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CPOE Alerts Still Vex Doctors

Posted on April 20, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study by Castlight Health has found that while nearly all hospitals have implemented CPOE systems, those systems are far from perfect. And that may be because too many clinicians find system alerts to be a distracting annoyance.

The research, based on an analysis of data collected by The Leapfrog Group, found that 96% of hospitals reported use of a CPOE system, up from 33% in 2010 in a scant 2% in 2001.  This data is drawn from the 2015 Leapfrog Hospital Survey of 1,750 U.S. hospitals.

But while the high adoption rate might be good news, it comes with bad news as well. The Castlight analysis found that even where hospitals had CPOE systems in place, 39% of possibly harmful drug orders and 13% of potentially fatal orders weren’t flagged by the system in place.

The most common errors that didn’t get flagged included when clinicians prescribed the wrong meds for the patient’s condition, or the wrong dose or meds entirely inappropriate for kidney function, and the failure to display a reminder to test drug levels after issuing medication.

These errors are occurring despite the fact that many of the hospitals studied by Leapfrog (64%) met its CPOE standard. To do so, the hospitals had to alert physicians about a minimum of 50% of common, serious prescribing errors. Also, physicians had to order at least 75% of inpatient medication orders through a CPOE system.

So if the CPOE system is being used actively, and performing as it should in most cases, why would nearly 40 percent of potentially harmful drug errors slip by? The answer may be that fairly or not, CPOE alerting is still seen as a hindrance rather than a help by many physicians.

While I don’t have hard statistical evidence to this effect, the anecdotes doctors share suggest that some click through alerts as quickly as possible. One physician blogger shared that he was quite frustrated by the alert generated when he wanted to prescribe 81mg baby aspirin tablets, which patients can buy over the counter. I understand his frustration (and even what seems like wounded pride).  And if it took several clicks to dismiss the related prompts, I’m sure it was indeed annoying.

On the other hand, as my colleague John Lynn rightfully notes, doctors aren’t going to blog or tweet about the time the CPOE system alert saved them from making a major prescribing error. So there is a bias to comments and blog postings since they only cover the negative side of CPOE and not the positive side. Perhaps the doctors who are working with these alerts successfully are simply going about their business and feel no need to vent. (Please note: I’m not suggesting that those who do vent are out of line in some way.)

Still, it seems quite clear that there’s considerable work to do in improving the workflow around physician alerting. If hospitals with CPOE in place are still seeing this level of potentially harmful or fatal prescribing, after many years to adapt to alerts, they need to do more to accommodate physicians.

P.S. They might want to start with a look at how Montefiore Medical Center succeeded with its CPOE rollout.

Making the Case for a Unique Patient Identifier – #MyHealthID

Posted on April 13, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

Healthcare is a high priority for the US Government and as HIM professionals, we know the importance of keeping our fingers on the pulse of issues facing our nation. We must stay current with proposed regulatory changes and those that address the needs of the US healthcare system as they relate to HIM, privacy and security, and Health IT. One issue our nation has struggled with is secure universal identification for citizens. Social security numbers were not originally meant to be secure identifiers yet they have controversially been used as unique identifiers by Centers for Medicare and Medicaid Services (CMS) for many years.

In our line of work, we see all of the potential negative implications and the important role that patient identification plays in patient safety, HIPAA compliance, and health record accuracy. When patients are not appropriately identified throughout the continuum of care, many issues arise that can lead to misdiagnosing, incomplete information, unnecessary testing, and fraud to name a few. Duplicates and overlays are far too common due to issues matching patient names and dates of birth versus using a universal secure identifier. Sharing information through health information exchange is nearly impossible when patients are registered in multiple systems with different spellings or misidentification.

The HITECH act of 2009 laid the ground work for the Department of Health and Human Services (HHS) to standardize unique health identifiers among other tasks but we have yet to see any real progress on this subject due to federal budget barriers. In response to this, AHIMA sees this as a critical need and has started a petition to the White House to:

“Remove the federal budget ban that prohibits the U.S. Department of Health and Human Services (HHS) from participating in efforts to find a patient identification solution. We support a voluntary patient safety identifier. Accurate patient identification is critical in providing safe care, but the sharing of electronic health information is being compromised because of patient identification issues. Let’s start the conversation and find a solution.”

The campaign is called MyHealthID and looks to have 100,000 signatures on the petition to garner the attention of the US Government. HIM professionals recently took to Washington, DC to visit with Congressmen and Senators from each state to advocate for MyHealthID. The message that “there’s only one you,” hopes to resonate with politicians and make the case that a unique patient identifier is necessary and important to healthcare.

