Since this is being done with government funds, it naturally is fronted by a big contractor, in this case AT&T.
It has fail written all over it.
- It's a top-down design focused on state-owned facilities.
- I see no commitment to coming standards like NHIN-Connect.
- I see no effort to make this a true HIE, integrating with the state's private hospitals and insurance networks.
Maybe I'm missing something, but questions like this weren't asked by the reporters gathered around the Governor and other dignitaries.
Without standards that are applied uniformly, all you can possibly have is a two-way transmission of data which is heavily dependent on both sides of the line using the same formats.
The focus, according to Daily Wireless Report, appears to be on setting up broadband at rural clinics, with enough bandwidth to transmit things like x-rays and diagnostic test results. The promise seems to be that experts will participate when clinics have a tough case.
Fine, but what about routine use? What EMR formats are being supported? Are you going to send the complex stuff stat over this network and then wait for FedEx to deliver some paper? I don't think so.
As much as these clinics need fast broadband, in other words, they also need a compatible system of EMR software. Preferably something that understands open standards, maybe even open source.
The key to any hope of success is the California Telemedicine and eHealth Center at UC Davis, which hosted yesterday's demonstration. The center does have connections to the state's private health system.
A summary of the group's intentions is contained in a January, 2009 report, which calls demand a key component of acceptance. So where is the integration with Personal Health Records like Microsoft Healthvault or existing EMR systems like Kaiser's system.
Yet while Kaiser is linked to the VA, I could find neither institution mentioned at the California Telemedicine web site. Nor did I find the names of major EMR vendors, their HIMSS trade group, Microsoft or Google.
Someone needs to make some phone calls. Telemedicine cannot be divorced from EMRs.