Health Information Exchange: Bridging the Digital Divide

We’ve all heard and can probably sing along to the classic song Small Town by John Mellencamp, which romanticizes growing up and living in some place other than the big city. I, too, am what most would consider “small town,” and every time I hear that song I can’t deny getting flashbacks of Main Street parades and the pancake fundraisers I attended growing up in the Texas Panhandle.

I now live in a large metro area and have become accustomed to convenience and access to the best of any and everything that is available. I literally live three miles from three different grocery stores and five Starbucks Coffee shops – one even has a drive-thru so I don’t have to be inconvenienced by having to get out of my car and walk… exactly what Mellencamp hand in mind when he sung:

“Still hayseed enough to say, ‘Look who’s in the big town.’”

Many aspects of small town life haven’t changed a lot since I left. While the jobs may be harder to find and the median age of the residents has risen, there is still the ritual of attending Friday night football games and a good chance you’ll see someone you know when you stop in at the donut shop Saturday morning.

That small-town simplicity, however, also exists in the local health care facilities, which is something I witnessed as my grandmother passed away last February. She was a “tough ‘ol bird,’” as my Dad says, and she had a very long and fulfilling life, but I can’t help but think what a little bit of that big city convenience would have meant to her and the rest of us during the long process that eventually resulted in her passing.

About a year prior to her death at age 89, my grandmother was diagnosed with congestive heart failure after spending several days in the ICU in the nearest city hospital, located about an hour from her home town. She received several diagnostic tests and met with a handful of specialists while at the city hospital.

Twice over the next year, she was rushed from her assisted living home to the local, smaller critical access hospital for treatment of circulatory issues. Each time, she was stabilized and then placed in what probably is best described as a holding pattern because the local physicians were unable to make a diagnosis of her condition without first consulting with her cardiologist.

To us, this pattern was difficult because we were waiting to receive two very different messages: one, she would recover and live; two, this was the end and she would soon die. We only could worry and wait for three or four days until she was seen by her cardiologist.

Why couldn’t her local doctors tell us what was going to happen to her? Why did we have to wait for the doctor in the city to see her? What if she dies before he can make a diagnosis?