[PLUG-TALK] Electronic "Health" Records Re: AT&T buying

[Keith Lofstrom]

On Fri, May 23, 2025 at 03:46:44PM +0000, Eldo Varghese wrote:
> EHR systems have multiple ways to talk to each other, the standardized 
> way is FHIR (and it's predecessor XDS). Implementations vary across the 
> board, the FEHRM and MHS system for example does have this capability.
> While EPIC can do this, most system operators choose to sign onto their 
> propitiatory system called EPIC everywhere.
> i.e I have an EPIC record with UCSF that is accessible to my providers 
> at OHSU.

Connectivity begins between the ears.  Sadly, that
pathway is missing in too many medical organizations. 

Last week, I went to the Tigard Oregon Clinic.  They did
NOT look at my Electronic Medical Record from my prior or
my current MD, and prescribed imaging for a Providence
"urgent care event" that resolved (with imaging) two years
ago.  Legacy, Providence, Kaiser, and Oregon Clinic do not
interoperate, even after recent mergers.

If you've seen one instance of EPIC EMR, you haven't seen
any of the other idiosyncratic instances.

The Oregon Clinic online record shows my height as 4ft 9in
(rather than 5 foot 6) and my weight as 152 pounds (rather
than 138 pounds naked), hence a very high body mass index
(33 obese rather than 22 normal).  The med-tech did not
give me time to empty my tech-heavy pockets, nor subtract
an estimated weight for clothing, shoes, etc.

BTW, a decent BMI calculator here:
https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

And yes, I have personally maintained an electronic
medical record system (OpenEMR) for my wife's internal
medicine practice, which we closed this year.  She's
75, still competent, but increased restrictions,
requirements, lawsuit risks, and the televisionizing
of patients has made wellness medicine impractical,
leading to reduced life expectancy in the US.

We have MANY retired doctor friends; we will figure
out something for ourselves.  I fear for the rest of
you, but if you don't learn what medical excellence
is, and don't enable it, you won't get it.  

Keith L.

(P.S. BMI is defined as weight in kilograms divided
by the square of height in meters.  It does not 
distinguish between muscle and fat, full or empty
stomach and bowels).

-- 
Keith Lofstrom          keithl at keithl.com