Plan for Medical eRecord Network Could Save Lives
Posted on 02. Nov, 2010 by Amy Berryhill in Uncategorized
Health care providers will finally begin to communicate with one another like modern business people if ambitious plans to create a network for electronic medical records in New York state is approved.
Last week the New York Department of Health and the public-private partnership New York eHealth Collaborative (NYeC) released their joint plan for the state’s medical record network. The 160 page document shown below outlines a large scale strategy to link all of the electronic medical records in New York, so that a doctor anywhere in the state can access necessary records of any patient.
If approved by the federal office that oversees heath information technology, the plan will proceed with funding shared by the federal and state governments. Initial investments are $75 million and $54 million respectively.
The $129 million budget outlined in the plan will cover costs through 2014, and will be paid for with money that has been allocated through the federal stimulus and HEAL NY funding initiatives. Money is available, but other problems persist.
“The technical challenge, I won’t shirk. It is a big one,“ said NYeC Executive Director David Whitlinger. Electronic medical records do not use uniform technology, and their adoption with smaller medical providers is low. NYeC focuses half of it’s resources on the issue of adoption alone and it is a primary focus of the network plan.
In addition, there are both federal and state regulations relevant to the use of medical information that will need to be considered before medical records can be accessed through an electronic network. Some of the most significant regulatory issues deal with patient privacy and consent.
The New York Civil Liberties Union (NYCLU) thinks the plan has an incomplete, and potentially unlawful, proposed approach to privacy and consent for networking electronic medical records.
“NYCLU strongly believes, and has stated in previous comments, that the upload or conversion of medical information without prior patient consent is NOT consistent with New York law. In addition, reference to a “single consent” being needed to exchange all health information, including sensitive health information, is also not consistent with sound policy in this area,” said NYCLU Senior Council Corinne A. Carey in her public comments [PDF]. Carey was not available to comment for this article.
The plan calls for the foundation of the electronic medical record network to be built and made available to a limited number of medical providers by the end of 2011. Identifying a patient and combining their records from multiple providers is essential to the first launch. Security will be a requirement and the system will need a method of patient consent for the records to be made available on the network. It may seem straightforward, but there is plenty of disagreement over the details.
For the network to be useful, the concerns outlined by the NYCLU about privacy and consent have to be balanced with the goal of saving lives. “If somebody shows up unconscious in an ER, the ability to query information about that patient without their consent could save their life. No one wants to make a decision or a system that is going to prevent a life from being saved,” said Whitlinger.
Beginning with the release at the end of 2011, NYeC is scheduled to oversee a technical product release every six months until the end of 2013. After the initial launch of the network foundation, efforts will branch into two parts. One is statewide adoption of the network capacity that is released to date and the other is enhancement of the network itself. By the end of 2013 the goal is an electronic medical record network that allows medical providers to manage and share prescriptions, lab results and care summaries with other providers. Patients will be able to access components of their own records.
In addition to saving lives, which Department of Health officials support [PDF] as an outcome of the proposed network, there are potential cost savings. According to the plan, administrative costs to transfer records would decline. Costly lab tests could be shared between medical providers instead of repeated, and patterns could be tracked in a comprehensive way to inform both the medical community and public policy makers.
Dr. David Mendelson, Chief of Clinical Informatics at the Mount Sinai Medical Center, is optimistic about what he has seen from the plan so far. While he acknowledges the challenges inherent in the project, he is more interested in the solutions. “I like the plan in general, I thought it did show an organized vision of beginning to integrate health information in New York state,” he said.
For now it’s an organized vision. If the plan is approved, the barriers are overcome and the money keeps coming, it might become a lifesaver.
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