Ron Sims, Rich Moyer, Gail Graham, and Scott Armstrong continue to respond to Wednesday’s question about adoption of electronic health records.
Ron Sims: The original question was, “Who is going to come with the standards?” And I believe you’re going to see the Federal Government move on them with a great deal of aggression over the next couple of years, and there’s several reasons why. If you look at the issues that the three car companies face, one of the things that they’ve been raising on a pretty consistent basis is their healthcare costs, not only their pension costs, but their healthcare costs.
Gail Graham, Veterans Health Administration Director of Health Data and Informatics, and Joe Scherger, MD, Consulting Medical Director Lumetra, address this question as panelists at Healthcare Town Hall.
Barry: It sounds like everyone agrees that interoperability and some level of standardization with records and record systems and the language of them is important. Can anybody help me understand how that’s likely to actually be achieved? At the present time, Microsoft has its solution, Google has its solution, I’m sure many other providers working with software solution providers working with pairs and healthcare providers are offering all sorts of other solutions. There’s sort of a cacophony, a Tower of Babel potentially out there right now, am I right?
Gail Graham: Well, I think there are some breakthroughs. VA among about 14 other participants were in a demonstration project to display that we could send summary information of data through the healthcare continuum for patients.
Gail Graham explains how electronic health records have transformed VA.
Q: Gail Graham, the Veterans Administration has been using electronic health records for some time also on a very large cohort of patients in a very large system. What have been the results from your point of view?
Gail Graham: Well, they reflect in our quality measures, for example, which have been much higher than external report findings in the HEDIS measures. But I think the biggest thing for a closed referral system such as VA where we’re seeing patients in rural, very rural, and referral sites is the fact that the continuity of their care is there regardless of where they’re being seen. It also gave way to implementation of things like telemedicine, teleradiology, and other services that really take away the geographic boundaries that may have limited the care that people were getting in certain areas. For VA, it started 20 years ago with clinicians being used to looking up all results electronically.
Q: Gail Graham, in the case of the V.A., who owns the patient records in your system?
Gail Graham: Well, by statute, V.A., as the custodian of the record. But the information is actually owned by the patient, and the control and the release of that information is owned by the patient. We do have legal parameters for how we keep it and the duration for which we keep it. But disclosures of that information are established in the Privacy Act and in HIPAA. And I think for us, too, our patients have a long history of maintaining a copy of their record that dates back to their military service. So even before provisions of HIPAA allowed for amendment and getting copies of your records, it was a very commonplace thing for the veterans to keep a copy of their medical record as they moved around.
Who owns electronic health records? Gail Graham of Veterans Affairs, Washington State Insurance Commissioner Mike Kreidler, and King County Executive Ron Sims discuss the question of ownership and how electronic health information can and should be used.