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Is Interoperability Worth Paying For?

Posted on August 18, 2016 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

A member of our extended family is a nurse practitioner. Recently, we talked about her practice providing care for several homebound, older patients. She tracks their health with her employer’s proprietary EHR, which she quickly compared to a half-dozen others she’s used. If you want a good, quick EHR eval, ask a nurse.

What concerned her most, beyond usability, etc., was piecing together their medical records. She didn’t have an interoperability problem, she had several of them. Most of her patients had moved from their old home to Florida leaving a mixed trail of practioners, hospitals, and clinics, etc. She has to plow through paper and electronic files to put together a working record. She worries about being blindsided by important omissions or doctors who hold onto records for fear of losing patients.

Interop Problems: Not Just Your Doc and Hospital

She is not alone. Our remarkably decentralized healthcare system generates these glitches, omissions, ironies and hang ups with amazing speed. However, when we talk about interoperability, we focus on mainly on hospital to hospital or PCP to PCP relations. Doing so, doesn’t fully cover the subject. For example, others who provide care include:

  • College Health Systems
  • Pharmacy and Lab Systems
  • Public Health Clinics
  • Travel and other Specialty Clinics
  • Urgent Care Clinics
  • Visiting Nurses
  • Walk in Clinics, etc., etc.

They may or may not pass their records back to a main provider, if there is one. When they do it’s usually by FAX making the recipient key in the data. None of this is particularly a new story. Indeed, the AHA did a study of interoperability that nails interoperability’s barriers:

Hospitals have tried to overcome interoperability barriers through the use of interfaces and HIEs but they are, at best, costly workarounds and, at worst, mechanisms that will never get the country to true interoperability. While standards are part of the solution, they are still not specified enough to make them truly work. Clearly, much work remains, including steps by the federal government to support advances in interoperability. Until that happens, patients across the country will be shortchanged from the benefits of truly connected care.

We’ve Tried Standards, We’ve Tried Matching, Now, Let’s Try Money

So, what do we do? Do we hope for some technical panacea that makes these problems seem like dial-up modems? Perhaps. We could also put our hopes in the industry suddenly adopting an interop standard. Again, Perhaps.

I think the answer lies not in technology or standards, but by paying for interop successes. For a long time, I’ve mulled over a conversation I had with Chandresh Shah at John’s first conference. I’d lamented to him that buying a Coke at a Las Vegas CVS, brought up my DC buying record. Why couldn’t we have EHR systems like that? Chandresh instantly answered that CVS had an economic incentive to follow me, but my medical records didn’t. He was right. There’s no money to follow, as it were.

That leads to this question, why not redirect some MU funds and pay for interoperability? Would providers make interop, that is data exchange, CCDs, etc., work if they were paid? For example, what if we paid them $50 for their first 500 transfers and $25 for their first 500 receptions? This, of course, would need rules. I’m well aware of the human ability to game just about anything from soda machines to state lotteries.

If pay incentives were tried, they’d have to start slowly and in several different settings, but start they should. Progress, such as it is, is far too slow and isn’t getting us much of anywhere. My nurse practitioner’s patients can’t wait forever.

CommonWell and Healthcare Interoperability

Posted on June 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: In case you missed the live interview, you can watch the recorded interview on YouTube below:

2016 June - CommonWell and Healthcare Interoperability-headshots

For our next Healthcare Scene interview, we’ll be sitting down with Scott Stuewe, Director at Cerner Network and Daniel Cane, CEO & Co-Founder at Modernizing Medicine on Wednesday, June 29, 2016 at 3 PM ET (Noon PT). Cerner was one of the Founding Members of CommonWell and Modernizing Medicine just announced they were joining CommonWell. No doubt these diverse perspectives will provide an engaging discussion about the work CommonWell is doing to improve healthcare data sharing.

You can join my live conversation with Scott Stuewe and Daniel Cane and even add your own comments to the discussion or ask them questions. All you need to do to watch live is visit this blog post on Wednesday, June 29, 2016 at 3 PM ET (Noon PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’re hoping to include as many people in the conversation as possible. The discussion will be recorded as well and available on this post after the interview.

