By Jonathan G Ponting

Latest technology has simplified our lives to a great extent. Internet is helping to simplify many complicated procedures and few examples of the same are exchanging messages, contacting people in distant places using chat and emails, online shopping, reading information of latest events and happenings across the world and collecting information required related to any topic.

One of the most benefited industries from internet is the field of medicine. The latest innovation of medical technology is online patient portals. It is designed to increase communication and relation between patient and health care providers.

Online patient portal helps in efficiently managing the available resources with the local physician or provider to reduce the cost of treatment for both patient and the provider that uses advanced technology. It also enables doctors and providers in transmission of everything that is related to treatment of the patients like medical images for diagnosis, reports, medical date related to patient etc. It is also helpful in educating local physicians online on preventing development of chronic diseases via video conferences.

Online portals are also helping physicians to easily schedule appointment with patients as there is increase in demand for health care services which helps patients in avoiding to stand in lengthy lines. Patient portal helps patients to have better understanding of the disease they are suffering from, with the help of information provided and can also request for renewal of prescriptions at these portals. Patients are also offered to join various groups where other members also suffer from similar chronic diseases which help in lifting of spirits.

Patient portals not only help patients to directly contact with physicians but also to have remote access to mobile tools. Online patient portals are helping to improve quality of health care in remote and rural areas.

Patient portals are best and easy way of contacting doctors for various ailments and getting them treated without waiting for long time. They are best sources of getting advanced treatment for patients’ condition at affordable prices. They are highly beneficial for both patient and the health care provider in offering and availing best of treatments irrespective of geographic location.

Above article publish on http://healthcareblog01.wordpress.com/2010/05/04/online-patient-portal-another-innovation-of-medical-technology/

BY DR. SCOTT RANSOM

When Dr. Henry Plummer developed the concept of the “unit record” nearly 100 years ago, his idea was to place all of a patient’s records in a single file that traveled with the patient and could be stored in a central repository. His concept of medical care continuity quickly became the standard for medical record keeping worldwide.

I wonder what Dr. Plummer would make of today’s adoption of electronic medical records (EMR) by U.S. health care providers? After all, the concept is basically the same, just expanded to take advantage of today’s capacious electronic storage and retrieval methods.

Even the federal government has gotten into the act, defining a complete EMR system as containing four basic functions: computerized orders for prescriptions, computerized orders for tests, reporting of test results and physician notes.

In a perfect world, an EMR system tracks a patient’s entire health and medical history in a computerized, electronic format that is accessible wherever the patient is. These records are more easily retrievable than manual systems, and can make a patient’s navigation through the health care system much safer and more efficient.

But it’s hardly a perfect world. Even though the American Recovery and Reinvestment Act of 2009 has made the promotion of a national, interoperable health information system a priority, EMRs have not been adopted nearly as quickly in the U.S. as one might expect. Issues, including the high cost, lack of standardization, security and privacy have stood in the way of implementation.

A recent study from the New England Journal of Medicine points out that hospital EMR adoption rates are still abysmal, concluding that only about 8 percent of the 3,000 hospitals studied by researchers used even a basic EMR in a single unit, which included nurse or physician notes. And only 1.5 percent of non-federal U.S. facilities use a comprehensive EMR.

This seems counter-intuitive, especially when one considers the numerous advantages of EMRs, starting with efficiency. Information stored in an electronic format can be retrieved easily at the touch of a button or the click of a mouse. Search and retrieval times are a fraction of what they would be in manual systems. At the very least, this saves time by eliminating the need to complete the old manual medical history forms at a new physician’s office. This also reduces the chance for error when a patient forgets to list certain prescribed medications or supplements. It’s all there in one easily accessible record.

But efficiency isn’t the only benefit. For patients, access to good care becomes easier and safer when records can easily be shared. Important information — such as blood type, prescribed drugs, medical conditions and other medical history aspects — can be accounted for much more quickly. Doctors and other medical personnel can retrieve these medical records from anywhere using handheld devices like an iPhone, which allows them to continue treatment no matter where they are. And, in case of emergency, information can be shared with emergency room physicians who can then order diagnostic tests and share results online.

