This blog first appeared at The Health Care Blog. -Ed.
Now that the Obama administration and Congress have committed to spending billions of tax payers’ money on health IT as part of the economic stimulus package, it’s important to be clear about what consumers and patients ought to expect in return -- better decision-making by doctors and patients.
The thing is, nobody can make good decisions without good data. Unfortunately, too many in our industry use data “lock-in” as a tactic to keep their customers captive. Policy makers’ myopic focus on standards and certification does little but provide good air cover for this status quo. Our fundamental first step has to be to ensure data liquidity -- making it easy for the data to move around and do some good for us all.
We suggest the following three goals ought to be achieved by end of 2009:
- Patients’ clinical data (diagnoses, medications, allergies, lab results, immunization history, etc.) are available to doctors in 75% of emergency rooms, clinic offices, and hospitals within their region.
- Patients’ doctors or medical practices have a “face sheet” that lets any staff member see an all-up view of their relevant health data, including visit status, meds, labs, images, all of which is also viewable to patients via the Web.
- Every time patients see providers, they are given an electronic after-visit report that includes what was done and what the next steps for care will be according to best practices and evidence-based protocols, whenever these are applicable.
- Some who view this seemingly humble list of achievements will say that we can’t do it, because the standards aren’t ready, or the data is too complex. They’ll say that delays are necessary, due to worries about privacy or because too much data is still on paper.
We disagree. We believe that where there’s a will, there is going to be a way. And we already know most of what we need to know to achieve these goals. We know that:
- Huge amounts of digital data exist, already formatted electronically, but scattered across many proprietary systems (meds, labs, images).
- Software and the Internet makes it possible --in a low cost, lightweight way-- to get data out of these databases to the point of decision making (to the ER doctor, the patient/consumer, or the primary care physician).
- People are hungry for information in whatever form they can get it:.
- Getting it on paper is better than nothing
- Getting it quickly is better than getting it late
- Getting it in non-standard digital format is better than paper (software is pretty good at transforming non-standard to standard formats)
- Getting it in a standard format is better
- Getting it in a structured, standard format is best
An integration “big bang” -- getting everybody all of a sudden onto one, single, structured and standard format -- can’t and won’t happen.