Friday, April 17, 2015

The EHR and Its Performance

The NY Times bemoans the status of the EHR. As it states:

The ability to transfer electronic medical records from one doctor or hospital to another is essential to the smooth functioning of the health care system and to providing the best possible care to patients. Yet all too often these transfers are being blocked by developers of health information technology or greedy medical centers that refuse to send records to rival providers. This will not be an easy problem to fix, but some possible approaches were detailed in a report to Congress last week from the Office of the National Coordinator for Health Information Technology, a unit of the Department of Health and Human Services.

The problem, as we have noted over the past several years is several fold:

1. First, the Government directed the process. The same group who did the portal for ACA. In addition in my opinion the management team were politically selected not professionally selected.

2. The system should have been patient centered and not practice centered. Namely the system should have take advantage of a secure cloud based approach minimizing physician costs and overhead and allowing single points of collection and correlation. Unfortunately we have a plethora of systems which will be outdated and underused.

3. The system should be multimedia enabled. Now it is merely a text file system with some adjunct access for radiologists and perhaps pathologists. Other multimedia elements are piecemeal and unconnected.

4. The system should provide a customizable dashboard. If the patient is a Type 2 Diabetic one should see their BMI changes as well as HbA1c and others. If the patient has COPD the same.

The problem is NOT the vendors. The problem was in my opinion the very people who created this mess. We noted as such six years ago, but alas, it is this Administration.....And tens of billions of tax money has been spent and added costs to practices...not to mention physicians typing while not examining the patient!