“The case study involves software to manage health information for hospitals or physician groups in the form of the electronic medical record, or EMR. Proprietary software venders supply most of the products for this software market. Recently, the U.S. government undertook experimental steps to promote a FOSS package for EMR, raising the question as to whether the EMR software market is amenable to FOSS. This Article describes various factors that might signal a FOSS disfavoring market, including low technical aptitude among users, differences among users in their work flow and software interface needs, users with dispassionate computing agendas, and entrenched proprietary competitors in an area supporting minimal complementary goods or services. FOSS, however, might be able to overcome these impedances in a particular software market if its unique motivational mix is strong enough.”

Mark Hall is also working on this issue.

Some patients now keep exhaustive files, and scan information in (0r request CD’s or DVD’s from hospital records staff).

I’m glad Deven blogged the article–I found it pretty frightening. To me, let’s get some guaranteed backstop of care first. I’ll bet most of these pioneers (like Pinker, Dyson, etc.) will never have to worry about not having insurance, since they’re wealthy enough to pay for it all on their own.

Who owns your health data? Your historical blood pressure statistics, your chloresterol readings and weight, and so on.

Partly, this is a grand philosophical and normative question. I’m not asking about that.

More importantly, it is a powerful and important practical question. Data portability projects are underway all over the country, and institutions at several levels are salivating over the prospects of owning this stuff. They are the usual suspects — hospitals and physicians, insurance carriers.

In case of ambiguity, form contracts coupled to HIPAA notices will cover their butts vis-a-vis individuals.

Is that the right outcome? This stuff is just the basis for so-called bargains? We might not like the rhetorical presumption of “ownership,” but we’re stuck with some frame that presumes control. If control isn’t allocated to individuals, then it will be appropriated by other institutions, and that may be a bad thing. If we want to vest individual patients with control, how do we get from where we are now (state of acute uncertainty, capable of being exploited by large institutions), to that position? Again, I’m not interested in distributive justice arguments. I’m interested in pragmatics. How is this going to work?