By Miriam Paramore
Imagine that your son suffers from asthma and acute allergies, and takes a minimum of 4 medications daily to manage these conditions. Imagine that he also gets weekly injections to keep things in check.
Imagine one day that he can't breath, and does not have his emergency inhaler. You rush him to the emergency room where you are bombarded with questions about what he is allergic to, what drugs he takes to manage his asthma and how you are going to pay for the care needed to save his life. Through your panic and worry, you try to remember the exact names of the drugs he takes and the precise dosing, which changes as he grows. You try to recall any drugs he might be allergic to. You pray that you can remember what his major allergies are. You fear making even one mistake that would hurt him more.
Unfortunately, the hospital does not have access to the medical records kept by his pediatrician, nor do they have access to those medical records kept by the specialist who treats him for his allergy and asthma. It is evening, so they cannot call these physician offices to speak with someone immediately. You don't carry around his medical records, and your memory is insufficient. Time is wasted, care providers guess what to do, and you hope it works out OK.
My 12-year-old son, Sam, is the real child in this imaginary scenario, and I am the real mother. I am also the chair of the Louisville Health Information Exchange (LouHIE), a communitywide not-for-profit with the purpose of bridging the information gap. Imagine now that someone in the emergency room was able to Google “Sam's medical record” and instantly see a complete record of Sam's health history from his pediatrician, specialist, and any other doctors or hospitals that have treated him. They see a detailed listing of his allergies, a precise description of his daily drug regiment, and any other medical conditions that he may have. He is treated appropriately, and quickly. He gets better and we can both breathe again.
The idea of “health information exchange” is not as simple as Google, but it should be. Why can Google index essentially all of the information in the world, but we can't index the information about one child between a hospital and a physician's office that are across the street from each other? Well, for one thing, not all of the information is electronic since many medical charts are still on paper. Even when this information is electronic, it is not electronically shared between healthcare providers. There is no single, consolidated medical record for a patient, anywhere. As a result, we perform unnecessary and sometimes redundant medical tests, prescribe drugs that negatively interact with other drugs the patient already takes, misdiagnose, and sub-optimize the entire healthcare delivery system.
There is a national movement to create an integrated health information system, which would include an electronic medical record for all Americans. Here in our home town, the mission of LouHIE (pronounced like the name “Louie”) is “To improve quality of healthcare and contain rising costs in the Louisville area … by providing consumers and their providers anytime, anywhere access to complete healthcare information and decision-support.” For short, in my own words, “Just Google it.” The Louisville healthcare community should be commended for independently investing in information technology, and for beginning to make the slow and painful transition away from paper charts to an electronic medical record. The problem is that word “independently.” That means that one doctor's office buys a certain computer system, another office buys a different system, the hospitals have yet other systems, and none of these systems talk to each other. LouHIE is focused on the work “exchange.” The information is electronic in many settings, and simply needs to be aggregated in a way that is can be shared easily at the point of care, anytime, anywhere. To accomplish this big idea, the entire community needs to participate.
The good news is that LouHIE is well underway. We have a communitywide board representing consumers, healthcare providers, insurance companies, Louisville Metro government, employers and purchasers, organized labor, public health and more. We have a common vision and have agreed to collaborate as a community for the benefit of all Louisvillians. At this early stage, we are building out our committees and raising the funds necessary to put the money behind the mission. Go to www.louhie.org to learn more and get involved. We need your help! Let's work together to create a connected healthcare system that can provide anytime, anywhere access to the medical information needed, when you or your child needs it most.
