What it the impact of all of those HITECH Act billions for EHR and HIE?

Frankly, none that I can see at a patient level as I spend time in the health care system dealing with a melanoma (from diagnosis to aftermath).

I still get clipboards with stacks of paper forms to fill out one at a time at each medical encounter. Even simple stuff like having my name and birthdate pre-populated are missing from the forms. The people who change the oil in my car can prepopulate forms – and none of them got “meaningful use” taxpayer loot!

The best I have had for online interactivity is some of the forms being available as downloadable PDF. I can’t fill anything out online and have it saved, of course. I can just fill out the PAPER FORMS in advance (though my wife can edit the PDFs and at least type in the info).

Each providers and hospital seems to offer me a different patient portal – none of which share records with the other. They are also missing critical data like pathology reports. Cancer patients NEED pathology reports.

The oncologist’s office today was CALLING MY WIFE THE MORNING OF THE APPOINTMENT to try to get a copy of my original biopsy report. This was an essential record for the appointment, but they didn’t have it the morning it was supposed to take place.

(I thought the days of patients needing to carry all of their paper records around were over.)

I was booked for a set of CT scans (pelvis, abdomen, chest, and neck) – and had to tell the oncologist that I had just had two of those scans done at the end of June (UTI hospitalization). Had I not spoken up I could have received an unneeded high dose of radiation.

The office staff of one of the providers was honest and told me the problem is that none of these EHR systems can actually talk to each other. So, each office asks for the same stuff over and over again, even if you have already given it to multiple other doctors and hospitals.

Now, I did get handed a sheet of paper with a basic summary of information I had given them earlier from — of all place — my eye doctor. It was labeled as being for “meaningful use”. Unfortunately the summary contained the same errors that I had corrected when updating info at the start of the appointment.

One doc was willing to send me a PDF of a biopsy report via email, while another refused to do it citing HIPAA. C’mon, it is 2014 and patients use email! I will supply whatever HIPAA authorizations are needed, but I want my information sent to me electronically. Paper hard copies are 1914, not 2014.

I could go on, but basically I can’t find much evidence anything has changed after all those billions. Epic and a handful of other big EHR vendors got a massive infusion of taxpayer funds. That seems to be the big benefit of all of the HITECH Act spending.

Basically, at the patient level, it is still a disconnected, isolated, largely paper-based world. I am still the backup for ensuring Doctor A knows what Doctor B is doing – and have started leaving copies of medical records in the back seat of the car in case anybody needs them.

The HITECH Act may end up a colossal flop and plummeting Stage 2 and 3 meaningful use participation rates demonstrate that the promise of HIT isn’t meshing with the reality.

My prescription: A good first step would be to have prefilled forms waiting at physician and hospital offices, as I get tired of spelling out my name, birthday, and the same information countless times. If the most expensive and high-tech health care system in the world can’t pre-populate forms, then it isn’t really interested in demonstrating patient convenience. But then, if they REALLY want to do a good thing, get their @#$# portals to consolidate into one system that lets me see all my medical crap at once. It would be like if Facebook required you to have a separate Facebook account for each site you visited!

UPDATE: I did get a portal via the oncologist run by McKesson that, after a SNAFU in setting up, did have lab data on it. Yes! A small victory for patient convenience!


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