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Q&A with Dr. Danny Z. Sands

by Gus Iversen, Editor in Chief | March 24, 2015
Dr. Danny Z. Sands
A study conducted by ORC International and released by the Society for Participatory Medicine found that nearly 75 percent of American adults surveyed believe it is very important that their critical health information be easily shared between physicians, hospitals and other health care providers.

For most health care professionals, it's a relief to know that the general public is on board with record sharing because it is a central part of health reform and the overall initiative towards better, faster, more affordable treatments. So then why does it remain such an elusive goal?

DOTmed News spoke to Dr. Danny Z. Sands, co-founder and co-chair of the Society of Participatory Medicine and a practicing physician, about the hurdles remaining between the "dysfunctional" environment we have today and the integrated, open-access health care system of tomorrow.

DOTmed News: With so much conversation about integrated health records and access to meaningful information, why is the goal so difficult to achieve?

Danny Z. Sands:
Despite the dire need to have patients' clinical records available to physicians when they are caring for patients to improve the quality of care and reduce costs, it is still uncommon.

There are several reasons for this under the broad categories of technological, business, governance, and process, and overlaps among them.

Although physicians at many practices and health systems are now using an electronic health record, data would need to be sent to another site. This would have to be done using common standards for representation of data.

Moreover, there aren't yet mechanisms for a clinician caring for a patient to request a single data element or even an entire patient record from another facility.

In some parts of the country, this is done through a "health information exchange," which is a system with which participating practices and facilities share their data. Then authorized users can log in, identify the patient, and view their information.

DOTmed News: What are the barriers with regards to HIEs?

The barriers involve ensuring that patients in the region either opt-in or have the opportunity to opt-out, connecting as many health care facilities to the exchange as possible, streamlining the user experience, and getting busy clinicians to use the information. (In very few cases is this information available to clinicians directly through their EHR and stored along with other data.) Practices and facilities don't necessarily want to release the information, because that would mean patients could be seen at other facilities, and receiving facilities usually get paid every time they perform a test, so they're happy to repeat any tests needed.

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