Hospital CMIO: Patient-centered HIE would cut back on duplication

Patient participation in health information exchange efforts would go a long way toward improving quality and safety efforts, according to Joseph Schneider, vice president, chief medical information officer and medical director of clinical informatics at Baylor Health Care System.

Schneider, in an interview with the Institute for Health Technology Transformation, says that to date, care centered primarily on the concept of using electronic medical records--rather than on patients themselves--leads data to oftentimes be inconsistent.

"In any one EMR, a physician may take the time to keep their problem lists clean, but when EMRs share data in HIEs, problem lists rapidly can become useless because of data overload," Schneider says. "[B]y making patients responsible for their--i.e., making them a personal HIE--we will have better information because patients will be responsible for it."

One catalyst, Schneider says, is the fact that many patients already believe that their data is unsafe, especially in digital form. At a health law summit in Washington, D.C., last month, attorneys and other privacy experts talked about how providers are having a particularly difficult time complying with HIPAA's security rule, noting that the vast majority of security breaches reported to the U.S. Department of Health & Human Services have involved the compromise of electronic protected health information in EMRs, laptops and mobile devices.

"[I]t's going to become increasingly difficult for patients to feel that their data is secure, given our history," Schneider says. "Each year the records of millions of patients are exposed and cumulatively this has to be creating mistrust of our ability to protect data. So more and more, patients will begin to insist that we don't do data exchange to an HIE, but rather they will insist on getting their own data."

According to some researchers, patients want to be more active participants in their own care. A study published last fall, for instance, determined that patients able to view their lab results online overwhelmingly reacted positively to being able to do so.

Speaking at the Information Management Network Hospital Cloud Forum in New York last spring, David Mendelson, a professor of radiology at Mount Sinai Medical Center in New York, called personal health records "less cumbersome … for exchanging health information," adding that they encourage patient engagement.

"You as the consumer are interested in controlling the flow of your data and expediting that flow when necessary," Mendelson said. "It actually eliminates a whole set of consent issues out there."

To learn more:
- read the full IHT2 interview