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This post was originally a comment by SPM member Jeffrey Harris on our C-ME post from April 3, 2014. Jeffrey has a long history as a clinician, a health IT strategist, and as a patient. We thought his commentary deserved its own post.

Jeffrey Harris photoI had the opportunity to moderate a PCPCC e-Health Public Meeting recently. We interviewed Dr. David Kendrick from the Oklahoma My Health Network. I believe they are a good example of the top 10% of HIE implementations for quality and value added to most stakeholders.
The architecture makes sense as the HIE brings services that eliminate administrative costs among providers, policy experts, payers and even patients.

They are using HealthVault as a PHR which, as you know, allows patients to create their own information-sharing profiles as well as connect to lab hubs, pharmacy hubs etc.

Your comment on a regulated banking model is something I would support. Here is the reason: As a healthcare executive with clinical program skills and HIT innovation patents I would be short sighted unless I add in my 47 years as a person with diabetes and associated co-morbidity.

We were promised increased safety, reduced cost, etc. due to implementation of health information exchanges (HIEs). Instead, our providers (including integrated delivery networks) are taking incentive payments for technology and using data for performance payments, yet not electing to share data with patients through a Single Sign On technology. The HIE in Oklahoma would be a natural architecture as it could push CCDs to HealthVault where patients could then access their global history.

We forget that 5% of the US population accounts for 50% of healthcare expenditures. These are folks like myself, with multiple sub-specialists who belong to different networks of care. My experience has not changed, with the exception of postal costs.

To assemble my documentation for a new physician (in this case a neurosurgeon) I had to access three portals, drive to one imaging service and then cut and paste the sentinel data that patients often forget to report into HealthVault. Then, I extracted data again through cut and paste methodology to deposit as a personal e-mail note in my secure ‘MyHEALTH’ Record at Duke since they will not allow patients to upload information. Yes, patient data entry is extremely important and easily controlled with regard to how it is used (for you lawyer types).

Unless we can get competitive business units (the root of health care fragmentation) to allow their information to flow, we will not see the returns we have been promised.

Here is an index case: I had neurosurgery on my c-spine. My family has a history of malignant hyperthermia. That history is only noted deep within a paper record somewhere in California. Here’s the problem:

  • How many patients remember stuff like this?
  • What if I received Halothane – 50/50 chance of survival?

So, I cut and paste from Healthvault.

The variable that we completely forgot when re-engineering our system is the fact that our society is based on individual rights and will. While this gives rise to incredible innovation it does not guarantee that humans will exchange information without receiving some return on the investment. Even when someone’s life is in the balance.

Yes , it is that dramatic when one looks at one patient at a time.


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