We've Been Swindled
Monday, November 20, 2017
This is a truthful story. It is not--repeat, not--about the character of aid received past times my friend at 2 first-class Harvard pedagogy hospitals. He was really clear to me that the doctors too nurses too other staff were attentive, considerate, communicative, too proficient inwards their handling of him.
Rather this is close a beak failure of our regime to insist on interoperability betwixt electronic wellness records, a failure made all the to a greater extent than outrageous inwards that the regime has helped pay for those EHR systems inwards 1 of the biggest subsidy programs inwards modern healthcare history.
The friend was suffering from hurting too went to the urgent aid facility closest to his home, 1 operated past times Beth State of Israel Deaconess Medical Center inwards 1 of the western suburbs of Boston. The diagnosis was renal failure. A CT scan located the root of the problem, large kidney stones blocking the surgical operation of his kidneys. An ambulance was called, too the patient chose to become to the emergency subdivision at Brigham too Women's Hospital, where his main aid MD practices.
His creatinine marking was over 8 mg/dL. (A normal marking for men is 0.7 to 1.3.)
Upon arrival, he was whisked through the ED too was beingness prepped for surgery, but the doctors wanted to induce got a clearer feel of the place of the stones. His kidneys were inwards no status to induce got some other CT with contrast, too thence they wanted to expression at the CT scan that had been taken merely an lx minutes before at the urgent aid facility.
There was no agency to electronically deliver the icon to the BWH team.
The work-around? The BWH ED physician called his counterpart at the BIDMC ED, asked him to download the icon from the BIDMC figurer organization too john a re-create onto a pollex drive, which was too thence carried 3 blocks away for manus delivery to the BWH team.
Fortunately, all went good for my friend.
Years ago, my friend too colleague John Halamka, CIO at BIDMC, told me that at that spot was no technical argue that the BIDMC too BWH EHR systems could non hold out made interoperable. But they nonetheless are not.
Indeed, this is a designing nationwide, fifty-fifty though over 29 billion dollars of federal investment for EHRs were appropriated inwards 2009. Whether yous demo upward at an emergency room around the corner from your infirmary or a grand miles from your hospital, at that spot is to a greater extent than likelihood than non that the receiving establishment volition non hold out able to make access to your wellness record. The term "meaningful use," the measure according to which the the States regime funds these systems, is laughably inadequate when it comes to interoperability. We demand to empathize that a large pose out of healthcare systems, aided too abetted past times some EHR providers, stance it inwards their strategic involvement to become far hard for patients to movement from 1 healthcare network (ACO) to another.
We--the taxpayers too patients of America--have been swindled. Our national involvement does non coincide with those corporate strategic interests.
And the fraud is probable to hold out compounded. The adjacent pace inwards the procedure is a forthcoming Department of Defense procurement of an EHR organization to serve the armed services too its dependents, whether beingness treated at armed services healthcare facilities or other facilities inwards the communities inwards too around our bases too other armed services installations. As I understand, at that spot is no linguistic communication inwards this multi-billion dollar procurement that would require the vendor chosen to accomplish interoperability with those EHRs inwards community facilities where the regime volition post its patients--or where they powerfulness goal upward for emergent care.
Darius Tahir latterly reported on Modern Healthcare:
A defence retrieve tank says the regime may regret its programme to lock the United States Defense Department into a 10-year contract with an electronic health-record vendor.
The Center for a New American Security released a written report that sharply criticizes the department's procurement procedure for a novel EHR system, which is expected to damage $11 billion over the life of the contract too has attracted trigger-happy contest with iv bidding teams.
“DOD is close to procure some other major electronic (health-record) organization that may non hold out able to remain electrical flow with—or fifty-fifty lead—the state-of-the-art, or piece of employment good with parallel systems inwards the populace or someone sector,” warn authors, who include retired Gen. H. Hugh Shelton too quondam Veterans Affairs Chief Technology Officer Peter Levin.
