3 ms·
The problem is not necessarily closed systems or lack of interoperability support. In your situation with CT scan, it sounds like there was no electronic way t
by nwhatt 9y ago
The problem is not necessarily closed systems or lack of interoperability support.
In your situation with CT scan, it sounds like there was no electronic way to share the digital version of the CT scan. Furthermore, if there was an electronic way to share it, your ER where the patient presented would need to be connected to any and all other facilities they could be transferred to.
To further complicate matters, and electronic CT scan isn't really EHR functionality, it goes straight from the CT device to a PACS (picture archiving and communication system). There may be integration with the EHR, and definitely with the RIS (radiology information system), but outside of those two, you're talking about transferring 100s of MBs to GBs of data to the other hospital.
If I ran your hospital IT team (or rather the hospital you're referring people to) I would prioritize integrating the two. Duplicate scans cost them money, and if you have choice over where you refer patients - the integrated hospital will always be preferred right?
- Spooky23 9y agoThe problem is that IT and regional monopolization shouldn't drive patient outcome. The technology is a cancer here -- it's literally made everything other than prescribing (Note that pharmacies do interoperate) measurably worse. Paper & fax was better. A family member just was hospitalized for a serious issue that requires rehab, and the default from the hospital is to get you into an affiliated facility (a nursing home). The better facility (a rehab hospital) for this person's condition is in a different network. We handled data transfer by putting the records in my hands and delivering them to the physician hands at the rehab facility. If you're not aware of these differences and pushy, you'll get sent to the default and likely have a worse outcome. So my family member gets stuck with a worse quality of life, and the taxpayer via Medicare gets to spend exponentially more on providing care.
- robmiller 9y agoit sounds like there was no electronic way to share the digital version of the CT scan Seems unlikely. A few years ago I was given a CD-ROM of the scan of my jaw and was able to download a free DICOM viewer to look at it. These things seem to be standardized. Wasn't really excited to take that much dose to my head but at least I have the souvenir of a 3D view of my jaw...
- nwhatt 9y agoBy electronic I meant over a network - a burnt CD may have well been the media that got lost in OP's situation. The problem is that the digital scan is isolated to his ER's network, and without a business relationship between the two parties, a CD is the only way to transmit the data.
- ch4s3 9y agoThis is pretty key and why HIEs exist. They're a hackish solution though. Some sort of national data exchange would be useful.
- specialist 9y agoI wrote a DICOM fetch and view app (mid 2000s). Image viewer was the easy part. Network interop was a mess. Worse than any ASN.1, SNMP, or XML-based interop work I've done. I can't imagine it's gotten any better since.