There have been many posts and news stories on this topic lately – I’ve blogged it a few times, too. As public attention focuses on how to move the health care industry forward and how to reduce costs, technology is moving to the forefront. Recently IBM announced a program to test the sharing of health information records among hospitals, agencies and patients. David Fraser posts today on the move towards outsourcing centralized health record management, a natural consequence of the commoditization of information that must occur if it is going to be managed as a resource.
All of this is a good thing, subject to adequate precautions being taken for privacy. There ought to be a cradle-to-grave data source for all of our health records. It should contain all of our health records, including copies of all tests, notes and such. It should be dynamically updated as more data is created. It should be linked in to automated systems that will keep track of our ongoing health and remind us of important health events in our lives. It should be instantly available to any health professional to whom we wish to provide it. And it should all be available, on an anonymized basis, to researchers.
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Accessibility from different providers is definitely the most pressing requirement for EHR (and also the least fulfilled.) One thing that concerns me from a privacy perspective, though, is it seems that a lot of the pioneers in this area are doing it hand in hand with large employers instead of working exclusively with patients and providers (e.g. WebMD’s partnership with WalMart). One exception that I know of is a company called Chart Biopsy, (www.chartbiopsy.com) they have an EMR system that’s designed specifically to allow different offices to communicate. It was originally designed primarily for local free clinics that end up sharing a lot of patients. (I know about them both through volunteer work at these clinics and they asked me for feedback occasionally on the interface, however I don’t work for them.) Anyhow, recently they’ve announced they’re going to start offering office accounts to regular medical practices.
Personally, I think a better solution than chart biospy’s approach is to better standardize EHR exchange so that a multiplicity of EHR systems can coexist peacefully, with perhaps a government sponsored repository for records. If it gets left to the private sector, though, I’m much more comfortable with Chart Biopsy’s approach than WebMD’s.