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Three Things I Would Change About Health Care and EMR

by Derek Hedges, Senior VP of Business Development

I have the privilege of being the head of business development and product strategy for athenahealth.  I also have the privilege of being a surviving cancer patient - I was diagnosed with stage IV colon cancer in January 2011.

In light of my colliding personal and professional worlds, I have amassed a laundry list of opportunities for improvement within the delivery of health care, opportunities that are no longer seeded by conjecture, but ones that are very real to me.

If forced to boil down my list to three things, I would select the following:

1. We need to level the playing field for patients by bridging the gap between leading edge research and the point of care for all U.S. physicians!

As a cancer patient I am acutely aware that probabilities for a successful outcome are often determined in part by proximity to leading edge research organizations and connections to the right doctors within those organizations. This is WRONG.

It is impossible to replicate proximity and connections through technology. For example, I got connected to my doctors through my wife’s sister’s college roommate’s… stepmom. Tenuous, eh?

However, it is VERY possible to share leading edge protocols through a cloud-based EMR platform. If these protocols can be shared across a network of “wired” physicians, then the need for a patient to have proximity and connections to receive access to the very best research protocols is dramatically diminished. They just need to get to a “wired” physician.

This is a mission worth fighting for and it can be accomplished by creating a marketplace that connects suppliers (private & public sector research organizations) with customers (physicians) through a solution that delivers the “product” (diagnostic and treatment protocols) to the point-of-care.

2. We need to facilitate the efficient exchange of health care information across disparate organizations!

We need to ensure the appropriate delegation of that same information amongst clinical staff, such as medical assistants, nurses and physicians.

The next piece of the puzzle is pushing the right information to the right person at the right time to make the right decision. There are two concepts at play here. The first is “community-based information exchange” - the verb.  It requires participating organizations to pay for the successful transmission of relevant information across disparate organizations within their community.

The second concept at play is “intra-office delegation.” Once a patient’s relevant information gets into the hands of the appropriate office, it needs to get into the hands of the appropriate clinical staff member via the EMR. This requires organizations to think through exactly who should process the information and enter the next steps with the patient.

If these concepts are executed properly, a patient’s clinical information will get to the right person at the right time and enable right decisions. This empowers clinicians to “practice to the top of their licenses.”

In the absence of the first concept -- a viable model for the exchange of health care information -- patients are required to transform into “empowered patients” and carry their own medical information as they navigate the U.S. health care system.

That is not fair to a patient who is focused on saving his or her own life and doesn’t have any firsthand knowledge about what information is needed to facilitate their care.

We can fix this… and we will.

3. If 1 and 2 are givens, then we will have effectively leveraged information technology to enhance physician focus on the needs of their patients!

As a patient, I leaned on my care team more than I ever thought I would need to at age 39. Their preparedness and presence in the exam and/or operating room(s) gave me the two greatest gifts I could have asked for - confidence and hope.

They were always empowered with the information required for my visits and they gave me their time when I needed it most. At key times (e.g., the lag time between scans and results), they were quick to compile and review images. They were always prepared with the right information delivered with the appropriate demeanor to guide me through the news, whether good or bad.

Furthermore, they were all under one roof with one technology platform. This is not the norm. The majority of care in the U.S. is provided across disparate organizations and EMR solutions and requires information sharing and collaboration beyond the walls of any one organization.

If all health care organizations are given the option to “wire into a network” that:

  • Provides access to leading edge research
  • Enables the exchange and distribution of relevant health care information to the point of care
  • Enable clinicians to practice to the top of their licenses through the appropriate delegation of clinical tasks

Then, and only then, do we have a shot at truly protecting the sanctity of the physician and patient experience and leveling the playing field for all patients, regardless of family connections or proximity to leading edge research organizations.

This is my wish.

This blog post previously appeared on the Health IT Exchange blog.

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