U.S. Playing Catch Up in Health Care IT

SOAPware is an Electronic Health Record designed for clinics and developed with the goal of eventually replacing paper charts. SOAPware meets users where they are, on their own terms, by allowing them to continue using dictation and handwriting at the beginning, while still providing the capability to adapt and evolve into a fully digital system.

However, none of the top five hospitals has an electronic records system that connects into the community in any way, Grundy said. "Theyre siloed."

Added Grundy: "We need something portable, usable and with open standards, otherwise theres this big disconnect. The systems dont connect in any meaningful way."

Oates added, "The industry is fragmented with a lack of standards, information silos, and a near cartel approach to problem solving."

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Indeed, "Health information exchange is in its infancy in the U.S.," Oates said. "The payers control a highly fragmented system where information is not shared."

In a keynote presentation at a conference entitled "Health IT Trends & Marketing: A Conference Designed for Health IT Vendors in Boston two years ago, W. Walter Wego, M.D., slammed the vendors involved in the HIT business.

"I see the HIT industry as being critical to solving some major problems my patients and I are having," Wego said. "We really need your cooperation and participation to finally solve some serious problems with health care."

He went on to say: "…does your hypocrisy have any limits? I recently wanted to interface a practice management system from one of you to an EHR [Electronic Health Record] from another vendor. When it got right down to it, you were willing to interface your PMS [Practice Management System] to the EHR, all right, and only for a measly $27,500. And, this was for just your half of the interface. On the other hand, the EHR vendor required only $500 for their half and this seemed reasonable."

Moreover, said Wego in his keynote, "I wish this practice of overcharging for interoperability was unusual, but I have been checking around with my peers and discovered it is the norm for most of you HIT vendors to charge prohibitive fees in order to provide even a crude degree of interoperability."

Grundy said he believes the most important concept for the industry to consider is "dont delay good for the best." He said the health care IT system ought to "have enough information about you that if you should land in an emergency room somewhere, they can safely treat you."

To that end, the ASTM (American Society for Testing and Materials) Internationals CCR (Continuity of Core Record) can play a part, Grundy said.

CCR was developed in response to the need to organize and make transportable a set of basic information about a patients health care that is accessible to clinicians and patients, according to the AAFP (American Academy of Family Physicians) Web site.

The CCR is intended to foster and improve continuity of care, reduce medical errors and ensure a minimum standard of secure health information transportability. Adoption of the CCR by the medical community and IT vendors will be a great step toward achieving interoperability of medical records, supporters said.

The CCR is a core dataset to be sent to the next health care provider whenever a patient is referred, transferred or otherwise uses different clinics, hospitals or other providers. And practitioners believe the CCR will prevent physicians and other health care professionals from having to act blindly, without easy access to relevant patient information.

"The real bright spot of actual progress in standards that is promising to quickly deliver some wins for docs and patients is the Continuity of Care standard from ASTM," Oates said in his own keynote address at the conference Wego also keynoted.

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