Some thoughts on health and healthcare

 Abstract The computerization of evidence-based clinical pathways requires more than translating narrative recommendations into simple “if–then” statements. A reliable implementation must preserve the meaning of clinical observations, diagnoses, interventions, timing constraints, exceptions, and evidence provenance while integrating with Electronic Health Record (EHR) and Laboratory Information System (LIS) workflows. SNOMED CT and LOINC aprovide complementary semantic foundations for this work. LOINC is commonly used to identify laboratory tests, clinical measurements, and other observations, whereas SNOMED CT represents clinical findings, disorders, organisms, procedures, and many qualitative result values. HL7 FHIR R5 provides the structural resources for representing knowledge artifacts, while Clinical Quality Language (CQL) supplies executable patient-level logic. This essay proposes a reference architecture consisting of a terminology server, a clinical pathway or knowledge-a...

Introduction A “shift-left” data quality strategy in an Electronic Health Record (EHR) means that data are validated, standardized, governed, and made clinically usable at the point where they are created, rather than corrected later in a data warehouse, registry, audit process, medical coding or AI pipeline. In a European acute hospital, this is not merely an informatics improvement. It is a patient-safety intervention, a clinical governance obligation, and a regulatory compliance strategy under the General Data Protection Regulation (GDPR), the European Health Data Space Regulation (EHDS), and the Artificial Intelligence Act when EHR data feed AI-enabled clinical decision support systems. The central argument of my essay is that a shift-left EHR data quality strategy should be implemented as a risk-based clinical safety programme, not as a purely technical data-cleaning project. It should prioritize data elements that directly affect diagnosis, medication safety, care escalation, han...