post by Bill Gardner
So it happens that the medication I take to control my arrhythmia has stopped working. No one has any idea why, but I need to find a new one. Because these medications can have significant side effects, figuring out what will work and what I can tolerate will require a hospital stay. This is a trial and error process.
What is a problem is that it has been more than a decade since I last did this, and I have moved from Pennsylvania to Ohio to Nova Scotia in the interim. And, although I now live (mostly) in Canada, my cardiologists are still in Ohio. Now we need to get my Pennsylvania records to Ohio, so that the Ohio docs can learn about the drugs that were previously tried and failed in Pennsylvania. But I have to do all this from Canada... Otherwise, we have to repeat those trials, which will require a lot of hospital days.
Now, the Health Information Technology for Economic and Clinical Health (HITECH) Act requires that these records be made available to me, and the Pennsylvania hospital has a procedure for requesting them. However:
- To protect confidentiality -- and manage their risk of being sued -- the hospital will not begin the process until the requesting patient has printed, signed, and faxed back a form.
- The hospital is in the patient care business, not the document production business, so this service is understaffed. Telephone calls go to an answering machine. Attempts to fax get a seeming perpetual busy signal.
With a lot of patience, I think I have a solution that may get the records to Ohio in two weeks. If we can't, I'll be okay except for the inconvenience. We will, however, have generated many thousands of dollars of extra health care costs, just because there is no working standard format for the exchange of medical information
I don't hold my Pennsylvania hospital accountable for any of this. But seriously, people, electronic health care record systems ought to be inter-operable, so that a physician in hospital X can, with the appropriate verifications, just look at her screen to see my previous medical history.