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Why not here in ______?: Thoughts about Hospitals, Medicine and Health Care Issues February 19, 2012
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Paul Levy About the Author
Paul Levy

Provided by Not Running a Hospital

In the blank above, insert the name of your state and ask the question.  As reported by Lena Sun in the Washington Post: 
Maryland’s 46 acute-care hospitals will soon be able to share basic patient information among themselves and with credentialed doctors, a key step that health officials and clinicians say will improve patient care and cut costs.

The development, announced at a news conference Friday at Holy Cross Hospital in Silver Spring, is being led by the Maryland’s health information exchange, a statewide system that is working to promote the secure electronic sharing of health information among approved doctors’ offices, hospitals and other health organizations.

If you ask the question here in Massachusetts, the answer is clear.  The dominant provider network had for years an interest in not permitting its patients to be easily seen by other hospitals and physicians.  Indeed, that corporation made note of its proprietary information system as part of an investors' conference several years ago, in support of its case for being fiscally strong.

Perhaps that has changed.  Maybe someone will post a comment and let us know.

The minimum goal is that it should be possible to be seen at any emergency department in the state and have those ED doctors and nurses be able to get access to your medical record from your home institution and physician's office.

Beyond that, if we want to foreclose ACOs from having a strong hold on patients by making it hard for them to be seen by competing systems, we need "dial tone."

As long as proprietary electronic medical record systems exist, a given provider network can control the degree to which patients can choose lower priced or higher quality doctors and hospitals outside of that network.

Instead, we need the equivalent of the "magic button" described in this post by our CIO, John Halamka, demonstrating interoperability between our hospital and Atrius, the state's largest multi-specialty practice:

By working with Epic and Atrius, we enabled a "Magic Button" inside Epic that automatically matches the patient and logs into BIDMC web-based viewers, so that all Atrius clinicians have one click access to the BIDMC records of Atrius patients.

If this capability existed among and between all provider systems, consumer choice would be possible. Without it, a dominant network will remain dominant. 

As the Post story indicates, it takes time to have a fully functioning interexchange system, but if you don't start it doesn't ever get done.

Paul Levy is the former CEO of a large Boston hospital. He blogs to share thoughts about hospitals, medicine, and health care issues. Paul is an advocate for patient-driven care, eliminating preventable harm, transparency of clinical outcomes, and front-line driven process improvement.

The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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