When the 20th Century Meets the 21st: Health Information Exchanges


Nurse

Yesterday, Utah announced a statewide health information network called the Clinical Health Information Exchange. The system is run by UHIN, a quasi-public entity that has long run a health information network in the state that has been used to link payers and payees. Extending their reach into clinical information is a natural and will be a great thing if it comes to pass. From their "About Us" page:

The goal of the cHIE is to improve the quality of care you receive by increasing efficiency and maintaining patient safety. This is accomplished by enabling healthcare professionals to be better informed, and by reducing time and expense associated with missing information and ordering of duplicate tests.

The cHIE is a Utah effort to improve the quality of the healthcare you receive by making it easier for your participating clinicians to view critical medical information about you, no matter where you receive health care in Utah. It simply provides the means to locate and view information available from the healthcare entities that participate in this community effort.

The information that is shared may include laboratory and radiology results, transcription reports, medication and immunization histories, allergies, and other medical reports.

From myCHIE :: What is cHIE?
Referenced Fri Jun 17 2011 08:57:46 GMT-0600 (MDT)

My first thought was "cool, I want to sign up!" Heh.

Patients have to complete a consent form (PDF) and take it to each provider. The signing of the form has to be witnessed by an "authorized agent." Basically, you've got one more form to fill out. (I think it has to be taken to each provider. That's unclear from the site. If not, then once I give consent to one, I'd be giving consent to all.)

If you're a provider it's even worse: three forms that have to be faxed or mailed in. And your electronic health record and software vendors all have to do the same.

Hard to imagine how an online health information network can be founded on faxed paper forms, but I guess that's just normal in the health field. But it's really much worse than just paper forms. Since there's no way for me to "join" as an individual--just give my consent to providers to put my information in the system, I presumable don't have access to it, can't review it, and can't use it anywhere else.

What a lost opportunity. Imagine if it were set up as a personal data store, where I can join as an individual and really control my health information. Rather than some blanket consent, I could authorize and deauthorize provider access to specific information much more easily.

To be fair, there are legal restrictions on what can be done. And some patients wouldn't be comfortable with an online signup and account. Even so, the structure of this system reinforces the vision of the "all knowing physician" and further weakens the ability of patients to participate in their own care.