Friday, February 19, 2010

Don McDaniel: What's eHealth all about?

I’ve spent the past few weeks attending a number of healthcare information technology meetings focused on achieving interoperability in healthcare — so-called eHealth. You see, we have a major trading partner issue in healthcare — even if we gave every physician and hospital in America an EHR, all we would achieve are a group of discrete applications that don’t share information by and between them.

In other words they won’t be able to communicate with each other. This is a real problem — a real practical problem because unfortunately, because consumers, of course, attend care givers widely and without attention to what information system they use!

So, there’s been a lot of discussion about how to facilitate all these disparate systems to connect, communicate, and make the amalgam (the integrated data) information that is actionable.
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The Institute of Medicine (IOM) reports that about 1.5 million patients are injured each year because of adverse-drug events; events that presumably could be eradicated if we have true mission-critical healthcare information sharing.

While at the mHealth Conference, I saw a number of applications built and positioned for mobile devices — and this makes perfect sense in a world which is quickly becoming hardware- and even appliance-agnostic. These applications include a number of mobile phone applications to enhance disease management services and even review images remotely. We should be prepared for the integration of mobile systems.

At the eHealth Initiative’s annual meeting in DC, I learned about a number of functioning local information exchanges, mostly led by large Integrated Delivery Networks. For example, Boston HealthNet with it anchor tenant Boston Medical Center, has developed a health exchange that includes the BMC hospitals and eight to 10 discrete community health centers (FQHCs), allowing clinicians access to real time medication history for any patient seen throughout the system. This is one of what is today a limited group of operating health information exchanges; what I’ve described at BMC is really still an isolated HIE, but the promise is evident and I think the train has left the station.

I encourage you to do your homework, and seriously evaluate opportunities to pursue and engage a health information exchange. By the way, if you are a provider, and even if you plan to purchase an EHR, you will not be able to achieve meaningful use in the later adoption years without a relationship with a health information exchange. Food for thought.

1 comment:

  1. Interoperability is vaporware that this point. I have a popular EMR and when one of my patients moved out of town they chose a doctor who just happened to have the same EMR. I asked if it was possible to transfer their medical records as a data file to the new physician's EMR and the response was a resounding NO. i have to print out the records and the new doctor has to read them and manually input the information into his EMR. Ask most EMR vendors if their system can do this and you get blank stares.

    Until every company's EMR can talk to itself, the thought of competing EMR's talking to each other is just a pipe dream.