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Coordinated Healthcare or Accessing your Medical Records When You Break Your Leg Skiing In Switzerland

6/3/2016 11:17 AM

I was cruising along the other day working on the new Mail System that will be integrated into Sentia's EMR when the phone rings. It was one of my business associates, Bill Sykes and he was so excited he could barely speak. Seems he had been attending a conference that had five CEOs of North Carolina Hospitals or Hospital Groups in attendance. They got a little off topic, but the subject came up that the biggest problem they faced was coordinated care. They have no way to see what a practitioner at one facility does from another facility. They groused about this for a little while and old Bill just stands right up and yells "Sentia can do that!"

He's right, Sentia can do that. We have a repository for medical information based on the SNOMED_CT medical terms and it includes translations to and from ICD-10, which is undoubtedly what the hospitals use. We can translate their codes with a little work and at least show them the procedures performed in English. That's not the neat part though. We still have to get their data into our centralized, web based system so they can perform searches across facilities and geographic regions. Luckily we have just such an application.

The Information Integrator (originally written by Sentia Systems) is a tool developed for the mortgage industry in 2006. Yes, I know, those are the clowns that caused the Great Recession in 2008 and we were unwittingly duped into helping them. They needed an application that would look at aggregates of loans in loan definition files called "loan tapes." Usually these "loan tapes" were just spreadsheets of loan details with one loan per line. They needed a way to standardize these spreadsheets and import them into their proprietary database automatically with no code required. They mandated a Microsoft Access application for this import. Later, thinking that was a great idea, I wrote a similar application in a real, modern programming language (C#) and database engine (SQL Server). The Integrator today can take any data format, DB2, Oracle, SQL Server, Text, Excel, Access, whatever, transform it according to a visually generated specification and then import/export it into any other format. We can schedule transfers and we can specify "only get the new data" as well. One of our practices wants their medical records available as a spreadsheet so we use the integrator to load their patients and medical records at the end of every day. They can download this spreadsheet from out secure FTP Server (look it up) at any time. Here's a sample of the integrator:

Patient list generator image

In this instance we are importing Health Risk Assessment information collected from a client where there was no internet connection. These lines represent the flow of information from the source to the destination database. Notice the '38' between the 'Name' source field and the 'Entered By' destination. This is a conversion that we designed to transform the data as it comes across. We can do any transformation, but in this case we are just telling the destination database to put the '38' in the entered by field. This tells our system that the data was entered by the Integrator and not typed in by a user. There is also a facility to translate discrete values, graphically. Discrete values are ones you might pick from a list, as opposed to continuous values you would type in. A good example is Male and Female. Most systems use an M or an F but we keep separate lookup tables because if we hard code anything we might have to go back and change the code instead of simply updating the table. You might think that male and female are the only choices, but in 2016, you would be dead wrong. In our system male is 136 and female is 137, so we translate the 'M' or 'F' the same way we would the fields, by drawing a little line between them.

So yes, having one EMR to rule all healthcare systems and control costs (remember the $10/month to manage the data?) is the ultimate goal, we here at Sentia also have the tools to take the intermediate steps to bring that to reality by integrating all other disparate systems into Sauron's EMR.


Sauron was an evil overlord who's desire was to dominate the minds an wills of his minions. We don't want that, we just want to make people better. Let's try it this way: Yes, Virginia, there is a Santa Claus, or at least someone who has your warm, fuzzy interests at heart. See we can make fun of ourselves too, not just everyone else.

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