Another benefit is safety. It’s estimated that nearly 98,000 patients die annually by preventable medical errors of some type. It’s entirely possible that these numbers could be greatly reduced by a comprehensive medical history information generated through an EMR system.

The Mayo Clinic is setting the standard for EMR implementation. With one of the largest such systems in the world, all medical documentation relating to a patient’s care – physician notes, laboratory reports, surgical dictations, copies of correspondence, appointment schedules, X-rays, ultrasounds, CT and MRI scans, echocardiograms – is instantly available to caregivers via more than 16,000 computer terminals on Mayo’s three campuses. The efficiencies created by simply typing a few identifying keystrokes to retrieve a patient’s record saves a doctor’s practice or a hospital many thousands of dollars. That’s even taking the cost of the electronic system into account.

Even the federal government thinks electronic record keeping is important. Veterans’ hospitals across the country share an electronic system called VistA, which shares records of veterans in its health system. Should a patient find him or herself in a VA hospital, even away from home, the hospital will have the same access to his or her records that the hometown hospital does.

It’s interesting to note that a recent report from PricewaterhouseCoopers’ Health Research Institute contends that Medicaid penalties might do more to boost EMR adoption than incentives, like available funding to physicians to purchase and implement EMRs. According to the report, “Provisions in the stimulus law that call for cuts in Medicare reimbursements, rather than a multibillion-dollar incentive program, will do more to push the adoption of electronic medical records among hospitals and doctor practices by 2015.”

However EMR adoption happens, it’s critical that it happen sooner rather than later. The health care industry’s ability to provide efficient, coordinated, safe and high-quality care is only enhanced by the rapid availability of accurate data. And with the availability of solid data, researchers can also use the EMR to analyze large amounts of patient information more efficiently, speeding the application of new research findings and vastly improving patient care in the future.

Just as Dr. Plummer saw beyond the information exchange limitations of his era, we can see the benefits of using the latest technologies for the practice of continuity in 21st century medicine. But the goal, just as it was in Dr. Plummer’s time, or even going as far back as Hippocrates and his famous oath, is still nobly laudable: “First, do no harm.”

Above article published on http://www.fwbusinesspress.com/display.php?id=11302

Diana Manos, Senior Editor

The Certification Commission for Health Information Technology is expected to release more details on its “modular” certification on Sept. 24, and it is also tentatively planning training sessions in Chicago on Sept. 29 and Oct. 1, to orient vendors and developers to new programs, including updated application processes, certification criteria and test scripts.

The modular approach to certification would tell providers that a healthcare IT product is capable of performing to provide meaningful use, a requirement under the federal stimulus law under which providers could receive bonus payments beginning in 2011.

The certification would be provided in advance of the definition of meaningful use, which is expected out by the end of the year.

Federal officials have said providers would have to make “a business decision” as to whether to go forward in faith with the modular certification ahead of the final rulemaking.

The Certification Commission for Health Information Technology held a “town call” Web conference Thursday to gather input from the vendor and developer communities on the commission’s planned new paths to certification for electronic health record technologies.

CCHIT Chairman Mark Leavitt, MD, said the goal is to achieve more rapid, widespread adoption and meaningful use under the American Recovery and Reinvestment Act of 2009 (ARRA).

“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until spring 2010 - the expected date of (the Department of Health and Human Services’)’ final approval of requirements - to begin adopting this technology,” said Leavitt, “CCHIT has analyzed the recommendations of the federal HIT advisory committees and is preparing to offer new paths to certification beginning this October.”

Besides updating and enhancing its certification program for comprehensive EHRs in ambulatory, inpatient and emergency department settings, the commission plans to launch a more limited, modular inspection program for EHR technology, focusing solely on compliance with ARRA-required standards.

