David and Goliath

I am pointed by the (primarily US-orientated) Grand Rounds to this post by Dr Wes on the role of electronic health and medical “care” (e-Health) in the United States.

I am horrified and I become more aware of the ethical and confidentialty issues involved in this . The NHS IT Spine project is writ large in my thoughts and has come under constant criticism, the latest of which centres on the curtailment of its major contractor for the south of England, Fujitsu. I am concerned that a major health IT project has been hived off regionally to different companies.

Microsoft is intimately involved in US web-based “Personal Health Records” (as are Google, Walmart etc etc) initiatives. The NHS Connecting for Health “project” wants all our health/medical records online using Microsoft software.

In the US the multinational IT companies (Google, MS etc), retail outlets (Walmart etc) etc etc are allowing you to upload personal medical data to their on-line web services. When you get to the hospital, you will tell the hospital (if you're conscious and have signed up) to download your data from Google, Microsoft, Walmart or whoever.

Is this data accurate?

Polyclinics gone mad, NHS IT Spine gone mad. But I would rather have “my data” controlled by the nationalised and centralised NHS than by Google or Microsoft or Wallmart ...

I can only say that I am grateful we still have a (even if semi-) “socialised” system, that the NHS Spine/Connecting for Health totally fucked-up project is still in the hands of the NHS (or is it?)

Fuck ... with all of them.

P.S. Dr Wes points to the ludicrous system of hospital and physician ratings supported by these Personal Health Record websites. The UK government is now going to rate hospitals on their surgery mortality rates (report here) so you can choose where hip replacement surgery is more sucessful than a heart transplant. Silly – Papworths is not an expert in hip-replacement but is a leading centre for heart replacement. I am far more likely to die from a heart-transplant than hip-replacement. But note they are not going to rate on the type of surgery ...

But given my ignorance as Joe and Jane, I'll choose Papworth's as a centre of excellence for their surgical skills and have my hip replacement in Cambridge when I live in Exeter as they are superb surgeons ... except alot of cardiac patients there died last year.