[Openid-specs-heart] Fwd: FHIR Use Cases and relationship to other standards

[Adrian Gropper]

---------- Forwarded message ----------
From: *Adrian Gropper* <agropper at healthurl.com>
Date: Monday, May 16, 2016
Subject: FHIR Use Cases and relationship to other standards
To: Grahame Grieve <grahame at healthintersections.com.au>
Cc: "fhir <fhir at lists.hl7.org>" <fhir at lists.hl7.org>, "Boone, Keith W (GE
Healthcare)" <keith.boone at ge.com>, "McDonald, Clem (NIH/NLM/LHC) [E]" <
ClemMcDonald at mail.nih.gov>, Ioana Singureanu <ioana.singureanu at gmail.com>,
Josh Mandel <Joshua.Mandel at childrens.harvard.edu>


Thank you Grahame for the clear response. If there's not to be any standard
to deal with data blocking in the vernacular sense of the words, I'm hoping
to find some folks that would work together to define an objective measure
of data blocking. Given a measure, each regulatory jurisdiction could apply
it as they see fit and the standards would just have to follow.

My current favorite is what I posted at
http://thehealthcareblog.com/blog/2016/05/13/independent-decision-support-at-the-point-of-care-for-both-patients-and-physicians/

because it's easy to point to the patient-level FHIR Subscriptions and
History features and ask if they are implemented and accessible via any
patient-specified OAuth Authorization Server. For any particular
implementation of FHIR is concerned, the answer to these three questions
could be given a name and that name would be a measure of data blocking.

What do you think?

Adrian



On Monday, May 16, 2016, Grahame Grieve <grahame at healthintersections.com.au
<javascript:_e(%7B%7D,'cvml','grahame at healthintersections.com.au');>> wrote:

>
>> I'm somewhat familiar with DICOM and IHE and the gap between platform
>> standards and interoperability in the consumer sense of the word. I can't
>> think of any practical interoperability standard (in the real-world sense
>> of the term) that depends on conformance statements.
>>
>
> no. It's because there's no standards process for *healthcare*. It's the
> reality that HL7 lives constantly. We cannot produce tight standards
> because we cannot dictate the business and clinical practices of those that
> use them. The easiest illustration is allergy tracking. Everyone that
> provides care has to do this, and it's not a matter of differentiation of
> service. In any other industry, that would lead to a standard so that
> everyone could save money and improve their service by exchanging this
> information. In healthcare, however, we are only now trying to impose
> common record-keeping standards by stealth using IT interoperability
> standards, and the problem is that there are deep stacks of existing data,
> and everyone stores different information about this. And clinicians
> generally regard this as an IT problem.
>
> This is not consumer interoperability.
>>
>
> no, it's not going to be. And you're dreaming if you think there'll ever
> be in an international standard. Right now, we're trying hard to make a
> single little piece interoperable at the consumer level: vital signs. And
> we're facing stiff opposition for both technical and policy reasons.
>
>
>> I still don't know what the healthcare personal data interoperability
>> standard will be called but maybe some members of the FHIR community would
>> like to work on that with me.
>>
>
> The easiest way to explain it is:
> * Argonaut is working on consistent access to data - but the data won't be
> particularly consistent
> * HSPC is working on consistent access to consistent data - but the policy
> framework you want is not in scope; that will have to wait for the future.
>
> My view is that HSPC is a decades long process. Until then, 'data
> blocking' will remain the order of the day - except that I know it as 'care
> for legacy data and processes'
>
> Grahame
>
>

-- 

Adrian Gropper MD

PROTECT YOUR FUTURE - RESTORE Health Privacy!
HELP us fight for the right to control personal health data.
DONATE: http://patientprivacyrights.org/donate-2/

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-- 

Adrian Gropper MD

PROTECT YOUR FUTURE - RESTORE Health Privacy!
HELP us fight for the right to control personal health data.
DONATE: http://patientprivacyrights.org/donate-2/
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