Regional health information exchanges are being developed across the US to allow electronic sharing of medical records between healthcare providers. This reduces costs by eliminating duplicate tests and improves quality of care by giving doctors access to full patient histories. States are taking a leading role in establishing HIEs due to the large costs of healthcare for their budgets. Telemedicine is also expanding, using technology to allow remote patient consultations and care. National electronic sharing of records may eventually be possible if technical, financial and privacy challenges can be overcome.
1. Trend Report: Medicine
eHealth Initiatives Streamline
Medical Record Sharing
new health information Recently, a Man dIagnoSed wItH an aggReSSIve foRM
of cancer walked into a Memphis hospital looking for a second
exchange technology opinion. Rather than immediately ordering a battery of tests to
promises to improve the confirm the diagnosis, his doctor logged on to the MidSouth
eHealth alliance, a new health information exchange (HIe) that
quality of health care lets Memphis area hospitals share patient medical records. the
and reduce costs. doctor discovered that the requisite tests had already been
performed at a nearby medical center and that their results
were instantly available through the HIe’s electronic database.
Using existing test results, he was able to quickly confirm the
patient’s diagnosis without subjecting him to additional and
unnecessary discomfort.
for years experts have argued that the U.S. could offer better
and more cost-effective health care if it could find a way to
electronically aggregate patient records—often scattered in the
far-flung file drawers and hard drives of family medical practices,
specialists’ offices, clinics, pharmacies and hospitals—and make
them readily available to health-care providers everywhere. when
HIes provide patient records electronically, a doctor in california
will be able to immediately access the medical history of a visit-
ing Pennsylvanian needing care. cost savings would accrue by
eliminating duplicative medical tests—enabling faster and more
complete diagnoses—and by reducing the time spent tracking
down and sharing hard-copy medical records. costly mistakes
could be minimized too, if a doctor knew, for example, that a new
patient was allergic to certain types of medications.
this is becoming an increasingly realistic goal with the develop-
ment of regional HIes like the one used in Memphis. dozens are
springing up across the country, representing the leading edge of
the growing eHealth movement, which seeks to use information
technology to improve the quality and reduce the cost of health
care. other common eHealth initiatives include ePrescribing,
which uses the Internet and other online tools to create and >>
2. Trend Report - eHealth Initiatives Streamline Medical Record Sharing __________________________________________________________________________ 2
>> sign prescriptions electronically. eHealth experts say it can reduce
medical errors, decrease pharmacy costs and increase efficiency, in
daRRIn KlIMeK/dIgItal vISIon/getty IMageS
part by giving prescribers real-time information about potential drug
interactions and allergies and eliminating mistakes associated with the
interpretation of handwritten prescriptions. ePrescribing reduces the
need for phone calls between doctors and pharmacists and provides
patients with safer care. telemedicine leverages telecommunications
technology to enable long-distance patient consultations and delivery
of clinical diagnosis and other medical services. for example, physi-
cians can employ videoconferencing to consult with and in some cases
examine and treat patients in remote locations who otherwise might
not have access to their expertise. this reduces the need for travel by
patients and physicians, facilitates faster and more consistent treatment State eHealth initiatives are making it possible for doctors to access
of injuries and illnesses, and allows some patients to be treated at home patient records electronically, saving both time and costs.
rather than in a hospital.
States Take the Lead tennessee is among the leaders of the movement to create state-
State governments are providing leadership in bringing eHealth’s wide HIes. Its governor, Phil Bredesen, co-chairs the State alliance for
promise of broadly shared electronic medical records to reality. as eHealth, an organization created by the national governors association
partners with the federal government in administering Medicaid and to increase the efficiency and effectiveness of health information
the State children’s Health Insurance Program and as employers of technology initiatives developed by states. In addition to helping fund
millions, states are among the largest buyers of health-care services in the MidSouth eHealth alliance, tennessee has contributed money to
the country. Rising health-care costs, which now consume about 16% of the launch of a regional HIe in eastern tennessee and is overseeing
U.S. gross domestic product, have a direct impact on their budgets. “we the development of the tennessee eHealth exchange Zone. the Zone,
have to be involved in this,” says dave goetz, commissioner of finance a statewide HIe, is intended to enable ePrescribing as well as the
and administration for the state of tennessee who oversees its eHealth sharing of high-density medical images and secure exchange of
advisory council. “Making health care more effective and affordable is health information among all health-care providers in tennessee.
a worthwhile goal for us as a purchaser and as a government.” cara
campbell, a policy analyst for the national governors association’s announced at the beginning of 2008, the eHealth exchange Zone is
center for Best Practices says, “States perceive health information scheduled to go live with its first users at as many as 400 sites before
exchanges to be the top priority for the next two years.” the end of the year. Its rapid launch was made possible partly by the
decision to build the exchange on the back of the state’s existing at&t
virtual private network (vPn), which reaches into all 95 tennessee
counties. at&t has created a vPn-based portal for the network’s
Trend Report Note
users and has tapped a third party—covisint, a division of compuware
HIEs aren’t the only promising eHealth initiatives, of corporation—to provide a dual-factor user-authentication protocol to
course. Telemedicine applications that allow health- further ensure the privacy and security of the system. “It is very safe
care providers to deliver their services electronically are for the sharing of files,” says Melissa Hargiss, interim director of the
also becoming popular. Such applications let doctors tennessee eHealth advisory council, which is overseeing the initiative.
meet with patients remotely via videoconferencing;
receive readings from their diabetic patients’ glucose A National Solution
monitors via the Internet; send advice to their patients’ Ultimately, forward-thinking health-care professionals and policymak-
cell phones via text messaging; and share high- ers envision a day when americans will be able to reap the benefits of
resolution medical images with other physicians via a national HIe. Before that can happen, though, the industry will have
high-speed Internet connections. Read more about these to overcome an array of technical, financial and social challenges.
innovations in the Healthcare Research Library from for example, beyond figuring out how to get many different medical
AT&T at www.att.com/healthcare. information systems to communicate with one another, the industry
will have to persuade patients and health-care providers alike to >>