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0 pointsfitandfunction13y ago0 comments

Why do you think past efforts haven't "panned out" yet? Is it:

a) they're working on it, but just not there yet

b) the major EHR do everything in their power to delay progress by providing token access

c) it's actually very hard to sync medical records across so many different standards / systems

d) not enough patient / doctor demand / use-cases, i.e. people don't transfer as much as we think they do, diluting the value of inter-operability

? or something else? all of the above?

This area of HIT fascinates me because I hypothesize that it's a necessary precursor to reform. But, knowing little about the space, I'm not sure where to start my investigation.

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markolschesky13y ago· 2 in thread

None of the above, IMHO.

In San Francisco, Kaiser could electronically share patient data with every other system running Epic with very little technical work and price. We're talking hours of work here. That would let them share data with UCSF, PCMH and every other Epic site.

They don't. Why not? It's because sharing patient data makes it easy to poach patients, and that's bad for business. There are similar situations in other cities too.

I don't blame them because the government hasn't made data exchange required yet. It's coming, with some of the requirements for Meaningful Use Stage 2 & 3 and the work done by the S&I framework. APIs will help too, because HL7 is confusing to newcomers and costs money. Vendors could make this easier too, but it's not like Epic or Cerner could compel anyone to share patient data.

I have a more in depth answer about this topic here: http://www.quora.com/Electronic-Health-and-Medical-Records/W...

Mz13y ago

I would think HIPPA is one of the issues here. Federal law says it is a big no no to freely share health info without a raft of signed paperwork, basically.

markolschesky13y ago

Typically customers handle this through some type of waiver system. Generally at the initial visit in an organization a patient signs a ton of releases that state that the parent organization allowed to share patient information as needed through the course of treatment. Most people want to share their information, but there are systems in place to restrict access as needed by law/best practices. Patients can opt out of data, and some data sharing systems support this through various technical choke points. If you were a nurse at one organization, you may not want people snooping through your medical records at another medical organization. The Direct Protocol supports this through pseudo-anonymity of accounts.

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