TMC PULSE

T M C » P U L S E | J U N E 2 0 1 8 5 Thank You for Sharing It's getting easier to share health records in real time, but progress is slow B y R y a n H o l e y w e l l D uring a trip last summer, Sanjay Mishra, M.D., collapsed in Philadelphia International Airport. The child psychiatrist recovered after a weeklong hospital stay for undiagnosed severe coronary dis- ease. A 95 percent blockage in his main artery was cleared by cardiac catheterization. On his way home, his wife, Seema Verma, MPH, who oversees Medicare and Medicaid for the fed- eral government, asked physicians for Mishra's medical records. She wanted to take them to his health care providers back home in Indiana. "The doctors looked a little uncomfortable and they said they would get back to me," Verma said during a speech to health infor- mation professionals in Las Vegas earlier this year. Eventually, she received five pieces of paper and a CD-ROM. After finding a computer that could read a CD—no easy task in 2018—Verma discovered the disc was missing several test results, including her husband's MRI. The experience left Verma, one of the most powerful health care administrators in the nation, deeply concerned about the challenges of sharing patient records. "I couldn't help but contemplate the disconnect between the genius of the medical system that used the latest technology and science to save my husband's life, but didn't have the tools available to just give me his medical records—which I thought would have been the simplest task out of all they had performed," she said at the confer- ence of more than 40,000 health IT professionals. * * * * * In the greater Houston area, health leaders say we're on the verge of a major development for elec- tronic health records accessibility. Greater Houston Healthconnect, which launched in 2010, has created the infrastructure and policies to allow the region's health care providers to share patient data in real-time—even when doctors and hospitals use different systems to manage patient records. "To do that is easier said than done," said Nick Bonvino, the non- profit's CEO. Health care institu- tions, he explained, "were not built to do this." So far, Greater Houston Healthconnect includes most Texas Medical Center hospitals and their suburban affiliates, as well as clin- ics, locally-based insurance plans, health districts and large physicians' practices in two dozen counties in southeast Texas. But until recently, the network had one serious shortcoming: It lacked two major regional health care providers, Memorial Hermann and HCA Gulf Coast Division Family of Hospitals, which, together, include more than 24 area hospitals. However, in recent months, both have joined the network. Though neither is fully live quite yet (integrating records requires more than just flipping a switch, Bonvino noted), both should come online imminently, he said. The stakes, federal officials and other experts say, are tremendous. For starters, an inability to share patient data in real time can jeopar- dize safety and lead to suboptimal care. Longer term, a prolonged period without shared electronic medical information could prevent providers and patients from fully benefiting from the growing power of "big data" and artificial intelli- gence—twin technological powers beginning to unlock the secrets of diagnoses and treatments. * * * * * Nearly 15 years ago, President George W. Bush announced a 10-year plan to create a network that would allow health care providers to share medical records, but that vision still hasn't fully come to frui- tion. The aim was for physicians to be able to share patient data easily to prevent medical errors, reduce costs, provide information during emergencies and improve care. The plan, announced in 2004, also envi- sioned giving patients the option to carry all their health information on a key chain—the modern smart- phone hadn't been invented yet. So far, regional health care information-sharing networks are making progress across the country, including here in Houston. Still, there are gaps in coverage: Records aren't connected nationally and patients often lack full access to their own information. (continued) I couldn't help but contemplate the disconnect between the genius of the medical system that used the latest technology and science to save my husband's life, but didn't have the tools available to just give me his medical records ... — SEEMA VERMA, MPH Administrator of the Centers for Medicare and Medicaid Services Seema Verma, MPH, speaks during a news conference in 2017. Credit: Julio Cortez, Associated Press

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