Archive for February, 2008

Today during a most enlightened networking meeting, beyond what someone in transition normally speaks of, we got into a most interesting and thought provoking conversation.

Electronic Health Care Records

Somehow we got into a discussion of the evolution and problems involved in developing the eletronic patient record.  The gentleman, who will remain nameless, remembered a conversation he had with a man who was involved with the United Kingdom’s work on the exploration of space.  This knighted individual apparently suggested the key issue with developing the electronic health record was the issue of creating the patient’s electronic history from the previous pencil and pen records. 

His approach to solving this problem was to use prisoners as the codifiers.  Of course such an idea immediately causes one to worry about privacy and the threat to the patient and doctors when these prisoners were freed. 

As we talked an interesting thought occurred.  How often is a patient’s history relevant?  How often is the doctor quite happy to meet with a patient and simply focus on the symptoms described during that  persons visit? 

As we reflected, we both realized that often the patient’s history will never be pertinent to a future diagnosis.  In those situations where the history is relevant, let’s say 10%, then there is value to the effort of codifying historic medical records, charts and the like.  The doctor and his office staff can find the time to organize the codification of the relevant data.  Clearly such an approach with the reduction is the cost of establishing the basic health record, is connected with the value a complete electronic health record will have in reducing the cost of long term care, something insurance companies and public health authorities can understand.

For that 90%, after the doctor has become automated and is part of a system designed to capture and retain the Patient Health Record, at the next appointment the doctor in conjunction with the patient can record important facts such as allergies, reactions to drugs, existing conditions and any pertinent operations or procedures the patient can remember. 

Only when this basic profile indicates conditions that will have future implications, is there a need to go through the effort of backtracking through the records and recording any pertinent information.

China and Socialism 

I asked my companion what he was up to.  He talked about the five companies he was working with in China and the various trips he had taken to remote parts of that great country.  He said three things that stuck in my mind. 

  1. He remembered a bus trip where he asked about unemployment.  His Chinese companions asked him to look out the window and tell them what he saw.  His response “everyone is working”, “there are no beggars on the street”.  They smiled and he was reminded that in this socialist environment one of the fundamentals is that everyone has work however menial it may be.
     
  2. We then spoke of the economic divide that is emerging and like in all countries this is a reality that will always exist unless we can evolve to that social utopia described as the purest form of socialism where every man works to his ability and everyone shares equally. He then reflected on the reality that mobile phones, TVs and other luxuries were everywhere and the age old work ethic that is China, will drive these people to want more therefore work harder to get more.  It is this work ethic that is China’s strength and will be the issue we will have to address as the world moves forward in time.  If we in the west continue to expand our leisure time and the Chinese continue to follow their nature and continue to focus on work.  Who will win?  I think the answer is evident.  Those that work  will be the ones who win.
  3. He then spoke of issues within the industrial complex where mine accident occurred or dangerous products are released.  The interesting comment was that those in power, the top three managers, are shot when such things happen.  Of course this form of behaviour is abhorrent and clearly a violation of Christian thinking or western thoughts of punishment. 

Yet what is interesting, assuming they learn to balance the punishment (100 dead in a mine cave do to poor conditions and insufficient safety standards) to the crime, is that those ultimately responsible are ones that are punished. 

I then reflected on what happens in our society.  The executives always seem to go unscathed.  They successfully push the blame down to the supervisors and little people who work and manage the place where the disaster occurred. 

If we were to dig deep enough I am sure we would find that they did all they could do with the tools and budget they were provided.  Budgets and tools authorized by executives sitting in big offices taking down big salaries and only getting worried when shareholders not employees come screaming for justice.

Assuming that China is going to continue to evolve.  That they are going to embrace compassionate forms of punishment.  While at the same time maintaining their work ethic and maintain the premise that responsibility is top down not middle down.  They will become not only an economic power to deal with, but a country with a strong moral sense of responsibility and thus a threat to the soft life that has become the western dream. 

A dream that balances not working more than 40 hours a week with demands for more and more vacation.  China will be a country where hard work is rewarded, pleasures are sought and people have a moral sense of responsibility to each other.

We in the west need to be mindful and learn from those countries that take the goodness of socialism, merge it with the power of capitalism and the forces of the global economy.