Entries by C. R. (Rich) Abbruscato

Why Isn’t Telemedicine Achieving Cost Reductions?

Any discussion about cost savings to the health care sector should logically start by identifying the high cost areas. Then examine possibilities to reduce those costs. In the US, the first part is easy. It is estimated that 80% of health care costs in the US are incurred by just 20% of the population. This […]

Why is it so Hard to Integrate Telemedicine into EHRs? Part 4

Part 4:  FHIR LIHT In Part 3, we tagged consumer home telemedicine as the simplest telemedicine-to-EHR application and therefore a good place to start. In this part, we’ll look at an integration scheme that will build on FHIR concepts and be targeted at consumer home telemedicine.  We’ll call it Lite Integration for Home Telemedicine using […]

Why is it so Hard to Integrate Telemedicine into EHRs? Part 3

Part 3:  A 20/80 Approach to a Telemedicine-to-EHR Interface In Part 2 of this series, we gave some examples that showed the impact of having no standards and having complex standards in choice driven markets.  If a reasonable standard is not available when the market wants to charge ahead, it will do so making choices […]

Why is it so Hard to Integrate Telemedicine into EHRs? Part 2

Part 2: What not to do. In Part 1 of this series, we reviewed EHR systems and protocols of greatest concern to a telemedicine system seeking to pass clinical information to the EHR. That revealed the confounding situation where the least rigorous (from an academic/theorist point of view) standard – HL7 v2.x – dominates and […]

Why is it so Hard to Integrate Telemedicine into EHRs? Part 1

Part 1:  Which EHR? From a telemedicine vendor’s viewpoint, the first challenge to integration is “which EHR”? There are more than 1,000 implementations of EHRs and not all of them follow recognized standards such as HL7 v2, HL7 v3, FHIR, openEHR and VISTA.  Many have home grown infrastructures with interfaces to one or more of […]