Bringing Healthcare Records Into the Digital Age

It's common knowledge that the healthcare industry is undergoing a transformation. While the results of this process are still uncertain, one possible future is apparent in a project underway right now in Rome, Ga.

MyJourney Compass, a program supported by the Georgia Tech Interoperability and Integration Innovation Lab (I3L) is designed to help breast cancer patients be informed about and participate in their treatment process. Patients are given tablet computers, which provide credible cancer and cancer treatment information, secured access to clinical summaries of their provider-based medical records, and a symptom tracker to keep their caregivers updated on their condition.

When I first got diagnosed, I got handed huge stacks of papers, handouts and books,” said Koren Sinnock, a patient in the project. “I just stuck it all in the closet and didn’t even look at it because that giant pile of information was just too overwhelming.”

In contrast, the MyJourney suite's portability and ease of access has already made a noticeable difference, as her records are not buried in filing cabinets or dispersed across various locations. “It gives me a sense of freedom that I can actually leave town and know that I can have my medical information related to my cancer with me.”

This is the ease and freedom that the I3L team wants to bring to the management of health records. Steve Rushing, a member of the team, draws an analogy to personal financial information, noting that the goal is to make healthcare transactions just as seamless and transparent – hospitals should be able to easily exchange information with health services consumers and each other in the same way banks can.

“The way it all came together in other industries – banking, the travel industry – they all came together and agreed on standards,” says Rushing. “For a lot of complex policy and financial incentive reasons, hospitals and the large health systems many belong to have struggled to accomplish this goal. So the government said, we are going to accelerate a public and private consensus on interoperability standards.”

The legislation Rushing is referring to is the 2009 HITECH Act, which allocated billions of dollars in funding to the healthcare industry to improve health IT systems. Part of the Act stipulates that, starting in 2015, any healthcare provider doing business with the federal government will be required to use electronic health records, which are interoperable between different hospitals and physician practices in accordance with standards specifications.

While some hospitals and health systems use electronic records and some still use the lo-tech methods of mail and fax, there has been little agreement upon industry-wide, open standards for transferring information between different health systems or, sometimes, even different specialties in the same system. “The problem is not limited to lack of format or transport standards. There is also the problem of semantic inoperability,” notes Rushing. “What things are called can be very different between hospitals.”

I3L's Marla Gorges notes an example that the lack of even basic interoperability routinely poses patient safety issues in emergency situations with patients, where emergency responders are unaware of the network of caregivers and pharmacies involved in managing a chronic condition. “Wouldn't it be ideal if your primary care physician's system, cardiologist’s system, the pharmacy and your own online health portal... if you passed out, it would be easy to share and reconcile everyone's information about you so that they would know how to avoid dangerous or even fatal contraindications?”

This interoperability problem, 'one of the most fundamental problems in healthcare delivery,' as Rushing describes it, and its barrier to improving patient care coordination – is I3L's grand challenge, the problem it was created to solve.

The organization is working to bring together different stakeholders to develop a ‘living test bed’ to contribute to consensus agreement and then accelerate understanding, adoption and deployment of the rapidly emerging Health IT standards promulgated by the Office of the National Coordinator for Health Information Technology, a division of the US Department of Health & Human Services, working in concert with the industry standards development organizations. I3L is greatly helped by the fact that Atlanta is a major hub for companies in Health IT, with over two hundred companies tackling various elements of digital health management. Rushing and his colleagues at I3L hope to bring the Atlanta Health IT entrepreneurial forces to bear, along with those of policymakers, academics and of course, patients themselves.