What if a Web site, a card in the wallet or a thumbprint could tell all about the person’s medical history? At a touch of a button, a swipe of a card or a read of a fingerprint, doctors worldwide could know all there is to know about their patients’ medical past, including their allergies, medications they are using and radiology reports.
A group of local residents is leading an effort to introduce a Northern Virginia Regional Health Information Organization (RHIO), a system that would allow doctors and other care givers to access a person’s health information from anywhere. The group met in Reston on Saturday afternoon to present some ideas at its first community meeting, entitled ‘Better Communication, Better Care.’
"We are here to try to figure out the right way of making this useful," said Ian Kremer, a member of the group and a public outreach director for the National Capital Area Chapter of the Alzheimer’s Association. He added that in his field, Alzheimer’s disease, it is not the patients who hold most of their medical information, but rather a member of the family or someone close to them. At times it proves difficult to track down all of the necessary information if the patient sees another doctor. With a RHIO, and patient’s consent, the doctor could access the information more quickly.
Helayne Sweet faced a situation in which her father, now 82, was hospitalized while on a trip to Canada. It took days for her to gather, send and coordinate information and communication between the physicians in Canada, her father’s regular physician in Richmond, and herself in Oakton. "There were numerous calls about his medical history between Halifax, Richmond and myself," said Sweet. "The system is broken. It’s broken enough that I need to do something to fix it," she added.
Sweet said that Northern Virginia is a transient area, with many people moving in and out, and many people who travel a lot, for business or for pleasure. She said that parents who send their children to school elsewhere in the state or country would probably want doctors there to be able to access medical information they need to provide treatment to the student.
Gary Klein, a chief medical information officer with the Department of Homeland Security, was one of the first responders to victims of the terrorist attacks of Sept. 11th, 2001. He said the physicians at the scene had no information at all about the people whose lives they were attempting to save. "In an emergency situation, I don’t have the ability to know where, what and how, and yet I need to know that," he said. From a DHS viewpoint, he said, the greatest success story would be to create a system where a person’s thumbprint could be taken and all of the medical information would show up.
"This is a no-brainer, this is where we have to be," said Klein. "Northern Virginia has such technological resources, and it is beyond comprehension to me that we are just now starting."
THE RHIO WOULD give consumers, or patients, an option to have their medical information stored in one place — a Web site with a database, a card or some other medium — so that doctors and other care providers could access it from anywhere. Some of the technology for such a purpose already exists. It seems that the technology that does not exist already would be easy to identify and develop, especially in technology-rich Northern Virginia.
"We sit here, in what I call the epicenter of technology, and there are lots of opportunities to use that technology for the benefit of the community," said Supervisor Catherine Hudgins (D-Hunter Mill).
Because the Northern Virginia initiative is relatively new — Saturday’s meeting was its first public meeting — those who would oppose a medical information system have not been identified yet, according to Kremer. However, a major point of contention may prove to be the fear of keeping private and medical information secure.
Klein used the example of the banking industry, and wide acceptance of the use of automated teller machine (ATM) cards. He said when people traveling in Turkey need cash, they take out their ATM card and use it in a Turkish bank. The moment they withdraw money, the bank knows the account number, the balance on the account and much more information about the customer. When the system was first introduced, Klein said, some people did not want to risk revealing their financial information, but within a year the system was widely accepted. "We view our health information to be sacred, absolutely sacred, yet our financial information is known to everyone from the government on down," said Klein.
Ken Geoly, a doctor specializing in nephrology, said he believed the Northern Virginia RHIO would be patient driven. He described the system through an analogy of a deposit box, where the bank and the consumer must each have a key to open the box. The only way someone could access the information is if the consumer agreed to let him or her access it. "If you say, ‘No,’ it doesn’t happen," said Geoly.
WHILE THE IDEA for a RHIO is new to Northern Virginia, it is not revolutionary in the country. Some systems in the nation are considered to have failed already. Klein talked about why the system in Santa Barbara County, Calif., failed. "Santa Barbara failed because it did not ask consumers, ‘What is it you want, what is it you need,’" said Klein. He said he believed the Northern Virginia system, in its early stages, is different than other ones he has seen in the country because it is attempting to build its system from the consumers.
"The Northern Virginia effort is for consumers, by consumers," said Kremer.
Another reason why it is important to build the system from consumer input, according to Klein, is that the nature of acquiring health insurance is changing. While today most people obtain health insurance through their employer, Klein said employers are starting to put more pressure on the employees to care for their own insurance. Therefore, the consumers will have to be able to understand their own health care needs. He believes that is a good thing, because insurance companies will start vying for consumers’ individual business. "When they have to vie for your individual money, that will create competition," said Klein. "Costs will be lower, and more importantly, [insurance] companies will listen to you," he said.
Community pressure is key in bringing all of the actors — insurance companies, different hospitals and clinics in the region and businesses that provide insurance for many employees — to the table. Kremer said he believes that the Northern Virginia RHIO is the only system of its kind that is getting its start from the consumers.