Monday, November 17, 2008

Personal Health Records Need MARC/AACR Approach, I Think

I attended an IT Innovation in Healthcare conference in town today. Practically the entire morning was spent talking about the personal health record (PHR) and related electronic medical record (EMR). While the EMR is information about your health compiled by your health care providers, the PHR is maintained by you.  The ideal PHR would  gather data from many sources and making this information accessible online to anyone who has the necessary electronic credentials to view it.

The discussion centered around the fact that it is very difficult to move information between systems. The challenge is the lack of standards. The various PHR and EMR systems don't talk to one another. This got me thinking. The health care industry needs to take some lessons from the library community and establish some data standards.  

Libraries got over the hump from a paper-based to an electronic catalog in part since we had two tools to work from; AACR and MARC. AACR covers the description of, and the provision of access points for, all library materials. MARC provides the protocol by which computers exchange, use, and interpret bibliographic information and is responsible for the foundation of the online catalogs we have today. Add on top of this Z39.50 like functionality and we have a basis for a PHR system which could do what it is envisioned to do; harvest and syndicate content between other records systems. 

There is, however, a bigger challenge. As I bounced this concept off of a CIO of a major academic medical center, they said those standards are in place. They have SNOMED

The librarians out there will immediately see the problem with the response.  For the CIOs out there, well, please have your librarian explain it to you. 
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