As we usually do with these interviews, we’ll be doing a more formal interview with Scott Stuewe and Daniel Cane for the first ~30 minutes of this conversation. Then, we’ll open up the floor for others to ask questions or join us on camera. CommonWell has become a big player in the healthcare interoperability space with most of the major EHR vendors involved, so we’re excited to learn more about what’s happening with CommonWell.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

Healthcare Interoperability Tort Reform

Posted on November 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The more I learn about health care the more I think that health care would really benefit from tort reform. In many ways we’ve needed this for a while. I’ve never seen this study, but I’d love to see someone study how many health care costs are associated with unneeded tests and procedures that were ordered by doctors in order to help them avoid liability.

This happens all the time in health care and you can’t blame the doctors for doing it. Them ordering a likely unneeded extra test in order to avoid possible liability is a common practice. It only takes one time that they don’t order the test for the doctor to start over ordering tests and procedures. It’s unfortunately the lawsuit happy society that we live in and that’s why tort reform could help

Turns out that technology actually exacerbates this problem in many ways. A great example of this is in interoperability of health records. We all love the idea that everyone’s health information is pushed to the doctor so it’s available whenever the doctor needs it. I think we can all agree that the doctor having all of the information on a patient will lead to improved care for many patients. However, pushing all this new health information to the doctor raises a lot of questions.

From the doctor’s perspective they’re asking the question “Will I be held liable for health information that’s pushed to me?” “What if that health information shows suicidal tendencies for my patient and I don’t do anything about it because the information was pushed to me and I never actually saw it?” We could highlight a few hundred other scenarios where the doctor could be held liable if they don’t act on some information that’s forwarded to them. Any rational person could see how the doctor shouldn’t be responsible, but most lawsuits aren’t very rational.

Another example would be a doctor who has access to an HIE but doesn’t use it. Should the doctor be held liable for not using that information? What if the HIE had the allergies of a patient and could have prevented the doctor prescribing a drug to the patient because they were allergic? Should the doctor be held liable for information that was available in the HIE, but for whatever reason she chose not to access that information and ended up doing something bad?

I’m not a lawyer and I don’t play one on TV, but there are so many examples of potential liability that it’s quite scary. Is it any wonder why doctors are so frustrated with medicine? I think the right tort reforms could help. If we don’t, I think the cost of health care will continue to rise.

DeSalvo Says We Need Common Interoperability Standards – I Think There’s More To It

Posted on September 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I came across an article on FierceHealthIT which has a really fascinating quote from Karen DeSalvo, National Coordinator for Health IT. Here it is:

“What seems that it would have been helpful is if we had agreed as an ecosystem–the government, the private sector–that we would have a set of common standards that would allow us to have more seamless sharing of basic health information,” she said. “We’re moving toward that with the industry, but I think what that’s created is a complexity and aggregation of data … In hindsight, maybe some more standardization, or a lot more,” was necessary.

Is lack of a standard what’s keeping healthcare from being interoeprable?

I personally don’t think that’s the biggest problem. Sure a standard would help, but even with the best standards in the world if organizations see data sharing as contrary to their best interest then no standard will overcome that view. It’s been said many times that we have an issue of desire and will to share data. It’s not a technical problem. Sure, a standard would be helpful once there is a will to share data, but if organizations wanted to share data they’d figure out the standard.

Later in the article, CommonWell Executive Director Jitin Asnaani said “Standards are not standards because we say they are; standards are standards because everybody uses them.

This is the problem. People don’t want to share health data and so no standard is being used. I still wish they’d blow up meaningful use and use the rest of the money to incentivize organizations to start sharing. People went bat crazy implementing an EHR as they chased government money. I’d love to see healthcare organizations go bat crazy becoming interoperable as they chased the rest of the government meaningful use money.

Experiences Crafting a New API at Amazing Charts

Posted on August 21, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

A couple months ago, Amazing Charts announced an upcoming API for their new electronic health record, InLight. Like athenahealth, whose API I recently covered, Amazing Charts is Software as a Service (SaaS), offering its new EHR on the Web.

