Reporter's Notebook: From the Land Down Under

BRISBANE, Australia — I’ve often been described as a “medical writer.” I believe that’s inaccurate.

I don’t cover medicine. I cover health care. There’s a distinct difference, which I don’t need to explain to readers of this newsletter, but suffice it to say, I’m probably not the best person to come to if you want scientific explanations.

This push-and-pull between “health” and “medical” plays out in the debate between “electronic medical records” and the current darling of the health-IT establishment, “electronic health records.” EMR tends to refer to records kept within a single institution, while an EHR, at least in theory, encompasses many care settings to paint a comprehensive picture of an individual’s true health status.

Antics over semantics, perhaps, but the “health” vs. “medical” debate got another interesting twist at the recently concluded MedInfo 2007 conference, the triennial gathering of the International Medical Informatics Association (IMIA), when a prominent international health-IT leader suggested IMIA might be misnamed.

“I think it’s time to replace the name ‘Medical’ with ‘Health’ in the organization,” said S. Yunkap Kwankam, eHealth coordinator for the World Health Organization. “If we look at what makes people healthy, it’s a lot more than medicine,” Kwankam told the meeting of nearly 1,700 health-IT experts from all over the world during a keynote address.

Health depends on environmental factors, socio-economic status, lifestyle choices, and, indeed, know-how, Kwankam said. It’s a lot more than just receiving the right medical care.

He noted that the WHO Constitution, written in 1946, mentions the importance of knowledge in health, but those who drafted that document could not have imagined the potential information and communications technologies in delivering health knowledge worldwide, Kwankam said.

“My basic thesis is that ICT can contribute in the area of information, and, more specifically, knowledge,” Cameroon native Kwankam said, using a term popular outside the U.S., information and communications technology, or ICT.

For this American reporter, there was a lot of shifting between U.S. English and the Queen’s English — not to mention the Aussie variety — and a lot to learn about health-IT (or ICT) projects from across the globe, at academic medical centers in big Western cities, rural Kenyan HIV clinics, and nearly everything in between.

Apparently, the MedInfo program was top-notch, seeing that even Partners HealthCare System (Boston) patient-safety guru David Bates had two submissions rejected. He was part of a huge contingent of North American attendees, most of whom arrived with me on the MedInfo Express, otherwise known as Qantas Airways flight 176 from Los Angeles to Brisbane, early on Aug. 19. Even national health-IT coordinator Robert Kolodner was on that flight. Let the government bean-counters know that he flew economy, just like the rest of us.

After all, this meeting seemed to be more about substance than style.

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