I encourage all healthcare professionals to sign this petition and assist the advocacy efforts toward a unique patient identifier. MyHealthID will not only help with HIM and Health IT initiatives; it will be in the best interest of healthcare consumers nationwide.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Looking Into the Future of Hospital EHR

Posted on April 11, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been thinking a lot lately about where the world of hospital EHR software is going to head. At the top of the market we have Cerner and Epic taking most of the share. As we go down the market we see a lot of other large players, but we still only have 20 or so EHR vendors playing in the hospital EHR world.

In the last year we’ve seen aggressive moves by athenahealth and eCW to enter the hospital EHR space as well after previously only providing ambulatory EHR software. I’ve heard predictions that entrants like these are going to charge significantly less for their EHR software and that’s going to really shake up the market. You can imagine how the discussions in most hospitals will go if there’s an EHR alternative that’s 1/10th the price of their current EHR.

What’s interesting is that I haven’t seen any major moves by the large competitors to really accelerate the services, features, and functions they provide a hospital in order to justify the large premium. If I were Epic or Cerner, I’d be thinking about something really special that we could create that would be cost prohibitive for these new entrants to create. No doubt the Innovator’s Dilemma is at play here. Hard to fight against so much proven history around business dynamics.

Something that’s shocking to me is that these new entrants into the hospital EHR space aren’t really leveraging new technology either. They’re not building new features or functionality that doesn’t exist today (for the most part). They’re using things like cloud and mobile that are now relatively old technologies, but haven’t been applied to healthcare.

Said another way, will doctors love this new breed of hospital EHR any more than the current breed? I believe the answer to that question is no. Doctors will hate this new breed of EHR just as much. With this insight, I could imagine some other companies coming along and creating true innovation with new technologies that today we can’t even imagine. Although, it won’t likely be just technology innovation, but in healthcare it will likely include business model innovation as well.

EHR Ratings – GomerBlog Style

Posted on April 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I first saw this tweet without the image and wondered what the GomerBlog had done for April Fool’s day. I also wondered how I’d missed it on that day. Turns out that the above image and the corresponding blog post on the GomberBlog was definitely not on April Fool’s day, but on March 26th. Although, some might say that the GomerBlog celebrates April Fool’s all year round. For those not familiar with it, they’re basically the Onion of healthcare.

I had to laugh at the ratings they posted. The should have added another column to the chart “Vendor’s Take” and had them all say “Fantastic!” as well.

Dean Sittig is right in his tweet though that this chart isn’t far from the truth. Things that are close to the truth make for the best humor. However, if you’re a doctor or nurse using an EHR, it’s likely getting less and less funny.

Also, for those searching for EHR ratings, good luck. There are so many reasons that EHR ratings are a challenge to do. I’d be careful trusting any rating system out there.

Accessing Near Real Time Patient Data In & Out of the Hospital with Alan Portela

Posted on April 4, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Scene recently sad down with Alan Portela, CEO of AirStrip to talk about the shifting world of real time access to healthcare data in and out of the hospital. We cover a lot of ground including AirStrip’s experience being on stage at the announcement of the Apple Watch, the challenge of EHR data interoperability, and the amazing work that AirStrip is doing to make near real time health data available on devices across healthcare. Enjoy the recorded video interview with Alan Portela below:

In the “after party” discussion, we continue the discussion and are joined by Jimmie Legan, MD and Charles Webster, MD.

Tablets Star In My Fantasy ED Visit

Posted on April 1, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As some readers may know, in addition to being your HIT hostess, I cope with some unruly chronic conditions which have landed me in the ED several times of late.

During the hours I recently spent being examined and treated at these hospitals, I found myself fantasizing about how the process of my care would change for the better if the right technologies were involved. Specifically, these technologies would give me a voice, better information and a higher comfort level.

So here, below, is my step-by-step vision of how I would like to have participated in my care, using a tablet as a fulcrum. These steps assume the patient is ambulatory and fundamentally functional; I realize that things would need to be much different if the person comes in by ambulance or isn’t capable of participating in their care.