The impetus toward an API wasn’t faddish for Amazing Charts; they had a clear vision of what they wanted to achieve by doing so. They found that their interactions with various health care providers–payers, labs, radiologists, and others, along with accepting medical device data–has been hampered by reliance on common standards that involve HL7 messaging and EDI. The HL7 standards are inconsistently implemented and EDI is non-standardized, so each interface requires weeks of work.

I talked to Prayag Patil, product manager of patient engagement solutions at Amazing Charts. (They also offer patient portals to the institutions they serve.) For all their data exchanges, he said, they expect a RESTful API to provide standardization, speed, and simplicity in implementation. It should also be more suited to quick, fine-grained data transfers.

One of the common complaints of the older HL7 standards such as the CCD-A is that they are monolithic. EHR vendors and healthcare providers shove a lot into them without deciding what the recipient really needs. As Patil says, “it makes the 80% use case hard to do.” Nor is the standard used consistently by all correspondents (labs, practice management systems, devices, etc.), so extracting what’s really important at the receiving end is harder.

They’ve found that sluggish exchange has real effects on patient safety. For instance, a set of lab results, medications, and other information from a hospital discharge should be available immediately. If you wait, the patient their primary care provider won’t have it just after discharged, when its value is often critical, and the patient might lose interest and not bother to look at it later.

Amazing Charts, like athenahealth, also recognizes the value of a third-party marketplace. Patil says that innovation tends to “come from the smaller, scrappier vendors” that are enabled to produce useful apps by open APIs. The company already has a third party marketplace for apps in care coordination, revenue cycle management, patient engagement, and other tasks. But up to now the APIs weren’t published, so their developers had to work individually with any vendor who came to them, offering tools and the help needed to integrate with Amazing Charts’ service.

The company plans to introduce a patient engagement platform that will be open and accessible, with a focus on using standardized RESTful APIs to enable third party app developers to offer solutions. The company also plans to increase participation by creating thorough documentation for the APIs, and standardizing them. They are looking forward to standards such as FHIR, SMART-on-FHIR, and OpenID/OAuth, which are better specified and more consistently implemented than the currently available interfaces.

Here are the lessons I draw for others who are looking enviously at projects with APIs: going forward without all the pieces in place will be like driving on one flat tire. You just won’t get the results that you hoped for when investing in the project.

I applaud Amazing Charts for taking the difficult first steps toward API access, and doing it with good goals in mind. Their experience shows that an open API is still a hard process to get going–even as more and more companies take the leap–and one that calls for coordinated efforts throughout the organization in software design, publicity, documentation, and support.

The Tower of EMR Babel

Posted on May 28, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s the sad state of interoperability. This week when I was teaching an EHR workshop I asked for those attending to define what an Electronic Health Record was in their own words. I’d say 90% of them said something about making the healthcare data available to be shared or some variation on that idea. This wasn’t surprising for me since I’ve heard hundreds and possibly thousands of doctors say the same thing. EHR is suppose to make it so we can share data.

While people pay lip service to this idea and just assume that somehow EHR would make data sharing possible, that’s far from the reality today. This is true even in some organizations where they own both the hospital and the ambulatory provider. How sad is this? Extremely sad in my book.

I’ve often wondered what would change the tide. I’ve been long hopeful that ACOs and value based care would help to push the data sharing forward, but that’s going to be a long process. The private HIEs are working the best of any HIEs I’ve seen, so maybe the trend of hospitals acquiring small practices and hospital systems acquiring hospital systems will get us to EHR data sharing nirvana. Although, I don’t think it’s going to make it there in most communities. Instead it’s just going to have a number of large organizations not wanting to share data as opposed to some large and some small ones.

Do people really have much hope for true EHR data sharing? Does FHIR give you this hope? I’m personally not all that optimistic. We all know it’s the right thing to do, but there are some powerful forces fighting against us.