In an Aug. 14 meeting, the federal government’s Health IT Policy Committee adopted additional recommendations on meaningful use and proposed expansion of EHR certification to include 10 to 12 certification panels in addition to the existing Certification Commission for Health Information Technology. Physicians, activists, vendors and others warned the committee at a meeting that it was moving too fast.

Above article published on

http://www.healthcareitnews.com/news/cchit-maps-out-path-certification-meaningful-use-focus

By DAVE MICHAELS and JASON ROBERSON The Dallas Morning News

Dave Michaels reported from Washington, and Jason Roberson from Dallas.

An unprecedented effort to computerize the nation’s hospitals and physician offices could be the key to reducing crippling health care costs – or a giveaway to technology vendors whose sales will be subsidized by taxpayers.

Computerizing the paper-based world of medicine was a significant component of this year’s $787 billion stimulus package, which reserved $45 billion for hospitals and physicians to adopt electronic health records.

The Obama administration argues that electronic records will allow doctors to coordinate care for the sickest patients, eliminate errors such as adverse drug reactions and avoid duplicate lab and imaging tests. Medical errors alone cost the country $37.6 billion each year, according to the Institute of Medicine.

Despite years of technology development, most hospitals and physician offices, including those in North Texas, can’t electronically share information or even record patient data.

Data sharing confronts age-old assumptions that providers, not patients, own health records, which are valuable assets that can be used to obtain grants and market hospitals. It requires the government to decide what kinds of systems will improve care and how providers should use the systems to achieve that.

‘Meaningful use’

Congress dubbed that exercise “meaningful use,” and the government is taking most of this year to set the standards. The exercise is being closely watched by North Texas hospitals, vendors and consultants such as Plano-based Perot Systems and Addison-based MedHost Inc.

Some observers are concerned that the stimulus investment could be a bonanza for software vendors if the rules for “meaningful use” are too rigid and simply tied to buying software.

“Meaningful use is the whole shooting match,” said Richard Kneipper, a lawyer who co-founded Dallas health care information technology firm PHNS Inc. “The guts of the discussion will be how fast do you go?”

The first draft of “meaningful use,” produced by a federal advisory panel, resembled an approach advocated by the Healthcare Information and Management Systems Society. The government’s draft, however, was more aggressive.

Hospitals, physician groups and technology vendors have said the draft would require them to do too much too soon. Only 1.5 percent of U.S. hospitals have the comprehensive electronic records envisioned by the Obama administration, according to the New England Journal of Medicine.

The American Hospital Association, for instance, wants to put off one of the most important functions of electronic health records – having physicians enter all their orders electronically – until after 2015. “We don’t want to rush to do something just to chase money – and endanger patients’ lives,” said Rod Piechowski, senior associate director of policy for the hospital association.

The stimulus established a carrot-and-stick approach to lure providers into the electronic age. Physician practices could be paid up to $44,000 over five years, and hospitals could get a maximum of $15.9 million to install systems that comply with meaningful use rules.

The government would penalize providers that don’t participate, reducing their Medicare and Medicaid payments by 1 percent, beginning in 2015. In later years, the penalty grows to 3 percent.

“The penalties … are far more significant than the incentives,” said H. Stephen Lieber, president and CEO of the Healthcare Information and Management Systems Society.

But if hospitals think the schedule is too aggressive, they may sit out – and the government would have failed to achieve its goal, said Pamela McNutt, chief information officer for Methodist Health System in Dallas.

Dallas efforts

Many hospitals, including several in Dallas, have made big investments in electronic records, which they say can help prevent errors and reduce some costs. Methodist’s $25 million system allows physicians to order medicine from patients’ rooms. Nurses can scan a bar code to make sure patients have been given the right medication.

“Why would you want to set up a system and spend millions of dollars now, with all the questions surrounding it?” McNutt said.

Kneipper is urging a more expansive approach. He advocates not just a timeline that applies to everyone, but also extra incentives for providers that have shown they can use technology to improve care.

“The purpose isn’t just some idle technology,” he said. “It’s technology that is going to save people’s lives.”

