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When You're the NFL Commish, Getting E-Medical Record Interoperability's a Cinch
Lucas123 writes: The NFL recently completed the rollout of an electronic medical record (EMR) system and picture archiving & communication system (PACS) that allows mobile access for teams to player's health information at the swipe of a finger — radiological images, GPS tracking information, and detailed health evaluation data back to grade school. But as NFL football players are on the road a lot, often they're not being treated at hospitals or by specialists whose own EMRs are integrated with the NFL's; it's a microcosm of the industry-wide healthcare interoperability issue facing the U.S. today. The NFL, however, found achieving EMR interoperability isn't so much a technological issue as a political one, and if you have publicity on your side, it's not that difficult. NFL CIO Michelle McKenna-Doyle, who led the NFL's EMR rollout, said a call from a team owner to a hospital administrator typically does the trick. Even NFL Commissioner Roger Goodell once made the call to a hospital CEO, "and things started moving in the next couple of days," McKenna-Doyle said. "They're very aware of the publicity."
He needs that info right away so his boys can stand around in a field and do nothing for 3 hours!
My limited experience with medical records is that it isn't the hospitals that have issues interoperating, it's the vendors of the software. Try and convince them to give you access to the data in their system and they'll ask to sell you some hugely expensive component whose sole purpose is to translate their proprietary data format into a standards-compliant format. (And, again based on my limited experience, the "standard" version is so vague that you basically have to deal with every single vendor's output in a unique way anyway.)
My experience was limited because in the end we flat-out gave up trying to get data from EMRs because we weren't the NFL and therefore didn't have the clout to make demands.
Now if only the NFL could use their amazing abilities to rapidly get EMR interoperability to actually punish a team that's been caught repeatedly cheating and fraudulently "won" this year's Superbowl...
...fuck hospital administration?
I read TFA and the author completely misses the issue. The Clinton administration tried to implement this and congress (rightfully) voted against it. Until congress revokes the Patriot Act and proves that the Bill of Rights is still a valid contract, no informed citizen wants their medical records stored in a national archive. The privacy implications far outweigh the benefits and no amount of PCI compliance is going to ease that concern when the man-in-the-middle is tapping backbones with god damn nuclear submarines and lying to the tax payers about it. I'll stick to carrying my medical records in a banker box, thank you.
At what cost to all the other projects the hospital's IT department is working on? Every time one of these 'drop everything, the CEO wants this now!' projects come along it hurts everything else.
Yes, and what happens when the rich powerful hospital CEO doesn't get the ball rolling for the rich powerful team owner? Bad publicity. See, it isn't about the publicity from what they are doing, it's about the potential publicity from not doing it.
*HIPAA (heathcare information portability and accountability act) shouldn't apply so long as the caregivers working on the players are legitimate. Treatment, payment and operations exemptions are in HIPAA to allow just this sort of thing. So long as Doc A is actively caring for the patient, he has clearance to see Doc B's records. Likewise, when the bills are processed, those directly involved with itemizing/coding charges and then collecting from insurance or other payers can access the info as well. But in all cases, only insofar as needed to do what they need to do and in such a way they don't leak info to uncovered third parties.
Defending IP by destroying access to it? That makes sense, RIAA/MPAA. Go to the corner until you can play nice!
Disclaimer: PACS employee for state wide health system here...
Calling Bullshit here that it's as 'easy as a call to the Hospital Administrator'. All EMR systems are not created equal, and DO NOT all play well with one another. EMR systems CAN and do fall into vendor lock in. Our system that my hospital system uses, has somewhere between half a dozen to a dozen major hospitals in the US that use it. Possilby more, but I haven't been made aware.Why mention that? Read on.
Here's your example: The ONLY way we could do EMR sharing with an external hospital for patient PACS EMR information, is if that other hospital used the same PACS software that we use. There was a case here recently, where a hospital a few states away, DID have the same PACS package, and we were able to allow cross hospital EMR and image viewing for a patient who needed an organ transplant. Since they could view the records easily, vs. document and image faxing that it used to be... and since they had a donor for the organs, patient was transferred rapidly, and received the organs. Only made possible because of rapid access to the patients EMR and PACS.
Point is, the software package we use, restricts us to only those hospitals who use that same package for EMR image sharing for patients. The same can be said for a lot of hospitals. It IS vendor lockin. The NFL is not immune to that.
As for the 'NFL Commish' making a call? I'm sure he found out the nearest hospital that had the same, or a compatible, EMR and PACS systems with what the NFL uses and this is just publicity than the 'great breakthrough' of possibility with EMR & PACS in general.
And as far as where the tech side of things is at with EMR and PACS? (This is what I do...) There aren't enough hours in the day, and enough people in my department, to bring our system into what I would call, stable, and bulletproof! We aren't there yet by miles, and are still subject to corporate bullshit and politics.
True, but I expect the players sign a release authorizing the team or NFL to request their medical records. You can release your records to anyone you darn please.
Well, true. HIPAA itself doesn't really dictate technology, other than to say PHI / PII must be deidentified or encrypted if not transferred point-to-point.
My intent with my reply to AC was to illustrate that records-sharing doesn't necessarily violate HIPAA so long as qualified providers are doing direct care or TPO.
That said, what should be feasible at any hospital with HL7 or similar standards-based interfaces for existing vendors and/or a relatively modern EMR is that they can export the data and leave it to the NFL's team docs and IS people to import it into a human-readable form on their side.
Defending IP by destroying access to it? That makes sense, RIAA/MPAA. Go to the corner until you can play nice!
The original HIPPA law was called the "HIPAA: Health Insurance Portability and Accountability Act" but the portability never happened.
Calling HL7 a standards based interface is a very very large joke. It's about as 'standard' as semi-formatted XML document. Yeah you can communicate the structure, however each hospital/vendor/mapper implements where the data goes differently, hence the massive interop headaches.
While the NHL could generate their own canonical format for storage, they would still need to map it to each and every EMR they interacted with. Curious how they solved that one.
* We dance where angels fear to tread *