Saturday, October 28, 2006

dbMotion - sharing medical information

dbMotion: "dbMotion is an innovative provider of medical informatics. The dbMotion™ Solution enables healthcare organizations to securely share medical information, creating a Virtual Patient Record by logically connecting a group of care providers and organizations without data centralization or replacement of existing information systems. Healthcare organizations and health information networks (such as RHIOs, LHINs and HIEs) use the dbMotion Solution to share medical information among themselves and with other healthcare organizations. By sharing medical information, clinical staff can make clear critical decisions therefore providing safer and more efficient care. dbMotion currently serves one of the world's largest HMOs as well as other hospitals and health information networks."

This works well in developed countries, but is a very hospital-centric approach. I feel getting patients to own and operate their own PHRs ( personal health records) which doctors and hospitals could tap into ( when they setup their EMRs) would be a better approach in countries like India.

4 comments:

  1. I agree. These solutions for combining patient records across different clinical databases depend on structured and stable records and good systems of electronic communication. It would be more appropriate if the patient carried their own record. This not only applies to India but other healthcare systems where a patient-centered approach is desirable. One approach would be to advocate the building of Open Source and international standards for health records with patient organisations.

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  2. Patient access to his/her medical information is highly justified and desirable. However, it may be risky to assign the patient to be his/her own case manager and to be the one in charge of updating his/her medical information. I believe Dr.Malpani will agree that failing to get all necessary details of a new IVF patient, who had been induced by another physician, may end in a severe hyperstimulated cycle. What happens if the patient forgot to bring her card/key? Or what happens if the clinical system of the treating clinic was unable to update the key/card? What happens if this patient was brought in found lying in the street and appears to be in a hypovolaemic shock due to severe hyperstimulation, but does not carry her key? Clinicians all over the world will agree that best treatment mandates a comprehensive availability to all relevant clinical information.

    The dbMotion solution is capable of connecting different legacy systems with no need to replace those. This has been achieved on a large scale basis covering nearly 4 million people with more than 8000 physicians using the system both in primary clinics as well as hospitals. Patients access through a portal can be facilitated on top of this combined federated and cevtralized interoperable solution. Additional information is available on our website.

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  3. Why is it risky to assign the patient to be his/her own information manager ? This is a very patronising attitude, which takes the approach that patients cannot be trusted to look after their own records. We trust patients to provide us with their medical history , and all we are doing by giving them their own PHR is a tool so they can access a well-organised PHR 24/7.

    I feel both these approaches are complementary - not competitive ! It's just that our focus is on the patient - the final end-user; while dbMotion services hospitals and HMOs ( who have the big bucks).

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  4. You are absolutely right that there is no risk in assigning the patient to be his/her owner of the information, and this is not what I was pointing out previously. What has been written is that he/she can not be held responsible for being the "case manager" of their medical information. This is why dbMotion solution allows the patient to have access to his/her fully integrated medical history, facilitated by dbMotion proven integration/sharing technology. It is always the patient who owns the information, but it will be unethical to assign him/her to be responsible for storing, maintaining and managing the data in an integrated manner. Therefore, the calim for patronising is not valid and has no basis to lean on. Moreover, dbMotion solution contains a patient consent module which will give patients growing control and ownership over their own data. Yes, we are approaching HMOs and big hospitals, among others, who do have the big bucks to invest in infrastructure and technology to improve patients' care through availability of information at the point of care. Finally, I do agree that the two approaches are complementary rather than competitive. A good PHR must be based on a good integration solution and not vice versa.

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