A Year in Review – A Firsthand View of Why Health IT Is Needed

The value of and need for electronic health records becomes real for any of us when faced with a personal health situation, as you will read in the post that follows from Michael D. Paquin, FHIMSS, the 2011 Chair of the HIMSS Digital Task Force. The June edition of the Digital Office, released today, is Michael’s last newsletter as chair of the task force. In this post, which also appears in the Digital Office newsletter, he details the challenges he and his sister now face in caring for their parents, whose many physicians do not use EHRs. As I told Michael, ”you are a good son,” and of course, I hope that his family can return to good health soon.

But, as you will read in his post, ”Interoperable EHRs are a must-have.”

Mary P. Griskewicz, MS, FHIMSS

_____________________________________________________________________________________________

by Michael D. Paquin, FHIMSS

2011 Chair, HIMSS Digital Office Task Force

I first and foremost want to thank HIMSS and our volunteers for delivering a first-class product to all of our subscribers this year. Special thanks to Mary Griskewicz, Valerie Knoke and Joyce Lofstrom.

The last six weeks have been a real eye-opener to me as it relates to health IT and healthcare in general. I have been in healthcare for 35 years, always as a vendor or consultant. During the last six weeks, I have had the experience of being completely immersed as the role of a caregiver.

My journey as a caregiver was initiated by mother, at 82-years-old, falling and breaking her femur on Mother’s Day. This alone would not have been a huge issue had it not been for the fact that mother was my father’s caregiver. My dad is a congestive heart failure patient with diabetes and renal failure; he started dialysis the day after mother broke her leg.

So, here is what I have found…

…My parents have recorded all their daily vitals, glucose readings etc. on the back of small pieces of scratch paper. Nothing is shared with the doctors, including providers that include a general practitioner, cardiologist/electrophysiologist or EP; internist, orthopedist EP, vascular surgeon, home care, and now, a convalescent hospital…These doctors DO NOT SHARE ANYTHING electronically!

Not one of the providers my parents use in this Southern California community is even using an EHR product! The community hospital is using an EHR product, however. My sister and I take care of getting my parents to and from appointments and are trying to coordinate all the various aspects of my parents healthcare. Thank goodness for email.

So here is the dilemma, as I see it.

Electronic health records are a must-have, and interoperability, to share patient data, is a must-have for clinicians and patient care providers.
ARRA and meaningful use are huge value-added incentives. The value of health IT is tremendous!
The problems are cost, the amount of time for implementation and the lack of support, as it relates to the small ambulatory practice.

We all must start to realize that the future of health IT will be limited as long as we do not develop solutions that make use of the EHR affordable and simple.

A small doctor’s office may have three people, including the physician. Not too many even know how to load software much less file for meaningful use reimbursement. Most do not have a wireless router. We must start to understand that there is a need to develop more that software; we must develop vendors that support the small provider’s office.

It is only when we connect all the providers of patient care that we will have interoperability and a functioning healthcare delivery system. Every day, I am thankful for the opportunity to work in this industry and help develop solutions, friends, and partners that make a difference.

We have come a long way this year with health IT. I can only hope that when I reach my parents’ age, I am either healthier or the healthcare system works.

Michael D Paquin, FHIMSS, is with the MDP Group, Inc., in Thousand Oaks, Calif.

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5 Responses to A Year in Review – A Firsthand View of Why Health IT Is Needed

Lehr says:

June 29, 2011 at 2:58 pm

Thanks. I think Mr Paquin hits the nail on the head: “make EHR affordable and simple”. I’m probable over-simplifying but I believe the underlying problem and subsequent symptoms (“dilemma” bullets) are a result of:

-change management
-legacy systems

We’ve trained & practiced medicine in a paper world have have years worth of paper best practices…..change is slow and difficult

Legacy systems provide small incremental changes/improvements to old technology (cars, operating systems) until vendors guide us to the next platform. Providers, payors, and patients have spent tremendous $ to integrate and become “interoperable”

Remember ATMs and the adoption cycle? There’s definitely reason for optimism albeit stepwise.

Speedy recovery for mother
Lehr

Michael D. Paquin says:

June 30, 2011 at 11:51 am

Thank you for your comment! Once again I must iterate information exchange is the most important issue. I wish we could all have a simple place to store data ourselves! Then we could at least show it to all our providers. This week my experience was once again a disaster as it relates to my father’s EP and Cardiologists sharing of information… they are across the hall from each other! My father’s Pacemaker / Defibrillator battery is seriously past due! It went EOL (end of life in March). Why is it that physicians have devices that do not have software that sends important data to all associated providers? Why is it that Providers struggle with the sharing of information? Why is it that EMR vendors make products that are not a little less expensive and that are so difficult to use? Why is it that we must charge so much for the exchange of patient data?

- Rich Rosenthal says:
  
  June 30, 2011 at 3:45 pm
  
  I hope your mom makes a full recovery. I have similar difficult circumstances trying to manage my mother’s care from Colorado, as she lives in West Palm Beach. Virtually no electronic access to her healthcare info. The doctor who serves as PCP at her assisted living facility is a part timer with no real office. The basic function of the place, despite it being regarded as one of the best ones around, is to keep the mostly disabled residents stable and docile. The only way to get any health info is to place a bunch of calls to the medical director of the assisted living facility, and the response is usually along the order of ‘she’s doing ok’. Very frustrating for a family member.
  
Lehr says:

July 1, 2011 at 11:15 am

RIch/Michael: great comments! I agree information exchange will provide the solution to problem of sharing relevant clinical information. I am a patient with a very progressive medical group that has been using EHR & PHR for the past 10 years or so and it has been great…..except when I go outside the network……I can either print my PHR info and provide to the new clinician or request a hard copy of my file from medical records…..a very expensive and time-consuming exercise.

Having been on the device-side of the equation, I am guilty as charged! Seamless exchange of clinical data has generally been a topic of discussion but has always seem to come second to improvements of the device itself. Adding a “data export” feature via HL7 was something we were supposed to hang our hat on! Good or bad, the MU stages & requirements will help “direct” providers, payors, and patients in that direction. Enjoy the holidays!

chris riley says:

July 6, 2011 at 3:10 pm

Surely the key is to have systems that not just digitize the clinical information but also seamlessly and simply provide or enable the exchange of the clinical data between physicians and patients. That’s where the real value is in terms of improving patient outcomes and lowering costs. HL7 is not the answer in all areas. We need to build community’s around physicians in local areas, medicine is really a local art and systems need to build form that base layer