Edited by Anne S.Y. Cheung and Rolf H. Weber
Chapter 10: Lost in translation: transforming healthcare information for the digital and cloud domains
Between paper records and the cloud, two distinct steps are involved in the translation of healthcare and medical data from the analogue to the digital domain. The first step involves the conversion from data held on paper to electronic database systems. Generally held within a single institution or a group of related institutions in a client-server model within institutional boundaries, this translation of such biomedical data from the analogue to the digital is the first but fundamental step towards its use in the cloud. But to make the leap to the cloud, a further step must be taken to free the data from the confines and limitations of local infrastructure and design. This chapter examines both steps, and surveys the progress made at both bars as well as the obstacles associated with each. The argument is made that the fundamental nature of the initial transition from the analogue to the digital domain needs to be recognized accordingly, and appropriate care and attention be given to the design and process of this transition. In the realm of biomedical information and records, there seemed to have been reasonable grounds for optimism and hope at the dawn of the era of mass adoption of modern information technology. In his 1968 address entitled ‘Hospital Records in the Computer Age’, Sir Richard Doll (who subsequently became Regius Professor of Medicine at Oxford) wrote that he was ‘convinced that computers have a great deal to offer medicine and that they will eventually transform its practice’.
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