This conversation is closed.

A medical application for a plan B network system

The TED talk was about a fail-safe network that would (perhaps temporary) replace the internet in case it fails.

But I was wondering if it would be practical to create a communication network system not using the internet just for security reasons.
(versus using something like a VPN network service)
The reason I put "A medical application" in the title is that what I have in mind is exchanging medical/dental records and X ray images and the like between hospitals.

I believe that there is a need for such a system.
I live in Japan, but I heard that dental records helped identify the deceased in the earthquake in 2011. Had the records in the local dental offices survived, we would probably have been able to identify more people.
And for daily purposes, we would be able double-check what kind of medication the patient is on.

So is this a good idea, or just plain stupid?

Give me some thoughts. Thanks in advance.

  • thumb
    Jun 13 2013: Pharmacovigilance. In every country in the world, there are laws requiring the manufacturer of a drug to continuously monitor drug performance and reports, so research is a continuous process. These drug companies then report to government agencies such as the FDA in the US. There is a database already, Which we could expand so that patients could be identified by their DNA or Biometrics. It should then be possible for doctors to access a person;s medical history and upload any further treatments and diagnoses and lab test data. This would benefit medicine greatly as the pool of information for research would be increased exponentially.

    That is of course not addressing political, privacy, economic, considerations.
  • Jun 10 2013: Many years ago, I cooperated with 2 clinicians and measured patients' adherence to regimen and coauthored a paper published in the Journal of 'Clinical Pharmacology and Therapeutics.' (1969) titled "Measuring Intake of a prescribed Medication, A Bottle Count and a Tracer Technique Compared".
    During the 2 year study, the correlation for a long term followup of the bottle count and the blood measurement of bromide which is the chemical contained in the drug for treating peptic ulcer.. The result was poor (r=0.54). In layman's language, the error components of the relationship between the two measurements was as high as 1-r^2=0.70+, that is, the error rate is slightly larger than 70%. The patients cooperation for many chronic conditions usually drop off precipitously as time goes on.
    You might still find a copy of the paper from Google search, if you are interested.
  • Jun 9 2013: >Cameron
    Thanks for your thoughts!

    Medicine with accelerometers. interesting.
    There are lots of people who don't finish taking their medicine, which could be a problem.
    It would be very nice to have a accurate way to tell.
    But any idea has to beat the current alternative, which in this case would probably be "if really necessary, have the patient take the medicine in a in-hospital setting (hospitalized)" It's not 100% accurate, but very doable.
  • Jun 9 2013: Its a relatively good idea that I believe is already being implemented within society. I'm specifically talking about the United States, not quite sure of Japan, but non-the-less it's a good idea. The daily medication thing is interesting. I was thinking about the possibility of cheap tiny accelerometers that show which patient has taken their medication. Even though this is an invasion of privacy could be a good idea for people for which it is essential for them to take their medication.
  • Jun 8 2013: >John
    I didn't think about how current digital medical records worked. I thought there was a server in the hospital or something.
    Reality. Private companies are providing digitized services.High employment turnover rate in doctors offices(office employees).
    I don't see a immediate solution for this.
    If it were the patients that are responsible for keeping their own medical records there might be a solution, but I don't think that would be a good idea.

    When I wrote 'security' in the article, I was thinking of security from other citizens.
    Come to think of it, insurance companies/government will also want patient information. Perhaps our only hope is some rich individual funding to make this system, if it is to be completely secure.

    An example that any such system should be fail-proof also. Also, single person's mistake should not have that magnitude of an effect.
    It's probably hard to put money and manpower into something that might or might not happen.
  • Jun 8 2013: Thanks for all the comments!

    Money. It's always an issue.
    When I was writing the 'idea', I assumed that the system would be a nation wide one run by the government. In this case, the funding would be paid by taxes if approved. So the question would be "how cost effective the system would be?".Since I'm proposing to make a entirely new system from scratch, it will be costly. Like you said, a effective backup system requires an independent infrastructure=more money. And it's use will be limited due to patient-doctor privilege. For example, it won't be of any help finding an organ doner - anyone who has consented to donate would probably be already registered. Perhaps the police would be able to use it to identify someone with it - if they have a warrant.
    Anyway, a good estimation of the cost must be made before any decision could be made.

