Monday, June 26, 2006

Play that Funky Music

I talk a lot about the value of integrated systems. By making your fax talk to your server, and your records interface with your billing system, you can save a ton of steps and avoid stuff dropping through the cracks. The same is true of some sort of holistic medical record system:

Recently I was at a distinguished doctor’s office. This doctor – a very nice and knowledgeable person – described how there was no intersection between the records of his office and any other doctor’s office. A patient could visit a gynecologist, a cardiologist, an endocrinologist and a general practitioner, but there would be no systemic, holistic view of data. The gynecologist knows nothing about the patient from the standpoint of the cardiologist. The cardiologist knows nothing about the patient from the standpoint of the endocrinologist, and so forth. These specialists do not share data about their patients with other specialists. Period.
Some of this lack of sharing of data is because of HIPAA, but a lot of the lack of sharing of data would be occurring even if there never had been a HIPAA. The world of medicine is a world of chopped up, little systems where there is no interconnection from any point to any other point.
When asked about the fact that a patient – any patient – might want a truly holistic view of his/her health, the specialist simply said that there is no way to do that.
Perhaps the most disturbing aspect of the conversation was the fact that the specialist had no inclination whatsoever to create integrated data for the patient. There simply was no incentive – no motivation – to step outside of the silo.

It may well be that some variation of the Clinton-Frist bill will provide the driver for an integrated record system. Of course the potential for abuse is there, but the record systems we have are often abused. For all the funky goodness of distributed, fragmented and partial records like we have now, the time, effort and lives saved by an integrated system would most likely more than pay for its implimentation.

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