For the longest time I thought that infrastructure was just roads and buildings and such. Then I started realizing that communication was a crucial part of it. That led to information sharing, etc. Now I see it as a very complicated body influenced by countless factors where one had does not know what the other one is doing. It seems that in HC we have the basics down, the roads and buildings down, but the talking to each other part is still in the realm on the unknown.
We talked to General Harry Raduege who talked about infrastructure issues on the grand scale – state and federal and how everyone has a different system, how the systems are improved just to find out that they don’t work, and how data storage is an issue. Key word of this presentation was standardization. 
Actually, this seems to be a reoccurring theme in the course: standardization. Standardization of care, protocols, equipment.
We discussed using various forms of communication to bring doctors to soldiers out in the field where medical care in not readily available. Maybe then the Iraq Memorial will have fewer names then the Vietnam Memorial and we won’t be standing there contemplating why we had to waste so many lives needlessly.
This morning’s USA Today has an article on the increase in mental care cases among veterans. Problem is that after talking various people this week it’s clear that every branch of the military has a different way of dealing with medical cases in that branch – there is no standard of care among them – heck, General Raguege said that different VA hospitals don’t talk to each other and it’s widely practiced for medical service seekers to visit several hospitals to compare what each one offers for the same condition. We are hoping for a nation wide revolution, but we can’t even manage something that we have direct control over. Why? Too many egos in the way, and no one want’s to step on someone else’s toe.
The second speaker of the day was Harry Greenspun from Northrop Grumman talking about the ethical issues involved in implementation of technology, namely electronic health records: how much exactly do you want your doctor to know? Is that weird rash you had after a trip to Vegas relevant to the sore throat you have now? Are you sure?
Quite a bit of his presentation was about usage of technology and possibilities that it brings. We talked of airport security using biometrics and retina scans to skip security lines. There is one issue we did not mention – how much do you want your government to know about you…
The last two speakers were members of the Deloitte’s Center for Health Solutions, Asif Dhar, MD, and Howard Underwood, MD, MBA, MAAA… Both of them added to food for thought. Doctor Underwood talked about the exact science of underwriting insurance. Doctor Dhar discussed the possible usages of electronic health record data. Among them were drug efficacy, efficiency and safety, and even considering using patient data as post market FDA monitoring.
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