Personal Health records, Electronic Medical Records, Electronic Health Records and the endless quest for automation.

Posted by: Jack

One of the most active areas for IT these days is in medical IT – hospitals, physician practices, health care providers.  Market leaders such as Siemens, Eclipsys, Cerner, and GE supply electronic medical records systems to hospitals and physicians.  A recent Wall Street Journal article noted that by some studies only 4% of physician practices are using EMRs effectively, if at all.

   

Then there is the personal health record crowd, mostly lead by insurers like Aetna, Cigna, Blue Cross, United Healthcare, Wellpoint.  Their value add is to be a central repository/aggregator for all of an individual’s medical history – regardless of which physician, hospital, or other provider (say chiropractor) you visit – as long as you are insured by them.

   

But, of course, we don’t all stay with one insurer all our lives, nor do we always visit the same provider (doctor, hospital, other provider).  And in both approaches (put aside for the moment differences in the level of clinical data associated with a personal vs. a medical record) integration across providers or insurers is key.

   

Enter Google and Microsoft (among others) that are “provider or insurer” independent.  They’ll claim to interface with different health information sources and be the centralized repository and aggregator to keep your (HIPAA says it's yours) information in one place.

   

And threaded through it all is the issue of security, secure access, and privacy…..Kevin Kampman from our IdPS coverage area has blogged on that: http://bgidps.typepad.com/bgidps/2008/07/physician-heal.html

   

Three years ago you could walk into a hospital or doctor’s office, have an x-ray taken, and ask for your copy …and they would look at you cross-eyed, feign an inability to do that, or just plain ignore your request. 

   

Now if you do that (as I did at a recent emergency room visit), they’ll put it on CD for you and you can walk out the door with it.  But don’t ask for the doctor’s notes or the actual record of your visit with blood pressures, heart rates, drug test results, or any other actual data that was collected from your body.  It is almost impossible to get it, assuming the physician or nurse knows how.

   

The Google/MS approach follows the “Quicken” model from earlier years, in a different industry (financial services).   In subsequent blog entries, we’ll explore the financial services experiences for a unified financial record, and see what lessons can be gleaned for a unified health record. 

But before we go down that road, let's get some definitions straight.  I got these from "geekdoctors" blog - John Halamka at Beth Israel in Boston  ( http://geekdoctor.blogspot.com/2008/06/ehr-for-non-owned-clinicians-coming-to.html )

Electronic Medical Record
An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.

Electronic Health Record
An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff, across more than one health care organization.

Personal Health Record
An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

Health Information Exchange
The electronic movement of health-related information among organizations according to nationally recognized standards. HIE is a verb describing a process.

Health Information Organization
An organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards. HIO is a noun describing an organization.

Regional Health Information Organization
A health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community

The implications of what we do here are enormous - both from security, identity, and enterprise architecture points of view.  Not to mention our own health histories. If you are a healthcare CIO you are living it.

If you are a financial services CIO, you have already lived it.  There must be lessons and approaches that we can transplant.

Send me your ideas.

Comments

[electronic medical records]

This is understandable for anyone who has had to go to the emergency room and wait for an undetermined amount of time to receive admission or proper treatment. Part of the reason for the delay is finding medical records.

[Oliver]

I agree 100%...the one thing that concerns me with Google & MSN entering the space is that my health records may show up in their search results....the other thing is their service might be free but they are monetizing your health records with google adwords (i.e. serving ads within your medical records)

About three months ago I came across www.MedicalRecords247.com - while the site isn't free (less than $20 a year) it is secure and has hackersafe seal of approval. I feel much better knowing that there is no way my personal health records will show up in search results.

Just my $.02

[Adam]

The first benefit of obtaining medical records and immunization records is that it will allow you to properly evaluate your potential risk for developing certain types of medical conditions and numerous types of diseases. There are many types of medical problems that may occur based on genetics alone.

[x-ray fluorescence]

There are so many advantages in maintaining the medical records and immunization records,so that it will allow you to properly evaluate your potential risk for developing certain types of medical conditions and numerous types of diseases.