My Dream (Tablet-Enabled) ED Care Process

  1. I walk through the front door of the hospital and approach the registration desk. Near the desk, there’s a smaller tablet station where I enter my basic identity data, and verify that identity with a fingerprint scan. The fingerprint scan verification also connects me to my health insurance data, assuming it’s on file. (If not I can scan my insurance card and ID, and create a system-wide identity status by logging a corresponding fingerprint record.)
  2. The same terminal poses a series of screening questions about my reasons for walking into the ED, and the responses are routed to the hospital EMR. It also asks me to verify and update my current medications. The data is made available not only to the triage nurse but also to whatever physician and nurse attend me in my ED bed.
  3. When I approach the main registration desk, all the clerks have to do is put the hospital bracelet on my wrist to do a human verification that the bracelet a) contains the right patient identity and b) includes the correct date of birth for the person to which it is attached. If the clerks have any additional questions to pose — such as queries related to the patient’s need for disability accommodations  — these are addressed by another integrated app the clerk has on their desk.
  4. At that point, rather than walking back to an uncomfortable waiting room, I’m “on deck” in a comfortable triage area where every patient sits in a custom chair that automatically takes vital signs, be it by sensor, cuff or other means. In some cases, the patient’s specific malady can be addressed, by technologies such as AliveCor’s mobile cardiac monitoring tool.
  5. When the triage nurses interview me, they already have my vitals and answers to a bunch of routine clinical questions via my original tablet interaction, allowing them to focus on other issues specific to my case. In some instances this may allow the staff to move me straight to the bed and ask questions there, saving initial triage time for more complex and confusing cases.
  6. As I leave the triage area I am handed a patient tablet which I will have throughout my visit. As part of assigning me to this tablet my fingerprint will again be scanned, assuring that the information I get is intended for me.
  7. When I am settled in a patient bed in the ED, I’m given the option of either holding the tablet or placing on a swing-over bed desk which can include a Bluetooth keyboard and mouse for those that find touchscreen typing to be awkward.
  8. Not long after I am placed in the bed, the hospital system pushes a browser to the tablet screen. In the browser window are the names of the doctor assigned by case, the nurse and tech who will assist, and whenever possible, photos of the staff involved. In the case of the doctor or NP, the presentation will include a link to their professional bio. This display will also offer a summary of what the staff considers to be my problem. (The system will allow me to add to this summary if I feel the triage team has missed something important.)
  9. As the doctor, nurse and tech enter the room, an RFID chip in their badges will alert the hospital system that they have done so. Then, a related alert will be pushed to the patient tablet – and maybe to the family members’ tablet which might be part of this process — giving everyone a heads up as to how they’re going to interact with me. For example, if a tech has entered to draw blood, the system will not only identify the staff member but also the fact that they plan a blood draw, as well as what tests are being performed.
  10. If I have had in interaction with any of the staff members before, the system will note the condition the patient was diagnosed with previously when working with the clinician or tech. (For example, beside Doctor Smith’s profile I’d see that she had previously treated me for stroke-like symptoms one time, and a cardiac arrhythmia before that.)
  11. As the doctor or NP orders laboratory tests or imaging, those orders would appear on a patient progress area on the main patient ED encounter page. Patients could then click on the order for say, an MRI, and find out what the term means and how the test will work. (If a hospital wanted to be really clever, they could customize further. For example, given that many patients are frightened of MRIs, the encounter page would offer the patient a chance to click a button allowing them to request a modest dose of anti-anxiety medication.)
  12. As results from the tests roll in, the news is pushed to the patient encounter home page, scrolling links to results down like a Twitter feed. As with Twitter, all readers — including patients, clinicians and staff — should have the ability to comment on the material.
  13. When the staff is ready to discharge the patient — or the doctor has made a firm decision to admit — this news, too, will be pushed to the patient encounter homepage. This announcement will come with a button patients can click to produce a text box, in which I can type out or dictate any concerns I have about this decision.
  14. When I am discharged from the hospital, the patient encounter homepage will offer me the choice of emailing myself the discharge summary or being texted a link to the summary. (Meanwhile, if I’m being admitted, the tablet stays with me, but that’s a whole other discussion.)

OK, I’ll admit that this rather long description caters to my prejudices and personal needs, and also, that I’ve left some ideas out (especially some thoughts related to improving my interaction with on-call specialists). So tell me – does this vision make sense to you? What would you add, and what would you subtract?

P.S.  Some high-profile hospitals have put a lot of work into integrating EMRs with tablets, at least, but not in the manner I’ve described, to my knowledge.

P.S.S. No this is not an April Fool’s joke. I’d really like for someone to implement these workflows.

NYC Epic Rollout Faces Patient Safety Questions

Posted on March 30, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In the summer of last year, we laid out for you the story of how a municipal hospital system’s Epic EMR installation had gone dramatically south since its inception. We told you how the New York City-based Health and Hospitals Corp. was struggling to cope with problems arising from its attempt to implement Epic at its 11 hospitals, four long-term care facilities, six diagnostic treatment centers and more than 70 community-based clinics.

