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by breck 2418 days ago
Awesome! We are on the same page on a lot of things.

> It is your data and shouldn't belong to the provider.

Agreed! What do you think of the concept of the "Copy/Paste Test"? The idea is a good EHR should allow you to copy/paste your entire medical history into an email in a non-fragile way. If it can't do that, it's not a good EHR. We think this one dimension encompasses a lot of sub dimensions of what goes into a well designed EHR system.

> It would require an institutional body/government to standardize the EMR and centralize it

We're thinking the opposite: decentralized, git backed, concatenative grammars. You eventually probably would indeed have one grammar rise to the top, but the idea is to allow anyone to view, suggest edits, and fork the collection of grammars. Here is the current collection of Pau Grammar files: https://github.com/treenotation/pau/tree/master/grams. Note: this isn't even v1 yet, but the core ideas are there.
1 comments
ska 2417 days ago
> The idea is a good EHR should allow you to copy/paste your entire medical history into an email in a non-fragile way.

On the surface, this seems to be a poor test. Are you using it as a proxy for a patient to be able to get their EHR records out or something else?

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breck 2417 days ago
> Are you using it as a proxy for a patient to be able to get their EHR records out or something else?

It's a proxy to test a lot of dimensions at once: not only how accessible the records are to the patient (facilitating care, particularly in acute settings), but also how well designed the grammar and schemas are. Well designed grammars and schemas should survive copy/pasting easily. Any errors should be quickly and readily identified with the potential for autocorrections.

VA created a very cool thing called Blue Button (https://www.va.gov/bluebutton/). It is a step toward passing the copy/paste test. Any veteran can download their complete medical history in a single file. The schema isn't there yet and parsing these things is a pain, but a step in the right direction.

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ska 2417 days ago
Ok, that makes more sense.

I guess initially I would think of this as a round-trip requirement. In theory at least I should be able to download the entirety of my history (in an appropriate format); delete the record on the EHR; re-upload my history and end up with the identical EHR record mutatis mutandis.

Sticking "email" in there had me thinking your were focused on transmission.

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breck 2417 days ago
> I guess initially I would think of this as a round-trip requirement. In theory at least I should be able to download the entirety of my history (in an appropriate format); delete the record on the EHR; re-upload my history and end up with the identical EHR record mutatis mutandis.

I like this test! Yes, passing the copy/paste test should pass this test as well.

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