“We are concerned that a procedure that chooses a unmarried commercial 'winner,' unopen too proprietary, volition inevitably atomic number 82 to vendor lock too health-data isolation,” they conclude.
We've been swindled once. Will it hap again?
Rather this is close a beak failure of our regime to insist on interoperability betwixt electronic wellness records, a failure made all the to a greater extent than outrageous inwards that the regime has helped pay for those EHR systems inwards 1 of the biggest subsidy programs inwards modern healthcare history.
The friend was suffering from hurting too went to the urgent aid facility closest to his home, 1 operated past times Beth State of Israel Deaconess Medical Center inwards 1 of the western suburbs of Boston. The diagnosis was renal failure. A CT scan located the root of the problem, large kidney stones blocking the surgical operation of his kidneys. An ambulance was called, too the patient chose to become to the emergency subdivision at Brigham too Women's Hospital, where his main aid MD practices.
His creatinine marking was over 8 mg/dL. (A normal marking for men is 0.7 to 1.3.)
Upon arrival, he was whisked through the ED too was beingness prepped for surgery, but the doctors wanted to induce got a clearer feel of the place of the stones. His kidneys were inwards no status to induce got some other CT with contrast, too thence they wanted to expression at the CT scan that had been taken merely an lx minutes before at the urgent aid facility.
There was no agency to electronically deliver the icon to the BWH team.
The work-around? The BWH ED physician called his counterpart at the BIDMC ED, asked him to download the icon from the BIDMC figurer organization too john a re-create onto a pollex drive, which was too thence carried 3 blocks away for manus delivery to the BWH team.
Fortunately, all went good for my friend.
Years ago, my friend too colleague John Halamka, CIO at BIDMC, told me that at that spot was no technical argue that the BIDMC too BWH EHR systems could non hold out made interoperable. But they nonetheless are not.
Indeed, this is a designing nationwide, fifty-fifty though over 29 billion dollars of federal investment for EHRs were appropriated inwards 2009. Whether yous demo upward at an emergency room around the corner from your infirmary or a grand miles from your hospital, at that spot is to a greater extent than likelihood than non that the receiving establishment volition non hold out able to make access to your wellness record. The term "meaningful use," the measure according to which the the States regime funds these systems, is laughably inadequate when it comes to interoperability. We demand to empathize that a large pose out of healthcare systems, aided too abetted past times some EHR providers, stance it inwards their strategic involvement to become far hard for patients to movement from 1 healthcare network (ACO) to another.
We--the taxpayers too patients of America--have been swindled. Our national involvement does non coincide with those corporate strategic interests.
And the fraud is probable to hold out compounded. The adjacent pace inwards the procedure is a forthcoming Department of Defense procurement of an EHR organization to serve the armed services too its dependents, whether beingness treated at armed services healthcare facilities or other facilities inwards the communities inwards too around our bases too other armed services installations. As I understand, at that spot is no linguistic communication inwards this multi-billion dollar procurement that would require the vendor chosen to accomplish interoperability with those EHRs inwards community facilities where the regime volition post its patients--or where they powerfulness goal upward for emergent care.
Darius Tahir latterly reported on Modern Healthcare:
A defence retrieve tank says the regime may regret its programme to lock the United States Defense Department into a 10-year contract with an electronic health-record vendor.
The Center for a New American Security released a written report that sharply criticizes the department's procurement procedure for a novel EHR system, which is expected to damage $11 billion over the life of the contract too has attracted trigger-happy contest with iv bidding teams.
“DOD is close to procure some other major electronic (health-record) organization that may non hold out able to remain electrical flow with—or fifty-fifty lead—the state-of-the-art, or piece of employment good with parallel systems inwards the populace or someone sector,” warn authors, who include retired Gen. H. Hugh Shelton too quondam Veterans Affairs Chief Technology Officer Peter Levin.
“We are concerned that a procedure that chooses a unmarried commercial 'winner,' unopen too proprietary, volition inevitably atomic number 82 to vendor lock too health-data isolation,” they conclude.
We've been swindled once. Will it hap again?