Imagine: A patient checks into a hospital ER. The patient is cleared and ready to go home, but first given follow-up care instructions, along with a prescription. For whatever reason — time, the patient feels too bad, or the patient is my medication-averse father — the prescription doesn’t get filled.
That patient might soon wind up back in the ER — which could create major payment problems for the hospital. But thanks to an integrated and automated system, a nurse is alerted that the prescription wasn’t filled and contacts the patient immediately. Crisis averted.
“This intervention reminds the patient of the importance of taking medication as directed and provides an opportunity to troubleshoot financial or logistical barriers that prevented the prescription refill,” writes Gary Palgon, the vice president of healthcare solutions for Liaison Healthcare Informatics. “In this model, the nurse is able to track hundreds, if not thousands, of patients as opposed to the current model of a nurse only being able to keep up with a few discharged patients.”
I admit: It’s a nice, if somewhat Big Brother-esque, picture that Palgon gives us.
Certainly, there are B2B technologies that would support this level of monitoring — albeit with products and supplies, rather than people. Still, it’s technically possible.
But there’s a long way to go — both in the U.S. and, it turns out, the UK, where the Health and Social Care Bill is putting the focus on technology integration, just as the HITECH Act has in the U.S.
“Past experience has shown that whether it is time constraints or a lack of willingness to adapt to new technology, many clinicians simply do not want to move away from their disparate clinical systems, in which a typical hospital there can be up to 200,” writes Wayne Parslow, VP EMEA, Harris Healthcare, in a recent Information Daily column. He’s referring to the UK system, but the transition hasn’t been that different here in the U.S.
It’s not just health care providers that are a potential barrier to the kind of “big picture, inter-agency” integration health care needs; it’s also patients.
Marla Durben Hirsch of Fierce.com recently took a look at some “what if” situations that emerged this week after the Boston Marathon bombing:
“… what if a patient has invoked his right under the new HIPAA mega rule to pay a doctor out of pocket in full for his high blood pressure to keep his health plan from knowing about it — so when the doctor shares the patient’s data with a trauma hospital, either directly or through an HIE, that crucial piece of information isn’t included? Or what if patients opt not to shield some of their data from being transmitted to an HIE — as some advocates are recommending — so that the trauma hospital ends up working from an incomplete record?”
The technology may exist to dramatically improve patient care, but as is too often the case, this isn’t about technology; it’s about buy-in. Hirsch is right. This week’s events in Boston and West, Texas, give us an opportunity to help explain the case for better, integrated health care records systems.
This isn’t about politics; it’s about saving lives. And that should be part of the discussion in the months to come as we reflect on this week’s tragedies.
Let’s not waste.