The Obama administration is keenly aware of the high stakes of meaningful use. The goal isn’t just spreading technology – it’s using the technology to improve care and reduce costs.

“Not everyone may want to, not everyone will execute on the task,” said David Blumenthal, a Boston physician appointed by Obama as national coordinator for health information technology. “There is no guarantee in the law that people will be paid, even if they work hard.”

To qualify for incentives, providers must purchase “certified” systems.

So far, certification has been a voluntary, industry-led effort that identified the features and functions of a good system. But the stimulus law set a new standard, requiring providers to purchase certified systems to be eligible for the incentives.

Under the Bush administration, certification duties were outsourced to a commission founded by the Healthcare Information and Management Systems Society.

Kneipper and other critics argue that the commission has too many ties to industry groups to be the lone gatekeeper. The commission’s leaders contend that they are independent from the industry. But after three years of certification, most systems still don’t – and can’t – communicate easily with one another, according to health care technology experts.

“I don’t think the certification process has been particularly relevant so far,” Kneipper said. “It’s going to be very relevant for the purpose of having a toll gate for who gets into the stimulus money or not.”

The commission’s leaders acknowledge that certification has failed to achieve widespread interoperability. But they say the commission is now focused on making sure systems are compatible and is certifying systems that are homegrown, not just made by big software vendors.

“The missing piece is the government also envisioned what they called health information exchanges, which are sort of the switchboards to route data between doctors and hospitals,” said Mark Leavitt, the commission chairman. “They came up with a concept, but there wasn’t any money behind it.”

Progress in Texas

Texas has only a few small health information exchanges – in Austin, San Antonio and Fort Worth. Dallas and Houston, the two biggest health care markets in the state, don’t have exchanges up and running.

One exchange has popped up in North Texas, where Fort Worth-area doctors pay $150 to $200 per month to access SandlotMD.com, which supplies patient demographic data, lab results and patient history. Sandlot CEO Telly Shackelford says it serves 1.2 million patients.

In June, Arlington-based Texas Health Resources Inc. contracted with Epic Systems, a global supplier of electronic health records, to sync its records with those of UT Southwestern, Children’s Medical Center Dallas and Parkland Health & Hospital System. The Dallas-Fort Worth Hospital Council has begun a study of an exchange and is hoping to get stimulus funds to support it.

Shackelford expects the region will have several independent exchanges that can share data.

But in Texas, hospitals and providers have struggled to justify the money they would invest in such efforts. Competition among hospitals for patients has also stifled attempts to exchange data across numerous providers.

Two years ago, the Texas Legislature created an entity that was supposed to oversee the development of the exchanges – but lawmakers didn’t fund it. “For large institutions, many of them regard the aggregated data on their patients as a resource for grants – it’s worth something,” said Joseph M. Heyman, immediate past board chairman of the American Medical Association.

Three years ago, Kneipper, a former Parkland board member, tried to persuade three Dallas hospitals to share information about indigent patients. The homeless often bounced between emergency rooms, but each time physicians confronted their problems as if the patient were being seen for the first time.

The effort ultimately failed because the hospitals weren’t willing to devote money to it.

“If the stimulus monies were around [then], I believe that would have been the stimulus to make it happen,” he said.

Above article published on http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-healthrecords_14bus.ART0.State.Edition2.4bb476e.html

Health care facilities in the region are joining a nationwide effort to make medical records available electronically to cut down on costs and waste and allow medical providers in different areas access to patients’ medical records.

Many facilities in Minnesota, North Dakota and South Dakota already access medical records electronically or are in the process of developing, testing and implementing Electronic Medical Record (EMR) or Personal Health Record (PHR) systems.

Making health records available online in the electronic form of PHRs, which include medical histories updated by patients, could result in industry savings of $13 billion to $21 billion a year in the U.S., according to a November article in the Journal of American Health Information Management Association.

Rural health care facilities have lagged behind in converting to electronic records systems.

