Sunday, April 13, 2008

More on Health Information Exchanges

Although the advent of the RHIO as a business structure for the development of  Health Information Exchanges has largely failed to do what it was intended to do, the motivation for HIE will largely be driven by  CMS mandates and well as quality and safety concerns. 

(HealthDay News) -- "From 2004 through 2006, patient safety errors resulted in 238,337 potentially preventable deaths of U.S. Medicare patients and cost the Medicare program $8.8 billion, according to the fifth annual Patient Safety in American Hospitals Study

This analysis of 41 million Medicare patient records, released April 8 by HealthGrades, a health care ratings organization, found that patients treated at top-performing hospitals were, on average, 43 percent less likely to experience one or more medical errors than patients at the poorest-performing hospitals.

This analysis of 41 million Medicare patient records, released April 8 by HealthGrades, a health care ratings organization, found that patients treated at top-performing hospitals were, on average, 43 percent less likely to experience one or more medical errors than patients at the poorest-performing hospitals.

The overall medical error rate was about 3 percent for all Medicare patients, which works out to about 1.1 million patient safety incidents during the three years included in the analysis

"HealthGrades has documented in numerous studies the significant and largely unchanging gap between top-performing and poor-performing hospitals. It is imperative that hospitals recognize the benchmarks set by the Distinguished Hospitals for Patient Safety are achievable and associated with higher safety and markedly lower cost," Collier said. "

The entire article can be found at  Washington Post.

Of some interest to me is no mention whether their was a difference in the use of "health information technoloogy" between the "high achievers" and the underperforming" hospitals. Does anyone have statistics on this metric?

The Fifth Annual Health Grades Patient Safety in American Hospitals Study

2 comments:

Anonymous said...

Granted huge numbers of medical errors are occurring, granted that better sharing of information among medical providers is almost certainly a good thing, granted that having a centralized repository of patient information can help to some extent, it seems to me that HIEs/RHIOs/RHINs are akin to trying to kill a mosquito with a sledgehammer.

Take me and my family for example: I take exactly one prescribed medication and I see a GP, a psychologist, a chiropractor and a dentist one or more times a year. I have no chronic conditions. I have been in the hospital 3 times in my life, once at birth, once for a tonsillectomy and once for an appendectomy.

My dependents have similar stories, possibly even less interesting. What's my payback for turning over my personal medical history to an company or organization to make available to medical professionals, or more likely, hackers throughout the world?

Well, since we have but very few prescriptions we're taking we have but very few likely possibilities that doc A is going to prescribe something that will adversely interact with something doc B prescribes. Anyway, all our prescriptions are filled by one pharmacy and they check for drug interaction as well. So that's not it.

Then there's the situation where supposedly doc A orders a test that doc B has already ordered, which costs my insurer, which ultimately costs me. This has NEVER happened to me, my dependents or anyone I know or am related to. Any stats on how frequently this occurs?

Then there's the scenario that if doc A can't figure out what is wrong and has to refer me to doc B, but for some reason it is prohibitively expensive or completely impossible for doc B to see my history. How often does that happen? Never has happened to me or my dependents or anyone I know or am related to.

So, I guess I'm asking someone, anyone, to explain how I benefit by putting the security and privacy of my and my dependents' PHI at risk by turning it over to an HIE/RHIO/RHIN which may or may not be competent or interested in keeping my information secure.

Anyone?

Gary M. Levin said...

Enoll, thank you for your comments. They are excellent and I understand your point of view. You are fortunate to be so healthy. It is a blessing, indeed. There is no payback at this point in your life. However as time passes you may develop more serious problems. I believe any patient should be able to opt out of HIE or RHIOs.
Many doctors feel the same way.

Many patients move, use different pharmacies, have had multiple hospitalizations, are advanced in age, forgetfull and give inaccurate histories. In some cases obtainning medical records is very difficult or very delayed.

Insurers already have much of your information from your application and track your visits, diagnoses, from billing by your MD. Watch out for employers who offer free PHRs as well. Rather than being an advociate of HIE I am a source for better knowledge of what is going on. Big brother is watching, however the real danger is hacckers who can obtain and sell your personal medical information
to pharma, suppliers, etc etc