Meaningful Use Stage 3 Success Could Rely On Vendors

Posted on May 20, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today I was reading a report on the Health IT Policy Committee’s review of pending Meaningful Use Stage 3 rules — which would ordinarily be as about as exciting as watching rocks erode — when something leapt out at me which I wanted to share with you, dear readers.

The overview, brought to us courtesy of Medical Practice Insider, noted that proposed plans for the Stage 3 rule would allow providers to attest in 2017, though attesting wouldn’t be mandatory until 2018. What this means, editor Frank Irving notes, is that it would be up to EMR vendors to be ready for providers wishing to attest a year early.

The folks overseeing this discussion, the Advanced Health Models and Meaningful Use Workgroup, seem (wisely) to have had their doubts that vendors could be relied upon to meet the 2017 deadline. At the session, workgroup members proposed a couple of alternative ways of addressing this timeline. One was to make the 2017 deadline go away, requiring instead that EMRs have full 2015 certification by 2018. Another was to allow optional attestation in 2017, but if need be, with 2014 EMR certification.

I don’t know about you, but this whole thing makes me nervous. By “whole thing,” I mean adjusting the rules to deal with the likely resistance vendors will exhibit to keeping their roadmap in synch with federal requirements.

After all, consider the history of EMR vendors’ relationship with providers. As we’ve noted, HHS has paid out about $30B in Meaningful Use incentives under HITECH without insisting that vendors provide interoperability. And what have EMR vendors done?  They’ve avoided developing shared standards for interoperability with an alacrity which amazes the eye.

In fact, some EMR vendors — including top contender Epic Systems — have been slapping providers with fees for data sharing (even if they’ve kind of dropped them for now), at prices which could leave them millions in the hole. If that isn’t dead opposite to what those in public policy hope to see happen, I don’t know what is.

Bottom line, if the good people overseeing Meaningful Use want to see Stage 3 accomplish good things, they’ll need to see to it that the new rules give regulators some leverage when it comes to controlling vendors.

As the whole sad interoperability saga has demonstrated, vendors will not take actions that advance health IT on their own. Unlike in other IT markets, where interoperability and meeting regulatory deadlines have been the signs of a winner, EMR vendors actually have strong incentives to ignore providers’ business imperatives.

With any luck, however, between tougher rules on Stage 3 and public pressure to achieve interoperability, EMR vendors will do the right thing.  They’ve certainly had long enough.

Comprehensive vs. Complete: Creating a Truly Representative Health Record

Posted on May 12, 2015 I Written By

The following is a guest blog post by Stacey (@coffeemommy), an empowered patient and breast cancer survivor.

According to my EHR, I had breast cancer. And I had two mastectomies and I’m currently on Tamoxifen. If you read a little deeper, you’ll discover I also had a colonoscopy at age 39. It was clean.

According to my EHR from another institution, I had a colonoscopy at age 37 and two polyps were removed. I also had a series of ideopathic headaches. Beyond my verbally sharing this information with my current care team, they would have no record of these activities.

According to my EHR from yet another institution, I had a miscarriage in 2000 and went on to have two full-term healthy deliveries after that. More headaches and migraine medication. Again, these items are not reflected in detail in my current healthcare record.

And there are more health records of mine spread across the country.

Everything in those respective EHRs is accurate but my “electronic health record” is not really a record at all. My EHRs are snippets of time spanning several states of residency and ultimately dating back to a thick paper folder that, as a child, I remember checking out from the ground floor before appointments at the now defunct Wilford Hall Medical Center.

Beyond my memory of surgeries, inoculations and well visits past, I question whether documentation of my early health history really exists at all at this point.

And therefore, the burden of tying the highlights of my health history together for every new health care provider, falls on my shoulders. A doable task but certainly not an easy task in the typical 15 minute visit window.

Electronic health/medical records lack true interoperability and therefore are not comprehensive for most of the population. Teams of no doubt brilliant people are allegedly working on solutions and voices demanding interoperability and advances in the health IT space are loud.

