Patient data, a longitudinal patient record, and patient identifiers remain valid goals of healthcare reform, despite unhappiness with meaningful use.
Last week I spoke with a former CIO who assembled a longitudinal patient record dating back 12 years from seven different healthcare organizations her system didn’t own, all of which had agreed to use a single patient ID defined by her system’s master-patient index. She made this record accessible via the Web to providers and patients.
This wasn’t a recent development. The system went live in 2004 with 700,000 patients.
But then that CIO received a fateful phone call from a patient.
“The patient was crying,” says the former CIO, Leslie Kelly Hall. “She said, ‘I just read my record, and it said that I’m morbidly obese. I just looked it up…I had no idea I was killing myself with food. So tomorrow, my family and I are meeting with a doctor and we’re going to find out how I can live to see my children have children.’ ”
Even now, years later, Hall gets emotional recalling the story. It was also the moment that Hall realized that patient engagement was a very big thing. After she left the CIO position, she essentially devoted the rest of her career to that belief.
Leslie Kelly Hall |
More than a decade later, the U.S. healthcare system is still struggling to provide a longitudinal view of patient data. A common patient identifier is still a dream. Even though Hall and many others have championed patient engagement, today the industry is in a time of retrenchment, when grandiose plans hatched in the meaningful use incentive/penalty program, to verify that patients are being engaged, are on the chopping block.
Hall, now a nationally known expert on patient engagement, understands the pushback from providers on engagement-by-regulation. “For those that want to check the box, it will never be meaningful, and everyone has a choice to do something in a meaningful way, or to check that box,” she says.
How important is the health IT component of patient engagement?
After speaking with Hall and other health IT leaders such as CHIME CEO Russ Branzell, I now believe that only when the current push for the longitudinal patient record succeeds will America’s healthcare cost curve truly bend.
Getting there will require breaking down the technological and business barriers that prevent interoperability. We shall need more examples such as Hall’s, which occurred at Saint Alphonsus Regional Medical Center in Boise, Idaho. She points to more recent efforts at Tenet Healthcare, as well as at Taconic Independent Practice Association in upstate New York. A technology key at both organizations has been the Direct message format, which has had a troubled adoption curve nationally despite being a mandatory part of meaningful use EHR certification, Tenet used Direct messaging to connect long-term post-acute care facilities to its hospitals, Hall says.
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