During the second 2008 presidential debate between John McCain and Barack Obama, the candidates made the following statements regarding healthcare:
McCain: “And we need to do all of the things that are principal to effect it more efficient. Let’s do health records online, that will prick medical errors, as they call them. Let’s have community health centers. Let’s have walk-in clinics. Let’s do a lot of things to impose efficiencies.”
Obama: “And we’re going to do it by investing in prevention. We’re going to do it by making definite that we expend information technology so that medical records are actually on computers instead of you filling forms out in triplicate when you go to the hospital. That will slice medical errors and gash costs.”
Regardless of who wins, it is a agreeable bet to say we are going to have greater investment in our electronic health records being save online. The messages are similar for whoever comes out on top.
There are plenty of Health Information Networks (HINs) out there now. Usage of them is tranquil very coarse. Putting our data into them will eventually become commonplace. The put a question to is whose network will glean out and how do you motivate everyone to approach on board.
The Players
The expansive four candidates in the HIN market-space are:
-GoogleHealth
-Microsoft HealthVault
-Dossia
-Nationwide Health Information Network
There are plenty of other HINs out there. Most are specific to a state, vertical niche or funded by an organization making positive their needs are included in the HIN evolution.
There are currently so slight patient data out there in any one HIN. While sure hospitals and insurance companies are populating data to some HINS, it is very sparse and only paints a few pieces of the entire patient report. There is minute attention paid to retrieving the patient history or combining a patient’s history from multiple sources.
Anything funded and supported by Google, Microsoft or federal dollars has the backing and deep pockets to discover it through for some time. As the HINs continue to evolve and find data, the sharing between the HINs might be restrictive. There will be intense competition for the data. The investment to pick up said data will be heavy. Once the represent is in their system, we do not put a question to the owner to be so speedily to release it to a competitor. Each player may introduce different standards to force data originators to capture and resolve who they work with.
Where is My ROI?
As is, there is no ROI available to a healthcare group to publish this data. Even if we count the non-dollar utility of a provider being able to spy a patient’s information online and obtain a better diagnosis and treatment understanding, not many providers are going to trust this data.
It is well known any HIN has a spotty relate at best about the patient’s history. The groups on the leading edge only have data available on the HIN from a sure point tantalizing forward and that data probably only comes from their dwelling. No provider is really going to rely on this and will smooth expend used chart tracking methods to collect the information they need. The wait on of better patient care because of the HIN is not there yet.
From a systems efficiency viewpoint, there is no return yet. It would be convenient for the data entry person to not have to re-key a unique patient in to the clinics Practice Management (PM) or Electronic Medical Records (EMR) application. This would be nice, but the salaries of data entry personnel are not the cause of rising healthcare cost.
Connecting to a HIN from a PM or EMR system is nothing more than an additional expense just now. Someone has to program this interface, test it, install it, invent the bandwidth available and form server station available. These are events that are often trivialized or overlooked, but they are expenses that add up and passed downstream to the providers. These expenses will originate themselves shown in the provider’s maintenance fees and license expense.
There are a ravishing number of practices that have made the decision to not have an EMR, powerful less an EMR or PM that interfaces to a HIN. A stand-alone EMR can race a practice anywhere from $15,000 to $20,000 per provider. The same application connecting to a HIN is even more.
Exactly Why Are We Doing This?
More and more providers are giving up on Medicare patients because the margins are vulgar and getting lower. Providers are booked as is and are pressured to squeeze in more patients. There is no shortage of patients waiting to be squeezed in. Based on the provider’s activity, they are giving plenty of care. But they tranquil need to contemplate every dollar spent and track claims closely to finish righteous.
The last thing a practice needs to inspect is their software license fees go up. If they go up and there is an immediate support to the practice, the fees can be justified. But the HIN provides no immediate back. That information the provider honest establish into the HIN was already available in their existing applications. It only helps the next provider down the line and that next provider is not going to trust it because they know it is unexcited an incomplete narrate. The cycle continues.
With no immediate succor to the provider in terms of utility or efficiency, and smart the cost will rise, the interrogate has to be raised – Why do this and what are the eventual benefits?
This is Why…
Today the information is spotty at best. It will not always continue to be so. Every day recent pieces of the patient picture puzzle are added. There are kids born today that will grow up with every fragment of medical history keep online. The rest of us will have to wait for the conversion routine.
Having all the health records online and the ability to go it to every PM, EMR, lab system, radiology system and every other application does give us efficiencies. But this efficiency really impartial replaces some low-paid data entry people and some chart-tracking applications.
The trusty support comes with the next evolution in healthcare applications that can manufacture exercise of all this data. Imagine the pharmacy application that knows your drug prescription history and alerts the pharmacist about obvious combinations or allergies. Imagine the lab technician entering the test results and the doctor’s office is alerted and provides potential diagnosis. Imagine a recent inspect is completed about the effects of obvious combinations of drugs and the providers can be notified which of their patients are at risk. The possibilities healthcare can arrive up with will be approach endless. Each possibility increases patient care and decreases cost.
None of these possibilities can exist without the patient data being available online.
There was a time when the mantra in the computer industry was “a PC on every desk”. We have essentially arrived at that point and are now beyond it. Before we got there, there were visionaries that spoke of an “information superhighway” that would connect all of these PCs together and if that happened, fantastic things would ensue. While only speculation at the time, those incredible things turned out to be Google, eBay, Facebook, iTunes and a plethora of other technologies that were disruptive to weak standards, created novel markets, recent benefits and changed the draw we work and process information.
Online patient data is the equivalent standard of having a PC on every desk. We need that before more fabulous things can happen.