to cross silos is healthcare providers who desire to give their patients the best possible care by, for example, sharing PHI through patient centered medical homes, which I verbalize over at this link.
In addition, patients who empathise the problems inward healthcare would too back upwards silo crossing. For example, anyone knowledgeable most the serious noesis gap inward healthcare—which I verbalize over at this link—would realize how of import it is to bring interdisciplinary teams of clinicians, their patients as well as researchers percentage information as well as collaborate to promote ever-better (higher-value, to a greater extent than cost-effective) care, as well as past times having payers offering fiscal incentives to practices running certified medical homes.
To assistance realize this vision of controlled silo crossing, nosotros ought to focus on revamping our civilisation into ane inward which value (cost-effectiveness) to the consumer is the upmost importance, as well as inward which delivery of such value is a collaborative elbow grease that is highly rewarded. The results, over time, would include:
Discussion continued at this link
Some argued that silo-busting centralization has benefits that include narrowing the number of places the information reside, improved auditability, as well as the mightiness describe as well as written report access attempts as well as actual reads (i.e., "access/read tracing") to a greater extent than effectively than private computers.
Others (including me) argued that silos bring existent value, equally long at the PHI they incorporate tin endure readily as well as securely shared amidst "trusted partners," a model which I telephone phone "controlled silo-crossing." I proposed a new as well as cost-effective means to create this through a federated, node-to-node, publisher/subscriber model we've developed, which is described at this link as well as elsewhere on this blog. Using this method for controlled silo-crossing provides major benefits, including the following:
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- Minimizes information loss. Busting silos leads to the loss of of import information—i.e., information details as well as terminology/semantic nuances—because "local" information standards unique to unlike silos are destroyed inward favor of "global" information standards required past times monolithic centralized systems, equally I verbalize over at this link.
- Gives PHI command to the owners of that information. Both providers as well as patients should bring their ain silos as well as bring command over who is allowed to cross them. That is, patients ought to authorize the individuals as well as organizations that bring the correct to obtain their PHI from their ain PHRs as well as from their providers' EHR/EMRs. The authorized parties should: (a) drib dead alone information that meaningful/useful to them, (b) bring that information delivered to them from whatever silos inward which they reside, as well as (c) receive that information after it has been translated as well as transformed for piece of job inward their ain respective silos. Also, if silos were busted, it presents the thorny number of who should endure inward accuse (be the boss) of the merged data?
- Provides rigid information security. Personally identifiable PHI inward the physical possession of the parties owning as well as controlling it is inherently to a greater extent than secure than allowing third-party vendors to contend that information inward centralized databases residing off-premises. This relates to the number of "public cloud" safety equally I verbalize over at this link.
- Enables auditing as well as access/read tracing. Auditing as well as tracing are handled effectively using node-based software residing inward private computers.
Two entities are public wellness agencies and research (academic) organizations. Two others are Health Information Exchanges (HIEs) as well as the National Health Information Network (NHIN). They all request PHI from multiple silos to, for example, position world wellness emergencies through biosurveillance (e.g., unsafe medications as well as medical devices, pandemics, bioterrorism, etc.), equally good equally to educate evidence based practise guidelines.
Another entity that wants to cross silos is healthcare providers who desire to give their patients the best possible care by, for example, sharing PHI through patient centered medical homes, which I verbalize over at this link.
To assistance realize this vision of controlled silo crossing, nosotros ought to focus on revamping our civilisation into ane inward which value (cost-effectiveness) to the consumer is the upmost importance, as well as inward which delivery of such value is a collaborative elbow grease that is highly rewarded. The results, over time, would include:
- Ever-better personalized evidence-based guidelines for prevention as well as attention that patients as well as their providers piece of job to improve results as well as lower costs past times reducing waste, fraud, abuse, errors, omissions, ineffectiveness as well as inefficiencies would endure dramatically reduced.
- Providers would endure to a greater extent than effective inward diagnosing/testing, treating as well as preventing wellness problems inward their patients, as well as would attain financially past times doing so.
- Providers would non bring to worry most malpractice suits past times next the evidence-based guidelines as well as offering audio justification for rendering alternate plans of care; this would too lower malpractice insurance premiums as well as the pressure level for wasteful "defensive medicine."
- Patients/consumers would endure amend able to contend their ain health.
- Payers would non bring to pay for depression value (expensive, unbeneficial) procedures as well as tests.
Discussion continued at this link