Gary D Novack1, Michele C Lim2. 1. PharmaLogic Development, Inc., San Rafael, California; Department of Ophthalmology and Visual Sciences, University of California Davis, School of Medicine, Sacramento, California. Electronic address: gary_novack@pharmalogic.com. 2. Department of Ophthalmology and Visual Sciences, University of California Davis, School of Medicine, Sacramento, California.
Abstract
PURPOSE: To provide a first-hand account of a retinal detachment suffered by one of the authors and how it relates to electronic health record (EHR) interoperability. DESIGN: Single-patient, observational. METHODS: 1) Personal patient perspective - symptom, surgery, recovery and the worry about potential long lasting sequelae, and the need to reiterate detailed medical information several times during a stressful period. 2) U.S. National perspective regarding EHRs. SETTING: Out-patient and community hospital. Patient or Study Population: Single patient. Intervention or Observation Procedure(s): Retinal surgery. MAIN OUTCOME MEASURE(S): Visual acuity. RESULTS: Patient had a favorable outcome, but was required to provide medical history data multiple times to multiple providers. Only 41% of hospitals in the United States have EHR from outside providers or sources when treating a patient. Physicians in outpatient settings fare worse with only 14% of office-based physicians sharing data with providers outside of their organization. CONCLUSIONS: While adoption and use of EHRs are incentivized by the federal government in the United States, the lack of interoperability between different physician and hospital systems means that we are far from achieving meaningful digitization of records. This case report provides a close look at how it may be difficult to receive care in a fragmented health care model in which physician and hospital do not share the same EHR. Information blocking, now prohibited by federal law, still remains an obstacle to interoperability. It will take continued effort and commitment from key stakeholders such as health care providers, patients, the federal government, and industry to bring this dream to fruition.
PURPOSE: To provide a first-hand account of a retinal detachment suffered by one of the authors and how it relates to electronic health record (EHR) interoperability. DESIGN: Single-patient, observational. METHODS: 1) Personal patient perspective - symptom, surgery, recovery and the worry about potential long lasting sequelae, and the need to reiterate detailed medical information several times during a stressful period. 2) U.S. National perspective regarding EHRs. SETTING: Out-patient and community hospital. Patient or Study Population: Single patient. Intervention or Observation Procedure(s): Retinal surgery. MAIN OUTCOME MEASURE(S): Visual acuity. RESULTS:Patient had a favorable outcome, but was required to provide medical history data multiple times to multiple providers. Only 41% of hospitals in the United States have EHR from outside providers or sources when treating a patient. Physicians in outpatient settings fare worse with only 14% of office-based physicians sharing data with providers outside of their organization. CONCLUSIONS: While adoption and use of EHRs are incentivized by the federal government in the United States, the lack of interoperability between different physician and hospital systems means that we are far from achieving meaningful digitization of records. This case report provides a close look at how it may be difficult to receive care in a fragmented health care model in which physician and hospital do not share the same EHR. Information blocking, now prohibited by federal law, still remains an obstacle to interoperability. It will take continued effort and commitment from key stakeholders such as health care providers, patients, the federal government, and industry to bring this dream to fruition.