Activating a full architectural model: improving health through robust population health records
2010; Oxford University Press; Volume: 17; Issue: 4 Linguagem: Inglês
10.1136/jamia.2010.006098
ISSN1527-974X
Autores Tópico(s)Health Policy Implementation Science
ResumoIn the current issue of JAMIA , Friedman and Parrish have crafted an insightful and provocative call for the Population Health Record writ large.1 This paper contributes in an important way to the literature and appears at a propitious time in our nation's health policy history. Furthermore, it is appropriate for JAMIA in that the AMIA Board first called for such a development in 1997.2 The authors present a compelling case, with sufficient details to make clear exactly what is needed. I will therefore not seek to elaborate upon the paper's content except to say that I support it wholeheartedly. Rather, I offer some added thoughts related to overcoming critical policy barriers. My comments will deal with understanding our civilization culturally, and touch on the role and importance that health can yet play in our nation's priorities. Before engaging in these weighty matters, I note that the reason that it took 13 years for this proposal to be so ‘timely’ now has both technical and governmental components. The long delay in addressing the population health record—the final one-third of the data architecture that encompasses patient, personal, and population records—relates to the state of information and communications technology at the time that AMIA initially called for PopER. Bill Wolf, until recently President of the National Academy of Engineering, reminds us that even the Apollo moon missions in 1969 only had as much computer ‘memory’ to work with as one can now buy in an ordinary greeting card to sing ‘Happy Birthday’ to you. While our minds might have been willing to dream of crunching gigabytes of data on populations in 1997, most of us were at the time forced to live and work in megabytes, still using 3 1/2 inch ‘floppy’ disks. Electronic health records (EHRs) were largely hospital-based …
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