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WHEREAS:
1) electronic interactions when done securely and
efficiently will benefit the knowledge and data needs of our
world
2) electronic interactions currently often lack appropriate
security and efficiency
3) electronic knowledge bases often lack verifiable
authenticity and ease of use
4) electronic data is often in forms incompatible with
electronic systems at the point of use
5) with diminished energy and natural resources productivity
must be improved to maintain our current standard of living
and improve the resources available to other peoples of the
world
6) health care errors in the United States alone cause about
90,000 deaths a year(Institue of Medicine: To Err Is
Human, 1999 )
7) duplications of immunizations, laboratory tests, history
taking, and physical examinations add to rapidly increasing
health expenditures without improving health
8) omissions of cost effective preventive interventions
and/or services for high risk individuals increase the
resource use for all
9) the AMA Council on Medical Services (CMS Report 10/A-00/
June 2000 at http://www.ama-assn.org/ama/pub/category/3776.html)
in their "Electronic Medical Record Systems
Report" and the National Committee on Vital and Health
Statistics (http://www.ncvhs.hhs.gov/hipaa000706.pdf)
in their report to the Secretary of HHS on July 6,2000 on
"Uniform Data Systems for Patient Medical Record
Information" both note insufficient standards from HL 7
and ANSI and call for the creation of an electronic medical
record format to be used the multitude of vendors and to be
available at low cost to all providers and health
departments.(for HIPPA - standards have been set for health
business type transactions only for 2002)
10) other organizations lack the comprehensive approach to
infrastructure problems, cultural change, cost effectiveness
evaluation, and the broad expertise needed to deal with
government, industry, and all medical specialties
Therefore, be
it RESOLVED that:
1) the ACPM should work with the AMA, Intel, FCC
(Federal Communications Commission), and to
develop useable standards of security,
authenticity and reliability of electronic
interactions (the AMA and Intel have already
started a secure electronic physician
identification system)
2) the ACPM should guarantee the electronic
medical record systems (EMRS) emphasizes
prevention and high quality efficient health care
and is accessible to all people and providers
3) the ACPM with the AMA, AMIA (American Medical
Informatics Association), HCFA (NCVHS), WHO, and
others should develop an analysis of the system
(box diagrams) and design (Preliminary Design
Language or flow charts) the basic structure for
EMRS
a) develop a basic consensus structure for health
data
b) develop standards for structure and reliability
for knowledge
c) develop security standards for the public,
patients, and providers of care (private and
community)
d) design easy to use quality control for life
style and health care
e) develop standards of electronic communications
between/among the public, patients, and providers
and their data systems
4) the ACPM must ensure that data and knowledge in
such systems must be audited, verifiable, and
corrected in a timely fashion
a) all parties involved in data elements would
have secure access and a method to correct or
indicate suspected errors
b) knowledge bases would be maintained
continuously
5) such developed software and knowledge systems
would be available to members of the developing
organizations at a discounted user fee
6) the ACPM should work with other health care
organizations and industry to fund the coding (the
detailed programming) publicly and cooperatively
among many vendors and/or government. The basic
rules and communication protocols of this EMRS
would be free but government, providers and payor
would save by decreasing transaction costs,
preventing disease, injuries and duplication.
Vendors would make money on providing hardware,
communication links, and setting up the standard
shared software on the hardware. Optional
expensive add ons to a basic alpha numeric system,
such as graphic capture and storage might also be
sold.
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