As the interest in iotaMed and the problems it is intended to solve clearly increases, we need to get our ducks in a row and make it simple to follow and to argue. Let’s do it the classic way:
- What is the problem?
- What is the solution?
- How do we get there?
Let’s do these three points, one by one.
What is the problem?
The problem we try to solve is actually a multitude of problems. I don’t think the below list is complete, but it’s a start.
- Lack of overview of the patient
- No connection to clinical guidelines
- No connection between diseases and prescriptions, except very circumstantial
- No ability to detect contraindications
- No archiving or demoting of minor or solved problems, things never go away
- Lack of current status display of the patient, there is only a series of historical observations
- In most systems, no searcheability of any kind
- An extreme excess of textual data that cannot possibly be read by every doctor at every encounter
- Rigid, proprietary, and technically inferior interfaces, making extensions with custom functionality very difficult
What is the solution?
The solution consists of several parts:
- The introduction of a structural high-level element called “issues”
- The connection of “issues” to clinical guidelines and worksheets
- The support of a modular structure across vendors
- The improvement of quality in specifications and interfaces
- The lessening of dependence on overly large standards
- Lessening of the rigidity of current data storage designs
- The opening of the market to smaller, best-of-breed entrepreneurs
How do we get there?
Getting there is a multiphase project. Things have to be done in a certain order:
- Raising awareness of the problems and locating interested parties (that is what this blog is all about right now)
- Creating a functioning market
- Developing the first minimal product conforming to this market and specs
- Evolve the first product, creating interconnections with existing systems
- Demonstrate the advantages of alternate data storage designs
- Invite and support other entrepreneurs to participate
- Invite dialig with established all-in-one vendors and buyer organizations
- Formalize cooperation, establish lean working groups and protocols
None of this is simple, but all of it is absolutely necessary. Current electronic health care systems are leading us on a path to disaster, which is increasingly clear to physicians and nurses working with these systems. They are, in short, accidents waiting to happen, due to the problems summed up in the first section above. We have no choice but to force a change to the design process, deployment process, and not least the purchasing process that has led us down this destructive path.