However, even if my EHR were comprehensive tomorrow in the above context, it would still be incomplete. While every physician who treats me has read/write access to the record I, as the very subject of the record, am unable to add my two cents.

And my two cents would add a lot of context.

As an example, for the past 22 months, I have been on Tamoxifen to keep my estrogen-loving breast cancer from recurring. For 21 of those 22 months, I have had random soft-tissue swelling, random bilateral rashes and a face tingling turned numbness that progressed to such a point I was running to a mirror to see if my left side was drooping. Since there is no documentation of these symptoms as a side effect of Tamoxifen, I’ve been told to take Loratadine for swelling and have had two brain MRIs to rule out a tumor.

What my current team struggles to understand is that historically, I am reactive to many things. Soaps, shampoos, penicillin, sulfa drugs, ciprofloxacin, lanolin and a variety of other substances trigger rashes and soft tissue swelling in my body. So, starting on a new drug and having ‘undocumented’ side effects was not an unusual series of events for me.

When I asked to take a half dose and was told, “We don’t have a protocol for that.”

Again, what is missing from my EHR is the history of my taking half doses of many of the drugs I have been prescribed and having therapeutic results. As a child this was never a problem. For the first 22 years of my life, I was considered a US military dependent and the continuity of care, regardless of what base we were stationed at, was solid. The next twenty years has been a scatter shot of services across zip codes, providers and payors.

A comprehensive (including all of my past) and complete (including my two cents) would save time, money and headaches. Instead of emailing pictures and bringing a written diary of skin rash and swelling, I could simply upload directly to my own record. Instead of emailing a physician with my side effects and saying, “Please add this event to my record” I could add it myself for no cost to the healthcare system treating me. Patterns could be clearly seen and treatment could be modified appropriately if the situation was warranted. Side effects could more accurately be documented and communicated to other patients as trends were noticed.

The idea of patient reported outcomes being included in the EHR seems incomprehensible to some. I’ve heard, “But you can’t trust patient data” and “Patient supplied data is unreliable.” Really? To me it seems that patients themselves are the only ones who could supply this level of data to enrich the health record. And they have the biggest interest in comprehensive care. And, by the way, providers trust my input when I document my health history on the long sheet of paper on an initial visit – why is my information suddenly invalid as a patient?

To be clear, I’m not asking that patients have the ability to edit or rewrite what the healthcare practice has so diligently recorded. I am simply asking that our record reflect more than the set of symptoms we present with at any given visit. Tracking trends real-time will prevent the dreaded question, “How long has this been going on?” The answer will be front and center.

So as the great minds gather to create the interoperable EHR, please consider the patient voice. Interoperability may allow for a comprehensive record but, until my side of the story is reflected, the documentation will remain incomplete.

My body, my data and my health. Please allow me to participate.

Stacey is a strategy and communications consultant inspired to empower patients and caregivers through collaborative education and community building. Runner. Cyclist. Coffee drinker. Organic gardener. Wife to one. Mom to two. Empowered patient and breast cancer survivor almost two years NED. Connect with her on Twitter @coffeemommy

5 Lessons Providers Can Learn from Payers Infographic

Posted on May 1, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

ClinicSpectrum has been putting out a whole series of healthcare IT infographics. I recently saw one of them that really caught my eye as it came across my Twitter stream. The infographic offers 5 things providers can learn from payers. I’m sure that concept is a bit unsettling for some providers, but the list is quite intriguing:

  1. Leverage Data to Identify High-Risk Patients
  2. Help Patients Manage Their Meds
  3. Designate a Patient Engagement Advocate
  4. Build Partnerships
  5. Seek Interoperability Opportunities

What do you think about these ideas? Check out the full infographic below for more details:
5 Lessons Learned from Payers
Full Disclosure: ClinicSpectrum sponsors posts on Healthcare Scene.

Why I Hope to Help End EHR’s Lack of Interoperability

Posted on March 23, 2015 I Written By

The following is a guest blog post by Donald M. Voltz, MD.
Dr Voltz
I am tired of waiting. Millions of medical professionals and patients are tired of waiting.  We have been waiting for EHR interoperability since the dawn of EHRs in the 1960s. Enough is enough! Our goal is to achieve EHR interoperability through a grass roots coalition of medical professionals and patients who are tired of waiting.

