This past summer Google announced that it would be retiring Google Health. This happened at a time when the healthcare industry is struggling with issues of interoperability and creating Electronic Health Records (EHR). Many medical centers, individual hospitals and ambulatory care centers are well on their way to implementing their own Electronic Medical Records (EMR) and meeting “Meaningful Use” criteria as established by the HITECH Act. Without Google, who is going to create an EHR?
First, let’s take a step back and clarify the difference between an EHR and an EMR. While the acronyms are often used interchangeable, there is a technical difference. An EMR is a digital version of clinical care data. It is a patient record generated by information collected at the point of care, either given by the patient (i.e. current medications, subjective complaints) or by diagnosis and treatments (i.e. radiologic tests, doctors’ observations). An EHR focuses on the total health of a patient, going outside of the treating healthcare organization. An EHR can be managed by clinicians and staff at more than one healthcare organization. Better yet, an EHR can be accessed and managed by the patient.
Having a comprehensive EHR would be very beneficial for patient care. Suppose you are a patient at Newton-Wellesley Hospital. You have a record there, so they know your medical history. You get in a car wreck in downtown Boston and are rushed to the nearest ER. Luckily it is Mass General. Like Newton-Wellesley, they are part of Partners Healthcare, so your EMR can be accessed. Now supposed you get in a car wreck in New York and are rushed to the nearest ER. They don’t know anything about you and because of HIPAA, Newton-Wellesley is very limited in the information they can tell the ER in New York. An EHR would solve this problem.
But who is going to create an EHR? Individual medical providers don’t have the incentive as they each as well on their way with their own EMR. Companies that design and sell EMRs don’t have the incentive to make their products interoperable because that allows competitors in. Regulators are unlikely to mandate a standard in our capitalist economy. Google was headed the right direction, but was unsuccessful. This is a two-sided network problem that is up for grabs now.
Personally, I don’t think we will ever have a completely interoperable EHR. We will have better transmission of data between EMRs in the next five years. I also think that many more people will carry around some sort of card/ bracelet/USB that allows their medical data to be uploaded into anyone’s EMR. While this is not reaching a status of EHR, it will increase probabilities of successful medical care for those who are specifically concerned or invested in their health. I think only a small portion of Americans would take an active step to carry their data with them, but for those who do, we will be able to increase quality and quantity of life.