At the time of last writing, the project budget had exploded upward from $302 million to $764 million, and the public chain’s CTO, CIO, CIO interim deputy and project head of training had been given the axe. In the unlikely event that you thought things would settle down at that point, we bring you news of further strife and bloodshed.

Apparently, a senior clinical information officer with the chain’s Elmhurst and Queens Hospital Centers has now made allegations that the way the Epic install was proceeding might pose danger to patients. A New York Post article reports that in a letter to colleagues, outgoing HHC official Charles Perry, M.D. compared the EMR implementation process to the 1986 Challenger space shuttle disaster.

In his letter, Dr. Perry apparently argued that the project must be delayed. According to the Post, he quoted from a presidential panel report on the disaster: “[For] a successful technology, reality must take precedence over public relations, for nature cannot be fooled.” Another Post article cited anonymous “insider” sources claiming that the system will crash, as the implementation is being rushed, and that the situation could lead to patient harm.

For its part, HHC has minimized the issue. A spokesperson told FierceHealthIT that Perry was associate executive director of the Elmhurst hospital and liason to the Queens Epic project, rather than being CMIO as identified by the Post. (Further intrigue?) Also, the spokesperson told FHIT that “if a patient safety issue is identified, the project will stop until it is addressed.”

Of course, the only people who truly know what’s happening with the HHC Epic implementation are not willing to go public with their allegations, so I’d argue that were obligated to take Perry’s statements with at least a grain of salt. In fact, I’d suggest that most large commercial Epic installations (and other large EHR implementations for that matter) got the scrutiny this public hospital system gets, they’d probably look pretty bad too.

On the other hand, it’s fair to say that HHC seems to crammed enough scandal into the first few years of its Epic rollout for the entire 15-year project. For the sake of the millions of people HHC serves, let’s hope that either there is not much to these critiques — or that HHC slows down enough to do the project justice.

What Does Health Informatics Mean to You?

Posted on March 23, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

A couple of weeks ago, I was involved in a great discussion about health informatics and what it actually entails. This wasn’t the first time I have been involved in this type of discussion as informatics has been a buzzword in healthcare for several years now. Since no two organizations are structured exactly the same, Informatics can mean different things to different people.

For me, I have seen informatics in practice as those roles involved in building and optimizing the electronic medical record (EMR) and clinical workflows. Informatics professionals ensure data is being collected appropriately so that it can be used for further healthcare decision making and operations. This was a daunting new task several years ago when Meaningful Use first came into play. I remember many articles and statistical reports stating there was a major shortage of IT professionals who were going to be needed to help organizations meet Meaningful Use criteria and perform the role of health informatics.

I do not see informaticists as being confined to any particular department of a healthcare organization but rather they are professionals that are skilled in applying technological and data science techniques to healthcare practices. I have seen many roles such as IT, HIM, and licensed clinical professionals take on informatics responsibilities to address the needs of the changing healthcare environment. Informatics needs the collaboration of these different skillsets to bridge the gap between the technology and healthcare consumer outcomes using data and research.

When we start to look at informatics as it relates to healthcare research methodologies, I believe this is where informatics starts to split off into a more refined usage of data. This goes beyond the EMR workflow optimization and into the realm of using the data to build registries, look at cause and effect relationships, and review patterns and trends in healthcare treatment and outcomes. Since most of us healthcare professionals are at different stages of EMR implementation and optimization, there are some early adopters testing the waters and beginning to understand the value of all of the healthcare data that has become readily available. I am excited to see what the future holds for health informatics and how these tasks will be aligned with the HIM professional’s skillset.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

GE Healthcare Is Still In The Game

Posted on March 14, 2016 I Written By

David is a global digital healthcare leader that is focusing on the next era of healthcare IT.  Most recently David served as the CIO at an academic medical center where he was responsible for all technology related to the three missions of education, research and patient care. David has worked for various healthcare providers ranging from academic medical centers, non-profit, and the for-profit sectors. Subscribe to David's latest CXO Scene posts here.

Below is the recent press release from GE Healthcare.  Their EMR will be used in the Rio 2016 Olympics which is a great win for GE.  The product has come a long way and they are making some great strides.  The challenge is where will the product fall in a healthcare EMR ecosystem that is predominately Epic and Cerner.   Personally I know of a few organizations that are evaluating a transition away from the GE Centricity platform due to either a merger with a bigger healthcare system that already has an enterprise EMR or they had a bad experience with Centricity and are moving on.  It will be interesting to see in the next 2-3 years how many EMR vendors we will have left.  I will definitely keep an eye on GE to see whether the recent win with the Olympic games will help create positive momentum in 2016.

