As we traced down the multiple reasons, they boiled down to :
1. Government regulations
2. Poor implementation of current healthcare IT technology (many hospitals lack the informatics support to use their EMR well)
3. Competition between EMR vendors.
4. Competition between hospitals.
5. Competition between doctors.
6. A lack of a common standard technical "Esperanto" to let the data flow.
Google Health and Microsoft Healthvault have "cloud-based" EMRs (generally called a PHR - Personal Health Record) - And there are SOME hospitals which transfer their data to these, but it's mainly because Google/Microsoft developed partnerships with these particular hospitals, and invested heavily in developing electronic interfaces.
Still, these required a significant effort to get these places up-and-running. And the rest of us? We would still hypothetically have to send our paper reports to a scanning company who will then make it electronic and transfer it to Google Health / Microsoft HealthVault.
Even though there are a handful of common protocols (.CCD - Continuity of Care Document) and .CCR (Continuity of Care Record) - Most EMRs don't have a standard way of sending the data to these PHRs.
So Kip, Nick, and I were talking about the lack of communication, and how it impacts patient care. We are working hard to improve this, but it seems to be an uphill battle, frought with issues :
- Political issues
- Financial issues
- Educational issues
- Technical issues
- Regulatory issues
- Clinical issues
(If I were a patient, I would want a hospital that spoke this language!!)
So then we wondered : "Why don't patients ask for this?"
The obvious answer : Patients know there is difficulty coordinating their care electronically - And they want better - They just don't know how to help a hospital do this better. (The technical standard to do this would be quite complex!)
So then we wondered : How can a patient ask a hospital to use a particular electronic standard?
And then we thought : What if we gave a NAME to this technical standard - So that a patient could ask for it?
Then we started to imagine : What if Wilford Brimley had a commercial on the Superbowl, where he talked about a hypothetical standard for information interchange : Flower.
"I almost had a medication error because my primary doctor didn't know what my cardiologist had just ordered... And then I almost had an extra echocardiogram in the emergency department because they didn't know what my cardiologist had ordered. But now, with Google Health, powered by FLOWER, all of my doctors can trade their information easily!"
This would introduce the American patient to some concepts :
- Medication errors happen because of poor information interchange.
- Extra tests happen because of poor information interchange.
- Flower is a way hospitals could trade information better.
- Sharing information better could improve their healthcare.
"Dr. Stanley, does your office speak Flower?" "Dr. Stanley, does your hospital speak Flower?"
- Patients would suddenly show up asking for Flower.
- Front-line doctors would suddenly start asking administrators about Flower.
- Hospitals would start asking their EMR vendors about Flower.
- EMR Vendors would suddenly hear a lot about Flower.
- To remain competitive, EMR vendors (even legacy systems) would need to speak Flower.
So, it appears I've launched a healthcare technology revolution.
For it to be successful, however, this has to be patient-focused.
We've already given it the formal Twitter hashtag : #hcflower
Keep your eyes peeled - We'll see where this goes...