Lynette Dickson, program director for the State Office of Rural Health in North Dakota, said federal stimulus package funds aimed at supporting the advancement of health information technology will put pressure on some rural health care facilities that have not developed EMR plans.

A recent survey conducted by the Center for Rural Health to assess the adoption status of EMR systems in North Dakota found that larger hospitals use EMRs at a much higher rate than rural facilities.

“There’s an obvious rural/urban divide amongst health care facilities with regard to IT staff support and financial resources as well as much-needed planning activities,” Dickson said. “Although one third of rural hospitals indicated they had some level of EMR adoption, we know most don’t have a fully-functional system. We’re cautiously optimistic that stimulus package money may provide some grant opportunities to facilitate adoption of EMRs.”

Dickson said that most stimulus package dollars for Health Information Technology (HIT) will fund Medicare and Medicaid incentives to encourage the adoption of a certified EMR system capable of exchanging information from site to site. The incentive programs will be phased out over time, replaced with financial penalties for providers not using EMRs. Stimulus funds will also be available to states to set up loan and grant programs to cover planning and implementation costs of Health Information Exchange (HIE) systems. Dickson said this puts the onus on states to support the effort as matching funding from the state will be required to access federal dollars.

Dickson said the challenge of covering up-front costs to invest in an EMR system remains a challenge for rural providers. North Dakota’s Health Information Technology Steering Committee has been in place for more than two years, but is made up entirely of volunteers and its power is limited. Dickson said North Dakota doesn’t have a state office

Responsible for providing oversight for HIT or HIE. Caryn Hewitt, executive partner for health information management at MeritCare Health System, said MeritCare began establishing EMRs 10 years ago because of the size of its market area. MeritCare — North Dakota’s largest private employer — encompasses 20 locations in the Fargo-Moorhead area, 19 regional Minnesota clinics, eight regional North Dakota clinics and a regional hospital in Thief River Falls, MN.

“We have about 1.5 million patient records online,” Hewitt said. “No matter where a patient or provider is, if they have access to the MeritCare system, they can access those records.”

Hewitt said the benefits of MeritCare’s electronic records also reach rural hospitals that haven’t yet implemented an EMR system because MeritCare providers work in the hospitals and MeritCare clinics are often located near hospitals.

The cost of licenses, software installation and upgrades, equipment and training have prohibited some health care providers from making electronic records available. Privacy and security issues as well as individual state regulations also come into play. Many of these issues will be addressed through government HIT initiatives.

Sioux Falls-based Avera Health and Sanford Health have spent years developing and testing electronic medical records systems and utilize EMR and PHR systems in portions of their health care systems. Avera Health, which encompasses five regional centers and more than 230 locations in South Dakota, North Dakota, Minnesota, Iowa and Nebraska, plans to use EMRs system-wide by late 2010. All but one of Avera’s hospitals currently utilize EMRs and a recently-acquired hospital in Marshall, MN, is scheduled to implement EMRs in November.

Avera Health began offering online appointments at its McGreevy Clinic Avera locations three years ago as a step towards adding a PHR system. Current economic conditions will affect how quickly PHR software is implemented.

Sanford Health, which serves nearly 100 communities in parts of South Dakota, Minnesota, Iowa and Nebraska, recently completed a three-month PHR pilot. My Sanford Chart will allow patients to review clinic visits, request prescription renewals and schedule appointments online. Dr. Dan Heinemann, chief medical officer of the health services division at Sanford Health, said the pilot program allowed Sanford to fine tune the system before making it available to patients.

“PHR gives physicians another avenue of communication,” Dr. Heinemann said. “Patients can view their chart at night, weekends and schedule appointments when it’s most convenient for them. This paves the way for physicians to look at e-visits and e-health.”

Sanford officials said its PHR system utilizes a highly encrypted and secure process and is more time and cost effective.

“As our system develops, patients will be able to complete their own patient history before they come to the office and can be seen immediately because the physician already knows why they’re there,” Dr. Heineman said.