The simple life-saving ability of hospital EHRs to connect to one another so healthcare providers can easily and readily access patient data is not being addressed.  This type of issue is traditionally solved by industry or government initiatives. But so far they have not, and apparently will not solve it so I have decided to raise this issue through an outpouring of angry citizens, hospital patients, physicians and others being impacted.

Petition on Change.org

I have posted a petition on Change.org to demand EHR operability. Please visit the site and sign it if you are tired of waiting and want change now.  This is an issue that affects all U.S. Citizens.  My goal is gather 25,000 signatures so the petition is reviewed by the White House and acted upon.  I don’t care is this is done through an executive order, a law passed in Congress or industry initiative, as long as it is done.

By signing the petition, we are telling the President and Congress that we need a direct path of communication between all EHR systems through a specific and comprehensive policy of interoperability.

Why do we need government intervention?

  • There has been no improvement in patients’ health information flow in medical communications systems and no support for sharing this crucial data flow among care providers since the transition from paper to electronic medical records. The result is the high number of medical errors leading to death will remain unchanged without government intervention.
  • Hospital boards have no incentive to adopt technology to solve the problem because inaction costs less money than fixing it. The result? Hospitals are not actively looking for a solution, unless it is mandated as part of a government intervention, similar to the same intervention to transition from paper to electronic medical records.
  • Most of healthcare vendors, notably electronic health record (EHR) vendors, have no incentive to address these issues in order to push for their own product solutions. This leaves the lack of EHR interoperability, the most critical area to reduce medical errors leading to death, with no near term improvement.
  • Existing government bodies are in place, but the focus and timetable are not aligned with the urgency for improving patient outcomes, which claim US lives on a daily basis.

Approximately 400,000 Americans die every year because of industry self interests, slow pace of government oversight and care providers stuck in the middle.  In the end, patients are the customers, yet they are bearing the brunt of this disservice.

1,000 Die Daily

At a recent senate subcommittee hearing, it was revealed that more than 1,000 people are killed and 10,000 injured every day due to medical errors largely caused by technology mistakes.  Approximately 40% of these errors are directly related to information omissions and miscommunications.  Why do these errors occur?

Many of these errors are a direct result of a technological communication disconnect within the electronic medical record system. Simply put, these programs designed to make access to crucial medical information easier do the opposite.

The average hospital operates competing EMR’s systems; none of which can share information with each other and all of which present that information in completely different ways, causing confusion by healthcare providers and taking away time with patients. The result are misread charts and forgotten results. Patients are also put at risk by healthcare providers who might not receive timely data in a life threatening crisis.

6th in the U.S. for Deaths

If the Center for Disease Control reported a category for erroneous medical deaths, it would rank 6th in the U.S.  And the cost?  A cool trillion dollars a year. Sadly, this figure is not too far from similar statistics found 15 years ago.  By implementing an EHR connectivity solution, hospitals and medical professionals would save billions in lower insurance premiums as there will be fewer medical death and error lawsuits.  These actions will lower medical costs and will benefit everyone.

The medical industry has had many opportunities to bring about interoperability. The January 2009 passage of the Health Information Technology for Economic and Clinical Health Act (HITECH), a $30 billion effort to transform healthcare delivery through widespread use of EHR technology. Also, the Meaningful Use EHR Incentive Program requirements have helped to create greater commonality in basic EHR functions across systems at a much faster pace than would have otherwise occurred.

Please join me in helping bring an end to this tragedy!

About Dr. Donald M. Voltz
By Donald M. Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University. 

Board-certified in anesthesiology and clinical informatics, Dr. Voltz is a researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.

Voltz petition on Change.org demands that the government and medical industry implement a solution to end what is a very easy problem to fix.  Once signed by 25,000 U.S. residents age 18 and older, the petition will be sent to the White House for review and a specific, timely action plan.