The Three Demons - Master Patient Index, Medical Lexicon/Standards & Middleware
Incomplete Solutions that have slowed adoption of the CPR:
- Master Patient Index - A master service that keeps track of patients and gives them a unique identifier (UID) that tracks them thru their health (e.g. young female, married, divorced)
- No agreed upon Medical Record Number systems
- Some base on Social Security Number, others UID.
- NO AGREEMENT between hospitals and clinics on what to use.
- Medical Lexicon & Standards - Pathology is ahead of the curve with SNOMED, LOINC, but ASTM, HL7, READ, UMLS and others cannot be ignored. Also imaging standards - DICOM.
- Middleware - How systems talk to one another there are many solutions each with its advantages and limitations::
- Router Strategy - Costly to deploy, easy to maintain, custom programming
- Interface Engines - Costly to deploy, costly to maintain
- Common Object Request Brokering Architecture (CORBA) - Not ready yet.
- SGML/XML - Standard Generalized Markup Language / eXtensible ML