Last week was HIMSS in Las Vegas.
While I was unable to attend this year due to a new role, new company, and not enough time to dedicate to being a Social Media Ambassador I was still able to interact and attend virtually through the power of Twitter.
As in similar years, the big themes of HIMSS were:
- Physician frustration with workflow
- Patient’s frustration in accessing their medical records
- Interoperability (or the healthcare system’s refusal/inability to share patient data with other clinicians, aka data hoarding)
There was a wonderful post on the Healthcare Blog by Ross Koppel and Stephen Soumerai entitled, “Dear CMS Administrator Verma.” I encourage all of you to read it.
It ignited some very passionate discussions online and in person.
I have a few opinions myself based on my own experience as a stakeholder with hospitals, medical technology companies, as a clinical person, and as a patient.
I believe the argument that many hospitals and healthcare organizations use that the data housed in their EMR, EHR, PACS, HIS, RIS, and other IT systems being Intellectual Property is weak.
I do believe that the data feeds the enablement of their clinicians, scientists, and others to develop unique algorithms and tools that help them to improve their clinical care (HCAHPS/CG-CAHPS), their business, their operations, and maybe the occasional improvement to patient experience.
I would agree that the algorithm(s) or modeling that is built from the data is intellectual property.
As we begin to move into the world of machine learning, deep learning, and artificial intelligence I would also agree that those models are intellectual property.
Here is the but….but in order for the above models to continue to iterate, improve, learn, and become more robust they need to continually ingest more and more data…..a patient’s data.
This is where the problem resides.
The patient does not have a say in whether they would like to opt-in or opt-out of the data share. The patient does not have readily available simple access to their data. (No, online portals are not simple nor are they complete) The patient does not get an option to share in the revenue if or when the developed algorithm becomes a commercial product. The patient may not even get free access to the algorithm.
Technology, in this case, EMR and EHR, is neither good or bad. It simply is.
It is the people that determine whether or not technology is implemented and used in a way that brings positive or negative value to patients, physicians, and others within healthcare.
We can sit here and point a finger of blame towards Epic, Cerner, McKesson, or even the Government but we need to realize that those of us that accepted the incentive, purchased, implemented, and adopted EMR/EHR share the blame as well.
We did not push and mandate that our expectation for EMR/EHR adoption was to break down the silos and barriers. We did not demand technology implementation to connect all us more intimately. We did not ask how this will allow us to focus more on patients. We did not ask how this builds a longitudinal view of the people in our communities. We did not command that our systems need to share simply from one competitor to another. We did not consider that what the government giveth that the government can taketh away.
Instead, we took the money, we shared best practices, and we tried to keep up with the Jones’s.
We failed to remember that outside of healthcare, technology connects the globe at the N of 1.
Healthcare is meant to be delivered at the N of 1.
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