April 24, 2008
Dr. C. Martin Harris, CIO
The Cleveland Clinic
Dear Dr. Harris:
Physician, heal thyself!
Sorry, I don't usually proclaim biblical passages without context. Let me explain.
First, I want to make clear that my admiration for you knows no bounds. The work you've done as chairman of the National Health Information Infrastructure task force in advancing the cause of the effective use of IT in health care on a national level is commendable. I applaud the relationship you forged with Google over a practical approach to portable electronic health records.
That leads me to this scenario. I recently broke a bone in the ring finger of my left hand. After the finger had swelled to the size and coloration of an uncooked bratwurst, my wife convinced me to have it looked at by a doctor. So we drove across town to the Cleveland Clinic Chagrin Falls Urgent Care Center, which accepted walk-in patients on a Saturday afternoon.
Things went well at first. I signed in at the receptionist's desk, first name only ("HIPAA," my wife whispered). In relatively short order my name was called, and the receptionist typed in my particulars and retrieved my data immediately: address, phone number, last appointment at the clinic, etc. The same was true for the initial screening by the nurse: She entered details about the bone break and queried me about the medications I'd taken in the past, etc.
Then it came time to get my X-rays. The Urgent Care Center is located on the lobby floor of a small office building that's part of a suburban office park. The X-ray department is on the same floor, so I had to walk only about 500 feet down a semi-circular hallway to reach it.
Quick aside: The Cleveland Clinic is the largest employer in the city. One of the ways it has achieved that size and influence is through an aggressive acquisition strategy, in particular merging with many of the small hospitals in the area.
It turned out the X-ray department, like many offices in that building, is run by Hillcrest Hospital. And even though Hillcrest is owned by the Cleveland Clinic, its computer systems apparently aren't integrated. That meant I had go over every personal data point--name, address, Social Security number, phone number, emergency contact number, employer name, address, wife's name, Social Security number, employer, etc., etc.--while the receptionist in the main lobby typed the data into the Hillcrest system before I could get my X-rays. Which I wouldn't have minded so much except that my left hand was throbbing to the beat of a Ginger Baker drum solo.
I'm sure the Hillcrest receptionist's computer is on the same LAN as the clinic's, not to mention the fact that the clinic receptionist could have printed out my data, folded it into a paper airplane, and sailed it down the hallway. I'm not trying to get sympathy for my broken finger (though I take what I can get). I'm trying to make the point that maybe data integration begins at home.
Thanks for your time, and keep up the good work.
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