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Sharing Electronic Medical Records Still Too Hard
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cbabcock
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cbabcock,
User Rank: Strategist
8/20/2013 | 12:03:29 AM
re: Sharing Electronic Medical Records Still Too Hard
Open source code projects rarely set up standards, then require participants to swear an oath of to follow them. On the contrary, they have many parties submitting code from various viewpoints and a founder of the project, or a trusted inner circle of committers, deciding which ones conform to the goal of the project and enhance it without interfering with already-established operations. It's a benevolent dictator model, and while the analogy is imperfect, I wish some force -- the Centers for Medicare and Medicaid Processing? -- would impose it on all medical record formats.
Ivan Miller
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Ivan Miller,
User Rank: Apprentice
7/20/2013 | 3:44:18 AM
re: Sharing Electronic Medical Records Still Too Hard
I'll add to your list of barriers for interoperability all day long, if you'd please show us just one clear path to smooth, reliable interoperability (within budget.)
Out of over 600 EHRs certified in 2011 for ambulatory clinics, less than 18 of them now certify for basic standards of interoperability. The reality is those disparate systems were not developed to work together in the first place. Therefore, any efforts for "interoperability" can only be a temporary fix. (Ie. "make-do" or "work-around")
Problematic, temporary fixes do not work in medicine.

At some point we'll have to give up the "jury-rigging" of current EHRs to adopt a more viable solution. A solution which is thoroughly planned & professionally developed from scratch. Essentially, it'd be what Epic has provided to the large hospitals, but for ambulatory medicine.
SusuE709
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SusuE709,
User Rank: Apprentice
7/6/2013 | 4:16:47 PM
re: Sharing Electronic Medical Records Still Too Hard
wow .. it seems the technology will take over everything susu kambing
anon4536176453
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anon4536176453,
User Rank: Apprentice
7/3/2013 | 2:46:21 PM
re: Sharing Electronic Medical Records Still Too Hard
Although no silver bullet, a document-based sharing architecture using CCDA would not be a bad idea. I think the driving force will not be PHRs, though -- if large insurers began demanding CCDA-based documentation as electronic claims attachments -- e.g. lab orders and results, for example -- and didn't pay for redundant labs for the same patient, then a lot of de facto interoperability would fall into place. See Wes Rishel on CCDA http://blogs.gartner.com/wes_r... and the NCVHS claims attachment summary from 9/2012 http://www.ncvhs.hhs.gov/12030...
jaysimmons
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jaysimmons,
User Rank: Apprentice
7/1/2013 | 1:56:17 AM
re: Sharing Electronic Medical Records Still Too Hard
I agree, the focus needs to shift more control over data to
the patients themselves. Patients need access to their data and need to be able
to share their data with physicians wherever they go. I like that you touched
on the point of all data versus selective sharing of only high level data. If
we can select only the data that is really needed and standardize that somehow
we may start seeing some results here.

Jay Simmons
information Week Contributor
slangpdx
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slangpdx,
User Rank: Apprentice
6/26/2013 | 6:44:22 PM
re: Sharing Electronic Medical Records Still Too Hard
The real issue is proprietary systems not talking to each other. Epic being the worst example, thus forcing everyone else to buy into their system. VA Vista has been working for years before the advent of meaningful use and is downloadable for free, some software providers have installed it at no development cost. The state of Indiana has had its own highly interconnected and efficient system for years, again long before meaningful use.

Someone in my office has a relative who was laid off from the Medplus physician EMR sales/training division in March. Their business fell off a cliff at the end of 2012. The reason of course was the end of the first two years of the most profitable meaningful use payments. The apparent message is that all the existing doctors offices who were going to implement EHR have already done it, and that I believe is only about 30%. Since most of those were most likely the larger practices who could afford it, most doctors will never implement EHR outside of assistance from a regional nonprofit source such as OCHIN in Oregon.
Harveyuk
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Harveyuk,
User Rank: Apprentice
6/18/2013 | 9:22:11 PM
re: Sharing Electronic Medical Records Still Too Hard
I would strongly urge you to watch a TedMed 2013 talk by Ryan Panchadsaram
http://tedmed.com/talks/show?i...
The way I am displaying my Personal Health Record is just another way of expressing clinical information, but in a format that I, my elderly parents and my children can understand more easily.
As you will see from the video, you should have access to your health data and it seems that this is covered under HIPPA (Sorry I am not from the USA, so do not know your laws in detail.)
cbabcock
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cbabcock,
User Rank: Strategist
6/18/2013 | 2:33:28 AM
re: Sharing Electronic Medical Records Still Too Hard
There are good reasons for it, but the health care industry is essentially playing a defensive game, on its own behalf as well as patients. There are too many malpractice suits,too much testing done to prevent malpractice suits and too little standard patient data put in EMRs to be shared among authorized providers. Charlie Babcock, senior writer, InformationWeek
Harveyuk
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Harveyuk,
User Rank: Apprentice
6/17/2013 | 9:57:29 PM
re: Sharing Electronic Medical Records Still Too Hard
Not a product off the shelf but technology available today just needs a bit of "Tweeking" which currently I do manually. But could be automated from SnomedCT or any other code (ICD10 ETC).
But as you can appreciate, that would take investment and time (and a PHD in C#), and a willingness from IT Healthcare suppliers to share data and clinical codes and accept them back!
ChrisMurphy
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ChrisMurphy,
User Rank: Author
6/17/2013 | 9:30:53 PM
re: Sharing Electronic Medical Records Still Too Hard
I like the comparison to SnomedCT as currency. I watched the video -- is that a real product you can use today? How do you get all that data into it?
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