e-Records in health-Preserving our future

摘要

Introduction: Papyrus manuscripts nearly 2000 years old, can still be read, but documents composed on a Wang or other word processor just 30 years ago are gone forever. Standards and formats used for storing and accessing information are constantly changing, and the required hardware or software will likely be obsolete or no longer exist in the near future. Purpose: To understand how to urgently address the data preservation issue as we migrate to greater use of e-records, in particular 'lifetime' electronic health records (EHR's), as our primary, perhaps sole, e-record. In principle, these dynamic and critical health data must be preserved and capable of real-time access on a 7/24/365 basis for perhaps 125 years. Without forethought, only a small fraction of the data currently stored within any healthcare jurisdiction will survive for more than a decade or so, or be exchangeable between jurisdictions. The situation will only be compounded as EHR's become ubiquitous. Approach: The literature was reviewed to identify data preservation issues and potential solutions, and guide development of policy recommendations to minimise the impact of this potentially catastrophic system failure. These recommendations are directed at the practice, program, and decision-making levels, and in both the public and private sectors. Conclusion: Data preservation poses a critical barrier to e-health and future healthcare systems. At this time broad awareness of data preservation issues is poor. This paper offers policy recommendations to stimulate debate and development of suitable strategies.