Our healthcare system is broken. We pay too much and get too little. Serious medical mistakes abound—with dire, costly consequences. While there are many explanations and excuses, most agree that one way to improve care quality and reduce care costs is to make a patient’s complete medical record available to care providers when and where they treat the patient.
Easier said than done! A patient’s complete record isn’t available because care provider records are too varied and can’t be aggregated. Most physicians and hospitals keep paper records and can’t share them easily. And those relatively few who keep electronic records use systems that are incompatible and can’t exchange information either.
Established leaders in health information, including vendors, professional organizations, care providers and government agencies, have spent thousands of hours over many years plus millions of dollars trying to overcome this problem. But despite the endless conferences, committees, hoopla and hundreds of millions spent to date, they have made precious little progress. Medical records still can’t be shared or—in the jargon of the industry—aren’t “interoperable!” Why?
The simple answer is they have based their proposed solutions on at least a dozen bad assumptions, or “myths,” which have led them astray! They have pursued unnecessarily complex, elaborate and expensive strategies, and have little acceptance to show for it.
Myth #1: The best, most efficient and cheapest way to exchange patient records among care providers is to make them available over the Internet. Reality: Storing patient records on Web servers is extraordinarily complex, expensive and creates more problems and issues than it solves. They are trying to use a nuclear bomb when they need a fly swatter! The MedKaz is a simpler, cheaper, less disruptive way to share records.
Myth #2: Complex, expensive, state-of-the-art networks linked across the country, such as RHIOs, HIEs, and an NHIN, are required to exchange patient records. Reality: Complex networks are unnecessary and financially unsound. They will take years to build, will cost hundreds of billions of dollars, are not sustainable financially, and don’t accommodate out-of-network encounters. This is another nuclear bomb!
Myth #3: When everyone agrees on the requisite standards and technology, the funding needed to implement and exchange interoperable patient health records will be available—as a last resort from non-profits, the Federal government, and/or state and local governments. Reality: The money simply isn’t and for the foreseeable future won’t be there to fund financially unsound solutions. We must adopt a solution like the MedKaz that we can afford, implement quickly and is financially self-sustaining.
Myth #4: It is acceptable to spend years developing and installing a Web-based network; there is little urgency. Reality: The needs couldn’t be more urgent or the costs of delay greater. People are dying while we dawdle. Lives can be saved, pain and suffering avoided, and billions of dollars saved each year.
Myth #5: Web-based networks or services can guarantee that a patient’s medical records are safe, secure and private. Reality: No one despite their claims and best intentions can guarantee security and privacy over the Internet. Web servers, including the Defense Department’s, often are breached and data are stolen. Additionally, patient records too often are lost, misplaced and even published on the Internet. Consumers know this which is why they resist Web-based systems.
Myth #6: Physicians don’t want to adopt electronic medical records. Reality: Most would like to do so but the costs—both financial and operational—are greater than they can or will tolerate. They want a simple system like the MedKaz that is cheap, easy to install, easy to use, and gives them the information they need without completely disrupting their workflow.
Myth #7: Sooner or later all care providers will adopt a comprehensive electronic medical record (EMR) system (which can cost as much as $50 thousand per physician to install and $10 thousand per year per physician to maintain). If they refuse, they must be required to do so. Reality: More than 80% of physicians and 70% of hospitals have not done so and refuse to do so because it is against their economic self-interest. Forcing them would be draconian and is unnecessary. We need their support not their opposition.
Myth #8: Physicians and hospitals will install electronic medical records if they are subsidized. Reality: Most paper-using care providers don’t want subsidies to install elaborate systems. They want a simple, manageable system like the MedKaz that fits into their workflow and helps—not hurts—them.
Myth #9: It isn’t necessary to give patients copies of their medical records. It is sufficient for a care provider to make a patient’s records available to other care providers. Reality: Increasingly, patients want to control their records, who accesses them and how they are used. Moreover, one Meaningful Use requirement is that care providers must be able to give their patients electronic copies of their notes within 36 hours of a visit.
Myth #10: Patients don’t mind entering extensive information into a PHR and keeping it up to date. Reality: They are put off by the burden and inconvenience which may explain why so few have embraced available PHR systems. To be acceptable, a PHR system must be easy to use by patients and physicians alike.
Myth #11: Patient-provided information, claim reimbursement records and/or information from other third parties are acceptable substitutes for actual physician notes, test results, images, etc. Reality: They are incomplete, may be inaccurate, and do not contain the clinical content care providers need. They are poor substitutes for the real thing.
Myth #12: New online healthcare platforms like Microsoft’s HealthVault and Google Health are the solution. Reality: They are not. They are focused primarily on wellness and disease management, not personal health records. Their PHR applications are incomplete, and require the patient to input extensive data (which may not be correct).