Right now US privacy laws aren't compatible with one overarching centralized healthcare record.

Short of that, however, would be an interoperable system. Epic, which is the largest US medical record system, allows for different facilities on the same platform to share information. It is up to the specific facility if a records release is required. Most systems in a given region will have that worked out ahead of time and build it into their general consent for treatment (a form everyone signs). It works quite well. Where I practice, I am able to get all the information I need from across the country, assuming they are on the same platform at the time I am seeing the patient.

For other platforms, it's more mixed. Federal law requires certain interoperability, but it is fairly limited and not real time. Generally it involves a flash drive with the info on it.

As for the comment about changing platforms in a similar system, that is a struggle. Hospitals are required to keep patient information forever. When they first started going up on electronic systems, they only went back so many years as the scanning costs were huge. As time has moved forward, many systems are bringing all the information over to the new system so they don't have to maintain more than one electronic system for archive purposes.

Source: I am a physician and chief medical officer.

We use Fluency Direct, but you are correct. Dragon is quite popular too.

Physician and Chief Medical Officer here. I started my practice on the tail end of paper records and I have been through, and led, several different renditions of electronic medical records. Like any other software, the technology has evolved and matured over the last 20 years. Electronic Health Records are just about patient information anymore either. They incorporate patient info, clinician orders, billing, and also provide numerous cross checks and safety systems to improve patient care.

The article discusses the issue with digitizing handwritten notes. This is always problematic as they are not searchable, indexed, etc. and can be very difficult to work through. The system where I work has been on the same medical record system for over 10 years. This provides an efficiency that I didn't have when I was working in a paper system. The entire chart is searchable. Medical history sections are filled out and robust.

From a safety perspective, these systems give us so much more than we had. One prime example is bedside scanning. When a nurse administers a medication in a hospital environment the medical record plays a pivotal role. As a physician I enter and order for a medication. If there is an allergy, medication interaction, or a host of other things, the system will alert me to it before the order is signed. Once signed, the order then goes to a pharmacist to review and approve. The patient's nurse will then be notified of the order and be able to pull the medication from an integrated medication storage unit with multiple drawers and compartments to ensure the right medication is taken. Finally, the nurse must use the EHR to scan the patient's armband and the medication barcode. If there is any discrepancy, the medication is not given until the issue is resolved.

From a user perspective, I can now create notes and write orders faster than I could in a paper world, even with dictation. Most docs use a combined template/voice recognition approach which works well. There has been a great deal of work in the Epic world (one of the largest EHR systems) to increase efficiency and improve the user experience.

Are these systems perfect? Far from it. But things are better now, at least where I work, than this article makes it seem.

Woodworker here. Building with "wet" wood will always result in some wood movement. For exterior applications, wood with around 9-14% moisture is reasonable. For interior applications, more like 6-8%. You can get moisture measuring devices to give you an exact reading.

Green treated wood is not great as most box stores will not allow it to dry properly before putting it up for sale. You can plan for this will corner bracing and such, but it will move on you if too wet. You can find stacks in the lumber yards that are drier than others which can help. Another option for exterior applications is to use kiln dried wood such as cedar and then apply a good sealer to it. If you really want to use the green treated stuff and it's too wet, stack it with shims between the layers and allow it to air dry until you get to the desired moisture. That should minimize the movement after building with it.

There is a good article here.

Interesting fact: Israel does not have a formal written constitution. Instead, they have a series of Basic Laws which is like rolling out a chapter at a time. Very interesting reading here.

Did someone throw the boy from the ferry?