Billions of dollars are going to be spent modernizing our antiquated medical record system.
However, if these new digital systems fail to talk to one another, it’s simply going to balloon costs.
Consider this example, which occurs pretty commonly. A man is urgently rushed to a hospital 25 to 30 miles away from the one he normally goes to. Both hospitals have EMRs, but because they are different systems, cannot talk to each other.
Due to the severity of the patient’s condition, decisions regarding treatment have to be made expediently, and his treating doctors don’t have time to wait for the old chart to come. It’s just easier to repeat the tests.
“Unable to access the tests and medical records,” the story goes, “the new hospital did all of those tests and images all over again . . . I can’t even hazard a guess how much it cost to repeat all those tests””except that it had to be a lot, and all or most of it on Medicare’s tab. So it’s a quality of care problem. A care coordination problem. And a money problem.”
Indeed. Unless we make EMR patient data less proprietary, this scenario won’t go away no matter how much is spent on electronic records.
Related posts:
- Poll: Will electronic medical records really save money?
- Are hospitals the primary beneficiaries of the health IT stimulus?
- Should patients own their medical records?
- Health IT in the economic stimulus bill, should we be frightened?
- Retail clinics don’t save money
- The New York Times finally gets it on electronic medical records
- Does coordinating care save money, and if not, is it worth the effort?
{ 8 comments }
Once again Kevin, you are completely correct. But also don’t forget that most health care occurs outside the hospital. The problem of EMR’s not being able to talk to each other goes far beyond one hospital to another. If all physicians are expected to use an EMR, then the primary care doc’s EMR should talk to the hospital and vice versa, the primary care doc’s EMR should talk to the specialist’s EMR and vice versa. The outside (non-hospital) lab, radiology center, etc. need to talk to all the doctor’s offices and the hospitals.
If we are to save any money by investing in health care IT (which I don’t think will happen, though I am in still in favor of invesitng in health care IT because it will improve quality), then intraoperability is the critical factor. The problem is that all the money is going to the hospitals to improve systems that they likely already have. It would be better (in my opinion) to spend the money on creating one good system that actually works well and then let everyone have it.
I have an EMR. It cannot talk to any other medical records systems anywhere currently. It cannot even interact with the same system at a different location. I can import data, but these are simply gif and tif type files. I do have a bridge with a lab company but I have to pay $22 per month to keep this channel open and pay for the link. I cannot even get the local hospital info into my system. Everything is faxed and then manually moved in the system. Forget trying to get info from any other hospital, they guard this info like Fort Knox due to scares about HIPAA.
Why can I go almost anywhere in the world and get money from an ATM but cannot access medical records easily down the street? I expect bank security is high and they don’t seem to have the problems that we do. Until they make the system communicate better they won’t save much money.
In spite of a long history and compelling justification, HL7 and its like haven’t been able to achieve anything even remotely close to interoperability. Lots of reasons why, some of which are reasonable. That so little of this has sunk in or been adopted by now, after all the effort and evangelizing, strongly suggests that the hope is utopian and doomed to failure in the future as it has in the past.
Chuck Brooks
FutureWare SCG
Pouring money at an EHR in the hope that it will be adapted seems a great way to ensure that money will be poured into a black hole. I remembember the IRS trying to come up with a computer system. I think it was 10 billion spent, then they abandoned it before it came into use.
To generalize, government organizations can’t do good systems. They are simply not flexible enough, and completely unresponsive to the customer. After all, they just have to please their boss to not be fired. That rarely translates into actually doing good work.
don’t forget that not all ct scans are the same, not all ultrasounds are the same…
Thus far, health IT is such a boondoggle that the IT Stimulus will eventually need a Bail-out. IMHO, the purpose of Health IT is NOT better patient care – it’s for Data-Mining.
“The nine most terrifying words in the English language are ‘I’m from the Government and I’m here to help.’” – Ronald Wilson Reagan
Kevin,
You do paint a very interesting picture… When I went to the Health2.0 conference, sharing records and talking more indepths on these topics was the focus. Although the technologies and ideas were great, the connections weren’t apparent. I’m of the opinion that government needs to help build the connection – Mama Bell – and then allow private industry to build “in” to the connecting point. At a certain time, the government should then resign the Mama Bell status and give back to private industry.
That’s not the point.
The point is not that the new hospital cannot get the patient’s old record. The point is the new hospital need the patient to take as many as new test since they make money on it.
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