NPR broadcasted an article, “Sharing Patient Records Is Still A Digital Dilemma For Doctors,” that provides some context to the current controversies about the MDH ERH mandate.

The article notes, “In an era when most industries easily share big, complicated, digital files, health care still leans hard on paper printouts and fax machines.” And, While those systems (EHRs, or, as the article refers to them, EMRs) are supposed to make health care better and more efficient, most of them can’t talk to each other.”

It quotes experts on EMRs as rating the current level of interoperability, or “the ability to converse with each other,” at about 2 or 3 on a scale of 0 to 10, which obviously is pretty weak. They also note that some major healthcare industry players have been fighting true interoperability in order due to some perverse financial incentives, such as maintaining the ability to order redundant tests or procedures if the patient’s health record isn’t immediately available, or even to make it harder for patients to change doctors or health systems because their medical history is “locked up” in a proprietary medical database.

The article also discussed some interesting incentives to change EMRs so that they are truly interoperable, including the facts that many health care consumers are savvy about IT issues and expect their records to be accessible by all of their medical providers.

The article does not, however, address the more mental-health-specific concerns about patient confidentiality.

My take:   (I am summarizing some interesting statements made by others).  There is an emerging concensus that we are, in effect, being mandated to be a Beta testers for a new and very complicated system.  We are also being mandated  to purchase an EHR AND a HIE service, only to end up having to still fax everything to the physicians because of interoperability barriers. .  

There is also an emerging concensus that, given that there is no known enforcement at this time of the Mandate, and given that the current EMR structure is, in the opinion of many knowledgeable observers,  not workable and has no fix in site, one very viable option would be to put purchasing an  EMR on hold until EHRs are available with workable standards, are interoperable without heroic actions on our part, and are, essentially, as simple to use as many common programs.  If this is your plan, it would be advisable to have a written document spelling out your plan for (eventual) compliance with the Mandate. 


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