    This is about an entire transition from paper-based to digital medical records, I think. This is probably also something to think about.
    About the U.S. medical record system. I didn't know this.
    About the how the information is to be gathered. Dentist tend to be doing solo practices. Hmm. I know this is not the case in the US, in Japan 90+% of the people are in some kind of insurance (mainly due to the National Health Insurance). In countries like this, medical information could be tied to health insurance, I think. In the US, if willing, big organizations like the ADA(American Dental Association) might be of help. There is a plus in digitalized records in the long run like get to have more space(medical records must be kept for some time, and paper/X ray films can be really heavy)and less paper leads to less costs also.
    DNA profiles. It's become so much cheaper and so much faster to sequence entire human genomes. I'd hate to pay more for insurance, just because I have a 'cancer gene' or something. I think that kind of information ought to be used only to treat patients.
    • Jun 9 2013: Shohei,
      I think that you misunderstood my comment on the DNA profile. The DNA records are used more and more in the U. S. on verification of criminals (whether they are guilty of murder/manslaughter), and for unidentifiable victims.
      This ID procedure is more accurate and can be done anytime or even the victim can not be identified.
      As a footnote on general medical records, I just read a news report last week that a women here got a successful treatment of her Merniere's Disease by an elderly physician. Then she wants the physician to treat her mother for a similar symptom. But she just found out that the physician died a year ago. The physician was in solo practice. thus she couldn't even find her own med record in which some information about the treatment regimen might be helpful to her mother.
      Yes, this is a very slow process even under the great might of the central government.
  • thumb
    Jun 8 2013: We had the problem of not having a backup for medical applications here in Sweden a bit more then a year ago. Our whole system crashed, it was on a cluster server on a single company and through a single technician error (very few people know this but I have a friend that worked at that company at the time) no one in Sweden got their medicals for over a week.

    The technician was supposed to change a server hard drive. only he did not follow the manual fully and took it out before the process was complete, it all crashed and there was havoc in all of Sweden. On top of that many of the credit card clients were also on that server so we couldn't pay with credit cards in most shops for some days. And all of the cleaning of airplanes also stopped working since they could no longer check their tasks and schedule...

    A backup is needed for every crucial system, sadly governments rarely make these kinds of things before the take a hit on it...
  • thumb

    R H

    • 0
    Jun 8 2013: I believe what you're suggesting is inevitable. Medical information is nearly sacrosanct and insurance companies and private citizens, and gov'ts, will lobby for readily available info across the world.
  • thumb
    Jun 8 2013: They do have such systems in place but most are privately owned. They offer to store all patients records and input older paper records for a fee. If a doctor needs this information, it can be costly, hence, the reason that offices want to charge your for a copy of your medical records You think they have them in a closet or computer somewhere but they are in these private storage companies. Many people don't realize that the employment turnover rate in doctors offices is very high. So it is hard for a doctor to bring new people up to speed about their patients. Their role in the office is to make appointments based on his scheduled and gather information about insurance which is also sent away to private contractors for processing. Most of the patient information is not at the doctors office nor readily available to the office employees.

    Before we can get all the patient information into some kind of cloud VPN environment, we would have to buy these contractors out so, at least in the US, this won't happen soon. As far as government regulations are concerned, the information is properly digitized and stored.

    Your idea is the idea of societies dream of instant freely available medical information. Yes, it would help along the lines you suggest.
  • Jun 8 2013: The U. S. medical record system has just been required by law that every large hospital system or large clinical group practice to have a computerized record on all patient visits regarding their medical history, diagnoses, drug prescription and lab tests (including X-rays and MRI images) results. However, my personal experience told me that the work is still in progress, probably won't be completed until a couple of years later. After this is completed, then there need to be a national archive to store them all in one place, which cost money, but it shouldn't be too costly.
    However, there is no computerized system for such data in dental services. Most dentists here are in solo practice, therefore it is practically impossible to have a computerized data base from each dentist. It is probably easier to collect DNA samples from all the citizens when they apply for something such as health insurance, driver's license or even birth certificate. So this is a real problem.
    However, the U. S, government is aggressively compiling DNA profiles on as many citizens as possible. So such system is approaching a realistic, but imperfect, goal for identification purposes (i. e. by DNA profiles.)
  • Jun 7 2013: Of course it is always best to have a backup system or a "plan B" as you call it, so it is not stupid at all. The problem with most of our current technology is that there is no backup, this occurs mainly for financial reasons. In order to be effective, a backup system requires an independent infrastructure which costs money. I cannot tell how expensive such infrastructure can be, but someone would have to pay for it, and that would be the internet consumers in the form of a price increase, which can vary from a few cents to several dollars. So your idea is good but in order to tell if it can be done and how you need to do some technical and financial research.