South Dakota’s eHealth Collaborative, initiated last spring, will result in a long-range plan to help facilitate information sharing between the state’s health care organizations and systems.

“Business owners are very interested in managing health care costs,” said Jim Veline, Avera Health’s chief medical information officer. “Electronic systems provide many cost-saving benefits.”

Above article published on

http://www.prairiebizmag.com/articles/index.cfm?id=9626&section=News

By Cody Kraatz

Sunnyvale Sun

Health care is going digital in Santa Clara County, which is rolling out electronic medical records at each of its Valley Health Center sites — including the one at 660 S. Fair Oaks Ave. in Sunnyvale. The goal is to make medicine safer and more efficient.

The switch from paper to digital records — something that President Barack Obama touted since he was campaigning — will take some time, and the county expects the Sunnyvale clinic to go live in June. The clinics provide outpatient services such as internal medicine, pediatrics and obstetrics.

“Patients have had untoward consequences and even deaths related to medication problems, inaccurate diagnosing or interactions between medications, or sometimes people didn’t completely know the information about a patient,” said Dr. Robert Horowitz, associate chief of primary care at Valley Health Center Moorpark in San Jose.

He was one of the first to try the electronic medical records system, starting in April 2008, and he said that despite some challenges it stands to help with several problems.

The county has numerous clinics in addition to the Valley Medical Center hospital, and a patient could have different charts at each location. “It’s really difficult to get a sense of one record that everybody sees and contributes to,” said Horowitz.

“The practice of medicine is really a collaboration, and many people participate in that,” including physicians, managed care coordinators, chronic disease specialists, pharmacists and dietitians, he said.

Doctors can also manipulate data from many visits or the course of a disease to tease out patterns in a patient’s history. “Those of us who have been using [electronic records] the longest are seeing the benefits of having the information at your fingertips,” said Horowitz.

The county is also hoping to secure funding from the American Recover and Reinvestment Act, or stimulus, for inpatient electronic medical records at the county hospital. But the county won’t decide how much stimulus money to seek until after May, when it expects the federal government to release criteria for how applicants must show a “meaningful” usage for the funds.

Besides the Moorpark clinic, the outpatient system was rolled out at the Valley Health Center Silver Creek in January and at the Valley Health Center East Valley in early April.

The county hopes that the cost of the system — which was one of eight elements of a $43.6 million information technology contract signed in 2006 — will be recouped through the efficiency that the system allows.

Take prescriptions, for example. The system allows a doctor to write a prescription directly into the computer and send it to the pharmacy electronically, saving the patient time.

Also, “you no longer have the doctor’s traditionally terrible handwriting to sort out,” Horowitz said. Moreover, because the patient’s existing prescriptions are in the electronic record, the system can highlight potentially dangerous drug interactions or allergies.

With paper records, that process would likely be slower. Refills — of which some doctors fill 25 to 100 per day — become more rapid through electronic requests, too.

All this could, in the end, save the county money. But many, including those who are not as technology-savvy, are finding that electronic medical records slow them down.

“That is definitely an issue that we will need to grapple with. I think it does make me a little bit slower,” said Horowitz.

It takes about six months to get comfortable with the program, which includes a mind-boggling number of pages, templates and data entry fields. There have also been technical glitches that the county hopes will be ironed out by the time clinics such as Sunnyvale’s go online.

Meanwhile, doctors who are accustomed to taking notes about patient visits by hand may feel that the many entry fields of the software disrupt their flow.

“It’s a significant learning curve both to learn the product but also to learn to use the [electronic record] and be with a patient at the same time,” Horowitz said. “You’re almost speaking a different language.” There is, however, a space for free text and he makes use of that.

There are also opportunities to make treatment more collaborative and transparent for patients, he said, by showing them what he is entering on the screen and asking them to review their medications with him.

Patients have been mostly enthusiastic about the electronic records, in Horowitz’s experience. “It’s sort of a`What took you so long?’ kind of feeling. This is a modern way to do medicine, and this is the way people expect medicine to be done,” he said.

