Bell Eapen

eHealth and Health Information System Consultant

If Ebola Spreads to Canada

While reading the news about the public health agency of Canada taking all possible steps to prevent the spread of Ebola to Canada, with a glass of Ontario wine in my hands, I for a brief moment thought, what if ………

Picture credit DFID @ Flikr (Image altered and text added) – If Ebola spreads to Canada

So let me set the context right. I am not an infectious disease expert, though my post on cutaneous signs of Ebola virus infection got more attention that it deserved. I am not an epidemiologist either to comment authoritatively on what healthmap is doing. To me it is the social media version of what John Snow did two centuries back to identify the epicentre of the cholera outbreak and established epidemiology as a speciality.

So if Ebola spreads to Canada, How do we identify the epicentre and take preventive measures? Turn to healthmaps and see where it originated and take measures to contain? Healthmaps will get that information from Google news and similar services. We have half a dozen major Health Information Exchange (HIE) initiatives in the country and would probably have accurate records of where each case presented with the characteristic symptoms. But we would look up to healthmaps and google since we cannot use HIE data for research!

i wonder how long it wil take for #ebola to hit #canada? which city first? and wil it get #outofcontrol? #crazy :headshaking:
— 411inToronto (@411inToronto) October 10, 2014

I am not a health policy expert neither am I an HIE architecture expert. But to me, if we have to realize the benefits of the ever increasing number of HIE initiatives, we have to find a way to use the wealth of the information there for population health. If we get it right, privacy is not even a concern.

HIE, built to abolish silos, paradoxically created larger silos, because of fragmented systems. The utopian population health requires a glue to bring these silos together. We got it wrong the first time, with data-centric HIS that offered little clinical workflow support and were (inadvertently) rejected by doctors. (We always have the doctors to blame as the universal slow technology adopters. BTW India’s mission to Mars discovered that all doctors in the planet originated from Mars!). We are sure to get it wrong again if we don’t change the data-centric HIE models.

HIE should be versatile, structureless and scalable enough to support disparate clinical use cases. The only option that comes to my mind is RDF.

If you are still unsure, read all that I have written about RDF. Convinced? Go ahead and head on over to the Yosemite Manifesto. BTW it has got nothing to do with the new OS X!

Yosemite Manifesto on RDF as a Universal Healthcare Exchange Language

Layered Semantic Web Technology Stack
Layered Semantic Web Technology Stack (Photo credit: jalbertbowdenii)

The Bring Your Own EMR (#BYOE) pronounced ‘bio‘, as explained in my last post relies on a reliable interoperability platform. I have always believed that RDF is the key to successful interoperability. RDF has successfully been employed in several other fields and has many stable tools such as jena. I was searching the web for information on how to present the advantages of an RDF based interoperability platform for healthcare data. Then I found this website.

Yosemite Manifesto, pretty much summarizes whatever I had in mind and a lot more! They are also trying to raise awareness about the possible advantages of adopting the RDF platform by requesting researchers to sign a form. I have already signed. Have you?

I am starting a wiki page for #BYOE too.

Bring Your Own EMR (#BYOE)

The e-Health lessons from healthcare.gov debacle is being debated widely. The idea of applying large scale IT initiatives in clinical domains has its own risks. As we relentlessly move towards a fully digital healthcare ecosystem, is it possible to hide some of its complexities from the clinicians?

Patient empowerment is the buzzword in eHealth now and clinicians are generally viewed with some skepticism. EHealth has learnt over the years (in the hard way) that the clinicians may be reluctant to relinquish their firm grip on clinical data. After all they generated the data and they are the custodians though they do not own it!

One of the approaches worth trying is to give the clinicians control and freedom over their end of things. In other words, separate enterprise EMR from the physician EMR. However the key to success in this scenario is interoperability.

Interoperability of EMRs are being actively explored by many research teams and organizations. However the emphasis is on better standardization. As interoperability emerges as a global paradigm, the standardization strategy that has failed for the last decade or so, still seems impractical?

Bring Your Own EMR

I am working on an interoperability solution that segregates physician EMR solutions logically and physically from Enterprise EMR solutions. I would like to call this Bring Your Own EMR (#BYOEpronounced as ‘bio’. The general framework is shown above. If you would like to join the #BYOE initiative or give feedback, shoot me an email!!

Creative Commons Licence
Bring Your Own EMR by Bellraj Eapen is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://nuchange.ca/?p=21.

Please cite this page as: Eapen BR. Bring Your Own EMR (#BYOE) . Available from: http://nuchange.ca/?p=21