LAS VEGAS–GE Healthcare announced today the International Olympic Committee (IOC) has selected the company’s Centricity Practice Solution as the official electronic medical record (EMR) to be used by the medical teams of the Rio 2016 Olympic Games. This marks the first time that all athletes and spectators at the Olympic Games will have their health interactions managed by an electronic medical record. The announcement was made at the 2016 Health Information Management Systems Society (HIMSS) conference in Las Vegas.

Centricity Practice Solution will be used for managing data related to injuries and illness for athletes competing in the games as well as spectators, officials, athlete family members and coaches who require medical assistance throughout the Rio 2016 Olympic Games. For the competitors, the data managed during the Games will be used to help drive optimal, individualized care to help athletes compete at a world-class level.

“The Olympic Games is about providing the best possible service to athletes,” said Dr. Richard Budgett, Medical and Scientific Director for the IOC. “The gold medal of medical services is something that is integrated and comprehensive: a total package. Adding access to an electronic medical record is key to our drive towards the prevention of injury. Without a proper medical, longitudinal record, it’s difficult for us to do surveillance and see what injuries are most common in certain sports. This would impact our ability to prevent and measure our effectiveness. The EMR is going to be a cornerstone for our medical services going forward.”

Centricity Practice Solution will be available in English and Portuguese and will provide access to next generation workflows, analytics and data to potentially help optimize athlete performance. The information will be analyzed to spot patterns and provide insights for future Games planning. Additionally, medical teams will be able to access diagnostic images and reports from within the EMR to assist in providing world-class care quickly and efficiently. GE’s EMR will be accessible at any of the multiple medical posts throughout the Games and at the central Polyclinic in the Olympic Village where more complex care is delivered.

“By selecting Centricity Practice Solutions EMR, the IOC is extending the clinical care and data management capabilities pioneered by the United States Olympic Committee (USOC), which has used GE’s EMR platform for the past two Olympic Games in London and Sochi,” said Jon Zimmerman, General Manager, GE Centricity Business Solutions. “Incorporating an EMR platform into the healthcare services will enable medical staff at the Rio 2016 Olympic Games access to real time data, analytics and health information to help their athletes perform at peak capabilities.”

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

A Complete Patient Record and You

Posted on March 9, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have discussed the first steps to getting an enterprise imaging facility but what does this and a complete patient record mean for the average patient? If I were to stop someone walking down Las Vegas Blvd (I would shoot for the more sober hours) and ask them “Who owns your medical records?” I am sure I would get the same look and response over and over. The look of confusion and the response of “my doctor’s office?”  This is exactly what enterprise data sharing is set out to change.

A complete patient record for the patient means that a patient can go from their primary care physician to sub specialist without having to call ahead and have their records faxed over. It means that in the case of an emergency room visit they don’t have to worry about leaving with paperwork and getting it back to their primary care physician. It means their records follow them to whatever doctor they (or their insurance) choose.

For example, a couple weeks ago I won myself a trip to the emergency room after cutting a chunk out of my hand while slicing vegetables on a mandolin. (OUCH!) Not knowing my experience in healthcare IT, the resident, who came in first, was checking off all the boxes and asked “do you have a primary care physician?” In my pain ridden and snarky voice I responded “Why does it matter? Your computer can’t talk to hers anyway.” He got a chuckle and said I had a good point and then asked if I was in healthcare. But we have all been there. We have seen one physician only to turn around and have to tell the story all over again with the follow-up care physician because the records just aren’t there.

Not to mention I had pictures of the wound on my phone I had taken right after the incident. My follow-up physician asked that I send her these photos so she could take a look (because she didn’t have access to photos snapped in the ER). I asked her if she could put them into my patient record being my PCP? Her response, “no I don’t have a way to get them uploaded.” Similar to what Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital, said in his session at HIMSS16, he has multiple pics on his phone and there is nothing wrong security wise with that, but that’s not where the belong.

A complete patient record should include all medical data related to you. This includes images or all kinds whether an X-ray or photo snapped on an iPhone, textual reports (path, lab etc), and even larger data files including genome sequencing data, and digital breast tomosynthesis. I don’t think you would find one physician who would argue that any of your data is unimportant and can be left out.  In the wise words of John Halamaka, MD, CIO of Beth Israel Deaconess Medical Center the next time you ask why your patient record can’t be all in one and they (physicians or IT) respond because there is too much data to store, you should ask them “well how does Google do it then?”