Intelligent Healthcare Information Integration 1/31/10

And In This Corner…

Boxing: the Sweet Science. Evidence of pugilistic contests can be found in ancient Sumerian, Mesopotamian, Minoan, and Egyptian art. The ancient Greeks record codified rules for fisticuffs and the onset of boxing as an honored profession.

Early pugilism in the more modern era had no written rules. It wasn’t until 1743 when Jack Broughton (Broughton’s Rules) and later John Chambers, in 1867, with the more widely known Marquess of Queensbury Rules, established some guidelines for what is to be considered “fair” when pounding upon another person that fist fighting began moving from bare-knuckled brawls to a sophisticated “science.”

These days, healthcare, and especially healthcare IT, could use some similar systematic set of statutes for what’s fair and what’s considered “below the belt.”

We are all only too aware of the titanic 15-rounder going on in Washington over healthcare reform. Some days it is difficult to tell who the inevitable winner will be … if any. But, in the subset of healthcare known as HIT, a couple of more sinister-appearing brouhahas are bubbling with just as much venom as that within the ring of the I-495.

As we move closer and closer to the onset of a digital national health Information network, the concern over who gets to play in whose sandbox broils more vigorously. This is a concern not only of those whose health information is being digitized for broadcast, but also for those who hold the dossiers.

As reported recently by Patty Enrado in Healthcare IT News, “Competition and lost revenue are keeping communities from participating in health information exchanges…” At the Regional Healthcare Stimulus Exchange Conference in San Francisco this month, one audience member argued that when it came to medical information sharing among healthcare providers and provider systems, “workflow issues [are] miniscule compared to the politics among providers.” Getting data-holders to share their data (play nice together in a shared sandbox) may not even be amenable to financial incentives. Tom Williams, executive director of California’s Integrated Healthcare Association suggested the state government may have to “’twist some arms’ and apply a stronger hand.” (Punch)

On the end user side of healthcare, consumers aren’t all that hep to trusting their personal patient portfolios to anyone, either. As Andy Greenberg noted in his recent article, The Next Health Care Debate, on Forbes.com this week, a study by the data privacy watchdog Ponemon Institute, shows that “Americans registered a deep distrust of anyone in either the federal government or private industry who might store digital health records…” Only 27% say they’d trust either the feds or a techno giant such as Microsoft or Google with their health records. Folks are much more inclined to let hospitals or their doctors store their info (71%) and are just fine with their personal doc having access to nationally stored data (99%). As Larry Ponemon commented, “There’s a lot of angst around centralizing this information, no matter whether it’s managed by private enterprise or government." (Punch, Punch)

This data will eventually be shared, I have no doubt. Systems and institutions will learn to “let my people” go and find ways to provide profitable healthcare services with mutually accessible data. Consumers will learn that the advantages to a reasonable sharing of their health data, in an as yet undefined and hopefully secure form, will lead to otherwise unobtainable individual as well as communal benefits.

Until that future day, I’m keeping my left up and my mouthpiece in. (Bob and weave)

From the trenches…

“To me, boxing is like a ballet – except there’s no music, no choreography, and the dancers hit each other.” – Jack Handy

Dr. Gregg Alexander is a grunt-in-the-trenches pediatrician and geek. His personal manifesto home page…er..blog…yeh, that’s it, his blog – and he – can be reached through http://madisonpediatric.com or doc@madisonpediatric.com.