Comments on: The Data Model That Nearly Killed Me

By: Richard Truex

Richard Truex — Thu, 03 Jun 2010 20:08:45 +0000

I would like to thank you for your detailed information. I believe that the model we are using is very much flawed and because of the database technology it is based on needs to change significantly. Take a look at the website link and let me know your thoughts. We need to fix the structure and start giving everyone some control over their information. We need to stop giving our information to other and hoping for the best. There is an alternative, but we have a lot to change.

By: Pablo Pazos

Pablo Pazos — Sun, 21 Mar 2010 17:03:28 +0000

What you describe is not a data model problem, is a systemic problem. Is not about an interoperability problem, is about how people communicate with each other and how them use the available tools.

I read your recomendations and solutions, and many of them have already been studied and builded for many years, did you know an open standard called OpenEHR? I think many of the ideas in this standard can surprise you (in a good way).

Main:
http://www.openehr.org/home.html

Legal and organizational:
http://openehr-es.googlegroups.com/web/openEHR+%5Bdoc+legal+y+organizacional%5D.pdf

Getting started:
http://www.openehr.org/shared-resources/getting_started/getting_started.html

Specifications:
http://www.openehr.org/releases/1.0.2/roadmap.html

Architecture overview: (great document)
http://www.openehr.org/releases/1.0.2/architecture/overview.pdf

Cheers,
Pablo Pazos Gutierrez

By: voicechat

voicechat — Sun, 31 Jan 2010 12:42:06 +0000

Dear Mr. Bugajski,

In case you’re still reading these comments, first I add my thanks. Second, did you ever find out why nobody bothered to read the notes from your allergist? Third, is the hospital taking any action to analyze why your course of care was so dangerous and nearly fatal?

Many thanks again,

RDGelzer, MD, MPH, CHCC
Advocates for Documentation Integrity and Compliance

By: Myth 32. Information technology will improve efficiency and safety. « AAPS News of the Day

Fri, 08 Jan 2010 02:08:15 +0000

[...] “The national health information network envisioned by President Barack Obama is a pipedream,” he writes (Joe Bugajski, “The Data Model That Nearly Killed Me,” Syleum.com 3/17/09). [...]

By: Fred Trotter » A geek in the ER

Fred Trotter » A geek in the ER — Fri, 14 Aug 2009 17:54:31 +0000

[...] Recently someone turned me on to a post by data expert Joe Bugajski entitled the Data Model that Nearly Killed Me. [...]

By: Alexandru Bolboaca-Diaconu (alexboly) 's status on Thursday, 13-Aug-09 07:36:09 UTC - Identi.ca

Thu, 13 Aug 2009 07:36:14 +0000

[...] The data model than nearly killed Joe Bugajski http://www.syleum.com/2009/03/17/healthcare-data-model/ [...]

By: A concerned person

A concerned person — Thu, 09 Jul 2009 00:15:18 +0000

Thank you very much for the description of your case. I never trusted the healthcare system as is. I had my own bad experiences, but yours make mine look like a mild headache. And also all those doctors that stopped by just to ask questions didn’t do a peep but had a nice hour tagged to your bill. As it is today the system stimulates this type of hidden mugging.

By: MitchellD

MitchellD — Fri, 05 Jun 2009 12:57:22 +0000

While I agree that every system is not perfect, it is still the responsibility of the clinician to rely on their skills to treat patients. People forget – the computer doesn’t treat your patient, you do! The computer system can’t be blamed for all of the different physicians asking the same questions over and over again. They’re being careful. People will always be responsible for what is placed in the computer (for the most part). Nurses, doctors, etc., need to be careful with what is entered in the system. I think the challenge is learning how to balance patient care (at all levels) with the technology.

By: Atul Salgaonkar

Atul Salgaonkar — Fri, 29 May 2009 23:53:01 +0000

I agree with many here that the root cause is related to the work-flow controls of a fragmented treatment. The same experience repeats everywhere despite paper records.

It also seems to me that organizations like CCHIT (www.cchit.org) that certify performance of software systems in healthcare can influence some aspects of product performance: for instance, false alarms with oximeters.Perhaps some post-certification monitoring is required?

By: Idea #100 for May 29th, 2009: What is EMR or The Heart of the Matter? Part 1 « Fixing Healthcare in 365 Days

Fri, 29 May 2009 14:03:49 +0000

[...] I think it’s hard to call what they have truly an EMR. This reminds me of the story told in “The Data Model That Almost Killed Me” . Delayed entry in many cases, particularly in a hospital environment with the expectation of a [...]