Stephen Downes

Knowledge, Learning, Community
All Canadians have most of their medical expenses paid for by our system of public health care. So health is a sensitive issue in this country, because while Canadians strongly support their system, corporations and private interests try constantly to undermine it, to open it up to private enterprise. It is in this context that the electronic patient record (EPR) is discussed in Canada. I have been involved in some of those discussions, the tenor of which has varied from "there has to be room for profit in the EPR system" to "we're going to implement it no matter what the public thinks".

How do you implement an EPR system without handing the keys over to for-profit enterprise? In my view, part of the answer is keep the management of the EPRs in the hands of the elements of the public system - the hospitals, the health insurance agencies, and most of all, the citizens themselves. The key to a public EPR system is that the records be personal health records - PHRs. Is the SmartCard an essential element of the system? Maybe. And maybe, as Derek Morrison suggests, the same architecture is what should underlie personal learning environments. Certainly, in my thinking, it should.

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Stephen Downes Stephen Downes, Casselman, Canada

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Last Updated: Mar 30, 2021 01:01 a.m.