Data exchange - big benefits, but high complexity
Sorry, but paper records and overnight delivery on request just won't cut it any more.
The formats for data cannot be settled for all time because (1) new science will lead to new dimensions of data; and (2) the semantics of what will be diagnostically significant in the future cannot be known in advance.
Even without emergency incidents, we need secure federation of health data. Imagine:
My orthodontist needs a high-fidelity copy of X-Rays taken by my dentist.
My dentist discovers she needs my blood pathology results.
My rheumatologist finds he needs my parents' genetic testing results.
My motor insurance becomes invalid if my psychiatric clinics are irregular.
The Centre for Disease Control needs to identify every carrier of a genetic liver disease who is likely to have been treated with a particular topical anaesthetic.
Imagine the cost of re-creating this data, if it is not shared. The personal consequences of inappropriate release of the data could be terrible. The need for these specific exchanges were not known when the data was created. No-one seems to remember their whole medical history. Providers go out of business and old records may not be recoverable. The population is ageing and the scale of healthcare services needed can be expected to rise. These issues have been well canvassed in the Health Informatics community. The competence of the NHS may be criticised, but no other organisation (in the world) has within it sufficient knowledge of the relationships between British health service providers.
Perhaps the only way the current SNAFU could have been avoided was to limit the first stage to deliverables which would produce measurable benefits within one year.
Biting the hand that feeds IT
