Sunday, October 29, 2017

Why Can’t Electronic Medical Records Communicate Easily with One Another?

Recently, the GBMC Chesapeake Regional Information Sharing for our Patients (CRISP) governance team got together. This meeting provides us with an opportunity to meet with our CRISP colleagues to improve our use of the network, to connect with other providers of care, such as private practicing physicians, hospitals and nursing homes that don’t use Epic so that we can better serve our patients and reduce the time spent searching for information, which frustrates clinicians.  We have also made so much progress in the use of the network. An example is that every morning our patient-centered medical homes get a report from CRISP on each of our patients who were seen in any Maryland hospital in the preceding 24 hours. This allows our care managers to check-in with them and make sure they have what they need.

But during the meeting, I became frustrated on more than one occasion because of the incredible complexity of getting one company’s record to “talk” with another company's record. The medial record companies keep their source code secret to maintain the value of their investments and this is understandable, but the net effect is that even in the 21st century it’s really hard to have all of one patient’s record available for clinicians who need the information. We are dealing with a real “Tower of Babel” where no two vendors' records talk easily with one another. In addition, the U.S. has not created a “unique patient identifier” (such as a social security number) to make sure that we are truly connecting records of the same person.

I am concerned that the citizens of the U.S. have no idea that this is happening. If they did, I believe that they would advocate for better planning and some stronger rules about cooperation around the goal of better information sharing. Market forces are not working and our country’s doctors and nurses and their patients are paying a very high price in safety and efficiency while billions of dollars are being spent to work through the confusion to try to make these records talk to one another.

Yes, we do have one patient, one record for patients served by our hospital, our employed physicians and Gilchrist and to the extent that the records are coming from the same EMR (Epic at other hospitals) we are okay, but when they are not, it’s a mess.  The American people need to think about this, decide what they want and make their opinion known to those in power.

We must all be united around the quadruple aim: The best health outcomes with the best care experience, with the least waste and the most joy for those providing the care. None of these four aims are truly possible without the efficient movement of information to those with a legitimate need to know.

Thank You!
Mother Nature was cooperative for the recent Baltimore Running Festival. Thousands of people participated in this year’s event including approximately 90 runners who joined team #RunGBMC to raise funds in support of the Gilchrist Center Baltimore – Joseph Richey House. The 19-bed inpatient center has been serving patients in Baltimore City for more than 30 years by providing residential, acute and respite care. We’re still counting, but so far we have raised more than $10,000. The money raised by team #RunGBMC will help cover Joseph Richey House’s operating expenses not covered by insurance or patient payments.

I’m very grateful to all of the employees, volunteers, patients and supporters of GBMC Healthcare who helped us raise money and awareness of the outstanding work at Joseph Richey House.  I hope you all had a great time in support of this fabulous part of our system of care.

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