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Beyond the Electronic Health Record

Tom Munnecke Open Health Technology Board Meeting February 24, 1012 Las Vegas, Nevada. Beyond the Electronic Health Record. Sir Tim Berners-Lee. “What was often difficult for people to understand about the design was that there was nothing else beyond URLs, HTTP, and HTML. .

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Beyond the Electronic Health Record

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  1. Tom Munnecke Open Health Technology Board Meeting February 24, 1012 Las Vegas, Nevada Beyond the Electronic Health Record Munnecke - Vista Expo 2011

  2. Sir Tim Berners-Lee • “What was often difficult for people to understand about the design was that there was nothing else beyond URLs, HTTP, and HTML. Munnecke - Vista Expo 2011

  3. Sir Tim Berners-Lee • “There was no central computer “controlling” the web, no single network on which these protocols worked, not even an organization anywhere that “ran” the Web.” Munnecke - Vista Expo 2011

  4. Sir Tim Berners-Lee “The web was not a physical “thing” that existed in a certain “place.” It was a “space” in which information could exist.” Munnecke - Vista Expo 2011

  5. Idea: Envision Health Information as a “Space,” not a “System” • Tweeting an Amazon book on Twitter does not require an API – part of universally addressable space • Move from “Castles and drawbridges” to “Passports and Visas” • Design from a state of connectivity • Focus on loosely coupled association, not tightly coupled “integration” • Decouple IT from Org Chart Munnecke - Vista Expo 2011

  6. ICD10 Codes W59.2 Contact with turtles W59.21 Bitten by turtle W59.21XA…… initial encounter W59.21XD…… subsequent encounter W59.21XS…… sequela W59.22 Struck by turtle W59.22XA…… initial encounter W59.22XD…… subsequent encounter W59.22XS…… sequela W59.29 Other contact with turtle W59.29XA…… initial encounter W59.29XD…… subsequent encounter W59.29XS…… sequela W59.83 Crushed by other nonvenomous reptiles Munnecke - Vista Expo 2011

  7. Complexity Catastrophe • 100,000 pages of health care legislation • 1.5 million UMLS terms • 15,000 ICD10 Codes • IEHR “Pay and Plug” architecture • When will it stop? • What can simplify it? Munnecke - Vista Expo 2011

  8. Intercom (Interfaced System) Real Costs Cost,Complexity Expected costs Increasing Scale Munnecke - Vista Expo 2011

  9. PBX (Associated System) Cost,Complexity Lower marginal cost Higher Initial Costs Increasing Scale Munnecke - Vista Expo 2011

  10. Interfaced Systems Integration Crunch Associated System Cost,Complexity Increasing Scale Munnecke - Vista Expo 2011

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