Comments on: The Data Model That Nearly Killed Me

By: Security and Privacy Considerations for Health IT Systems | Best Health

Security and Privacy Considerations for Health IT Systems | Best Health — Sun, 31 Jul 2011 07:56:39 +0000

[...] The Data Model That Nearly Killed me [PDF] [An excellent essay by a patient who is also a data modeling expert - ed.] [...]

By: Attorney Donnell Smullen

Attorney Donnell Smullen — Sat, 09 Oct 2010 17:06:28 +0000

You raise a very thought provoking point. I appreciate how you phrased it.

By: IanC

IanC — Sat, 18 Sep 2010 22:27:13 +0000

The fundamental problem to me (clinician/health informatician) is that clinical decision-making is fundamentally complex. Fortunately, well trained and thoughtful human brains are fairly good at it, but even then the wrong path can lead to misdiagnosis and less-than-ideal treatment that can last for hours/days/weeks/months/years.

Transporting information from brain to brain takes years of education. The seductive thought that a computer system can do it in seconds is folly. The cost of data capture of what is in one brain is too high and what can be captured is a mere fraction of what is there which makes the job of making a decision based on shared information even harder.

It may be that an amorphous data/document store and a cleverly tuned search engine/extractor that can understand natural language could do a better job than some dysfunctional complex systems with truly horrid interfaces.

I don’t think I have met anyone from an IT discipline who has understood the complexity of clinical decision-making and the clinicians because they just do it don’t fully describe what exactly they do.

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.