However, he does know of one patient who refused to have information entered into an electronic record, fearing that it would be insecure. Ultimately, there will be no opting out.

Likening electronic records to e-mail, Horowitz said that within a year he expects doctors to feel the way he does. “I don’t know how I could have lived without it. I couldn’t see going back to the other way.”

http://www.mercurynews.com/valley/ci_12203584

To help transform health care, the state should invest more in electronic infrastructure that supports the automated exchange of electronic medical information, writes Russell Sarbora of Community Health Network of Washington. Increased efficiencies, lower costs and less waste of resources will help improve the health-care system.

By Russell Sarbora Special to The Times

IN Washington, state spending on health care ranks second only to education. The state has consistently asked how we can improve efficiency, reduce costs and focus scarce resources on insuring and caring for more Washingtonians.

The rapid exchange of accurate and timely information is going to transform the delivery of medical care. Infrastructure that supports the automated exchange of electronic medical information is and will continue to be a primary driver for efficient health-care delivery. We need to encourage and realize an efficient infrastructure for interoperability between electronic medical-record systems.

Washington state has at least two key assets already in place that have the potential to support creation of this infrastructure. These are the Washington State Health Care Authority-sponsored Health Information Infrastructure Advisory Board (HIIAB), and the Community Health Network of Washington (CHNW), the nation’s largest system of community health centers.

The 19 community health centers that make up the network are the primary health-care home for more than 600,000 low-income people in Washington state, including one-third of the state’s uninsured adults and one-half of the state’s uninsured children.

At CHNW we are working with HIIAB to achieve its objectives and have already implemented electronic medical-record systems that cover more than 70 percent of our member clinics and more than 85 percent of our patient population.

Business pressures will eventually produce efficient health-data-exchange services for patients served by commercial insurers and providers who rely primarily on commercially insured patients. But who will ensure that similar services are provided to vulnerable populations?

Through continued support for the HIIAB and by strengthening efforts to encourage the interoperability of electronic medical records, Washington state can improve patient health and safety while simultaneously controlling state-funded health-care costs.

Electronic medical records are used in the vast majority of acute-care facilities in Washington state; by all laboratory-service organizations operating in the state; by almost 25 percent of Washington’s primary-care physicians, and by more than 70 percent of CHNW’s member physicians. Yet, there is no statewide or national infrastructure today that supports sharing this information.

This infrastructure needs to be created, and the states that do so will lead the nation in delivery of efficient health care during the next decade. Washington state can and should be a leader in realizing this goal.

To achieve this leadership position, our state must adopt existing data-exchange policies and standards for health-information exchanges between organizations receiving state funding, provide incentives for technology investments required to support health-information exchanges, and financially support pilot programs that enable health-information exchanges.

CHNW is already working with HIIAB to create a Health Record Banking system that supports sharing of health information between patients and their health-care providers. We need to upgrade this existing business process to use current generation technology and thereby overcome existing shortcomings in reliability, efficiency and accuracy.

Interoperability between electronic medical-record systems is the key to achieving widespread sharing of clinical data. Today, these proprietary systems are incented to constrict access to the data they contain and there are numerous unresolved issues regarding access to the data and under what conditions data are shared.

Fortunately, the HIIAB is well-versed in these issues and well-positioned to support their resolution. The HIIAB is already proceeding with the creation of mechanisms to support patient access and control of their health data. However, the single greatest shortfall in the proposed Health Record Bank system is the absence of mechanisms to automatically include physician-created health data in these patient-controlled record systems. Lacking this critical body of data, the value of Health Record Banks will be substantially diminished.

We need to extend the HIIAB charter and role to encourage interoperability between electronic medical-record systems employed in Washington State and to achieve automated exchange of clinical data. The technology to do so already exists. Policy and will are the only hurdles to be overcome.

Russell Sarbora is the chief information officer for Community Health Network of Washington.

Copyright © 2009 The Seattle Times Company

Above article published on http://seattletimes.nwsource.com