Mr. President, there's something BIG you're missing

Dear President Obama:

So, you're looking forward to seeing the country adopt one of your most treasured goals, the complete data-meld of the healthcare industry. We're talking about having all patient data flowing liquidly between all providers with a few clicks of a mouse. Grandma will be able to move from her home in Topeka to her retirement condo in Florida and her data will be there in a millisecond, well before she has her first primary care check-up.

Yes, I understand why this sounds like a feasible vision to you. I'm sure you've thought about something like this every time you use your ATM card (well, maybe you don't use one any more--a president can't be too careful). Why, you probably wondered, can banks share financial information everywhere and anywhere, while I can't go across town from one doctor to another without running into great big hassles over getting my medical records into the right hands.

The problem is, you've probably made the same error that many people do in assuming that banks and healthcare institutions are alike enough to solve problems in the same way. The truth is, banks are inherently national and ultimately global institutions, and have had to develop coherent standards for sharing data in milliseconds from the inception of electronic networking.

But when it comes to healthcare, we're talking about a bunch of dots on a map, a mosaic spanning everything from several-hundred-hospital chains to fiercely-independent two- or three-person medical practices who do things exactly as they please. While banks, by definition, are pretty much automated to the teeth, healthcare organizations range all over the map from some that barely use email to others that track patients with 21st century sensors as they move through the building--and everything in between.

Sure, you may be reassured that if a hospital buys an EMR that's certified by the CCHIT, it's compatible with other CCHIT-certified EMRs, and yes, that's good for something. Lord knows, it's a start. But it's only a start. What about connections between existing health information exchanges? Do we close them down, force them to change the standards upon which they operate (an extremely NON-trivial matter), or bypass them? What about networks between hospitals and affiliated doctors that are working just fine, but don't meet current CCHIT standards? And what about connecting to the National Health Information Network using its CONNECT protocol?

With all due respect, Mr. President, the idea that healthcare can just be nudged into national health data networking in a few short years is so flawed it's almost comical. (And hey, this is coming from one of your fans.)

By all means, I appreciate your leadership on this issue. Somebody had to point at the moon and say "We can get there." And if national health data networking is a worthy goal, why shouldn't it be you who points the way? But if you think we can pull this off during your presidency, or your wife's, I believe you're missing something very big. Health IT just isn't going to be tamed at this pace, hope as you might.

Sincerely,

Anne Zieger

Post a comment