That number represents the number of different ways to arrange the seventy-five numbers on a BINGO card—five columns of a specific group of fifteen numbers.
I may have mentioned that part of what drives me to write is the need to help me frame ideas for myself. It serves as a checkpoint before I unlock the gate and let them loose on you. This idea required a good deal of thought, just to get me comfortable that the premise even made sense.
Here’s what got me thinking about it. It seems there are three major groupings of things that need to work together precisely in order for EHR to work. Each time one fails, the network fails. What are those groupings?
The data are Personal Health Records (PHRs), Electronic Medical Records (EMRs), and standards. There are perhaps hundreds of variations among the elements of that group. Secondly, there are the systems, the Electronic Health Record (EHR) systems. Again, hundreds of different systems can house the data. How many possible combinations are there at this point in the process? The correct answer is that there are too many. Finally, there is the issue of transport, getting the data from one system to another system. Under the present model (the one to which everyone seems to be building) let’s include the Health Information Exchanges (HIEs), the Regional Health Information Organizations (Rhios), and the National Health Information Network (NHIN).
The problem with each of these grouping (data, systems, transport) is that their individual elements are not grouped. That lack of grouping means that the total number of paths that can be ridden to get a health record from provider A to provider B is much larger than that of the BINGO illustration.
Therefore, for inter-EHR (the transport part of EHR) to have any hope of functioning the groupings need to be fully grouped in such a manner so as to remove the hypergeometric distribution among the elements.
This is the point where some of you may tell me that I am not spending enough time on this planet. If the prior discussion is at all correct we need to solve the grouping problem. Here’s where I leave my pay-grade and need your help to see if this dog can hunt. I was able to clarify the idea for myself by thinking about potatoes–please don’t stop reading, this is not an attempt on my part to be funny. What happens if you take two potatoes and mash them together? The two become one, and any individual distinctions are lost.
Is it possible to create mashups of each of these groups such that instead of having billions of billions of permutations, we have just a few? A mash-up is a Web page or application that integrates complementary elements from two or more sources. That one sentence used up the entirety of what I know about the topic. I don’t know enough about it to know if the technology will work with EHR, however that is not my point. What I am pushing for is that we look at the concept of using mashups. If the concept is sound, then let’s figure out the technology that would be needed to drive it. I think a solution along these lines is what is needed to have a working national EHR system.
What do you think?