No Matter Where

1 hr, 17 mins2014
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Each year 200,000 people die from medical errors in American hospitals. There are a number of reasons for these mistakes, but everyone agrees the number would be much lower if doctors shared records. In this Internet age, we assume doctors anywhere can pull up our charts, but the truth is most have no way to do this.

At first glance, it might be an obvious conclusion that since many clinical practices use computers to record information and to look up past records, and since hospitals also use computers to look up information, these clinical practices must be exchanging data among themselves and among hospitals in the region. Unfortunately, while this has been a dream for many decades, it has yet to be fully realized in this country.

This process, known as health information exchange, is an absolutely critical though uncommonly available process up until very recently - and even then only in some locations. When I first told my family about the work being done to make this happen, and about the pace of that work, they were somewhat surprised. However, as we went through the reasons why this has not happened across the country, It became clear what a hard problem this has become.

It is extremely challenging, although not the least bit because of technical issues. Rather it is because patients do not ask for it, not all clinicians believe they need it, no one is willing to pay for it, and because some of the basic standards to connect one system to another are adopted by one system but not the other.

Like many of the major advances in this country and in the world, these standards are a critical part of the equation. There are people all over the country working to achieve this, and they are slowly making progress. Like the Union Pacific Railroad, the moonshot, the automated teller machine, and a number of large national projects, health information exchange is a complex project that will take years to complete.

No Matter Where scratches the surface of these complex issues that have been dealt with in recent times by a number of private foundations, public/private partnerships, and public entities, and uncovers the tragic, hidden cost on the lives of millions of Americans.