This morning I was looking out my window at a new 3 inches snowfall while making conference calls. Tonight, I’m driving past palm trees. This afternoon I was on I-95 driving to the Providence airport for a flight to see a new client. Tonight, I’m exiting a Florida airport in a rental car and merging onto I-95 heading south.
With google maps piped through the car rental audio, I am confident I will get to the hotel 50 minutes away. I have done all the initial lane changes and merging, so now I’ve got a 19 mile stretch before the next turn. It’s safe to call home on speed dial and chat with my husband. I do the ritual “woe is me” that my flight was delayed, the airport was busier than I expected, and there was a long wait for the car rental center shuttle. But I’m finally on the road to my hotel much later than expected and very hungry. I am aware that these all are first world problems.
We have the “I’m still on I-95 but with palm trees” conversation. When I exit I-95, it is crystal clear that I am 1,500 miles south of the I-95 I’m used to. The “lady” in the car audio is telling me to merge onto Dolphin Expressway. No road in Rhode Island is called Dolphin Expressway!
I dislike busy unfamiliar expressways, driving at night (especially with lane changes) and driving in the rain (in that order). Fortunately, this was only 2 of the 3 – it was dry, with no rain (or snow). In these situations, lane management is critical, and the navigator system can only help so much. And good signage is critical or as my daughter says, “use your eyes”.
What does this have to do with healthcare and IT? Continue reading
We have watched with sadness as Hurricane Harvey has flooded first southeast Texas and now Louisiana. We have seen the spirit of the American people at its best. Volunteers from around the country have brought their own boats to rescue residents while thousands have donated money and supplies. As of Thursday morning, there had been over 25,000 water rescues.
Hospitals are meant to operate and care for patients 24/7 through a disaster. But they too were impacted by the rising waters. I took a break mid-day yesterday to watch the news. I saw in that 15-minutes the evacuation of patients from Baptist Hospital in Beaumont, Texas after the city lost its water supply. Without clean water, the hospital had to close and transfer 190 patients.
Patients, many in wheelchairs, needing dialysis treatment were being boarded onto Black Hawk helicopters by teams of doctors and nurses. They were being handed over to military medics to be flown to a hospital in Jasper, Texas – 70 miles away.
The last step in the transfer process was a clinician giving a folded-up paper to the medic. She had stuffed it under her shirt until that point so it didn’t blow away in the wind from the helicopter propellers. We know that this critical paper handoff probably happened over and over this week as patients were transferred to other facilities.
In this age of electronic medical records (EMRs) and health information exchanges (HIEs), we hope that piece of paper is a backup document. Transfers within a health system with a common EMR should be able to rely on the system for access to critical patient information. Health systems that participate in HIEs should be able to rely on some level of data exchange and access between health systems and their disparate EMRs.
I was encouraged to see two health IT articles this week – “As Harvey Devastates Houston, HIE Leaders Move in to Help” in Healthcare Informatics, and “What’s Next for Health Information Exchanges?” in Healthcare IT News. The first article describes the power of the HIE in Texas; portals have been set up in the many shelters so clinicians can access critical health information as they care for people in need of medical attention. The second article talks about the future needs that HIEs could meet and their potential benefits as healthcare continues to evolve. Continue reading
If you remember the CHIN (Community Health Information Network) attempts in the 1990s or the next incarnation in the mid-2000s referred to as RHIOs (Regional Health Information Exchange), you know we’ve been on this interoperability journey in health care a very long time. And it’s not over.
Creating sustainable Health Information Exchanges (HIE), not to be confused with a Health Insurance Exchange, is what we are all focused on now. The Office of the National Coordinator for Health IT (ONC) published “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” for public comments earlier this year. There has been progress over the years but we still have a long ways to go.
The ability to easily access and share data with other health care providers in Michigan is critical for UMHS – we are the only provider in the state that serves patients from every county. But HIEs are important for all providers regardless of their reach. For example, when a patient shows up at an emergency room away from their primary hospital and physician, basic information should be readily available. This includes a patient’s current problem summary list, allergies, chronic conditions, and medications. Having this kind of information can make a qualitative difference in their care. And knowing that a certain test or procedure has recently been done along with the results can avoid duplication, saving both time and money.
Yet, unlike other industries where basic information is easily accessible and shared, health care lags far behind. Continue reading
Common goals are a key to success for any business venture. But for a merger, negotiating common goals and how best to achieve them is especially critical. I saw this again in the case of the Great Lakes Health Connect (GLHC) – a very recent merger of two major Michigan substate HIEs: Great Lakes Health Information Exchange (GLHIE) and Michigan Health Connect (MHC).
Michigan has had multiple substate HIEs organized by regional markets. While this was a conscious strategy several years ago, many health care leaders had come to question it over time. However, the obstacles seemed too difficult to overcome, and inertia prevented change. So the two major HIEs grew and became stronger and more competitive. Provider organizations in some regions were torn between the two and faced limits in the data they could access. Other organizations sat on the sidelines waiting for one to prevail.