Cloud-Based Medical Info: ONC, Feds Miss the Obvious

The federal Office of the National Coordinator for Health IT (ONC) has developed a Federal IT Strategic Plan aimed at reducing IT disparities between underserved communities. ONC published a draft of the plan in an online blog and is now seeking comments and suggestions.

We have one suggestion: Promote widespread adoption of cloud-based medical information exchange.

While the plan refers to telemedicine in general as one way to improve the usage of healthcare IT, there is no evidence the ONC recognizes that this long-used term should now include cloud-based data exchange. Nor is there any recognition of the superiority of cloud-based services for meeting the plan’s other goals.

Three of those goals are:

• Achieve adoption and information exchange through meaningful use of health IT

• Improve care, improve population health and reduce healthcare costs through the use of health IT

• Inspire confidence and trust in health IT

Cloud-based medical information exchange advances these goals in many ways.

Because it is vendor-neutral, it overcomes incompatibilities between different facilities’ IT systems –not just in underserved communities but also in the common scenarios where a rural facility is transferring patients with complex conditions to better-equipped institutions outside the community. Here is an example of just such a set-up in the San Diego area, where eMix has made a big difference:

The modest, per-usage fee for using a service like eMix also makes it affordable and scalable for underserved communities. No software or hardware purchase is required. Nor is there a maintenance contract because maintenance is the service provider’s responsibility.

Cloud services reduce costs in other ways, too – by avoiding the substantial labor associated with virtual private networks and the labor, postage, and courier costs associated with burning and sending files on CDs.

Cloud-based medical information exchange improves care, as well, because it is a much faster way of getting medical files in the hands of the physicians who need to see them. This is especially true for emergency cases.

Finally, cloud-based exchange inspires confidence and trust in health IT because it ends the frustration that until recently characterized most efforts to exchange files between IT systems. Until recently, sharing files between systems that didn’t talk to each other was labor-intensive, expensive, and loaded with breakdown potential.

Those days are over – but only for the institutions that are taking advantage of the technology.

If the ONC is serious about its goals, then it should be promoting this simple-to-adopt, simple-to-use solution in its strategic plan.

Healthcare IT’s Failings: Even the Onion Has Noticed

How far behind is healthcare in the full and efficient use of information technology?

So far behind that even The Onion has noticed.

The satirical newspaper and website normally focuses on “stories” such as Joe Biden’s fascination with hot babes and his muscle car. Recently, though, The Onion took aim at the shortcomings of healthcare IT with an article titled “Quick-Lube Shop Masters Electronic Record Keeping Six Years Before Medical Industry.” Written in typical Onion style that makes it seem like an actual news report, the article quotes a fictitious garage owner:

‘We figured that a basic database would help us with everything from scheduling regular appointments to predicting future lubrication requirements,’ said the proprietor of the local oil-change shop, Karl Lemke, who has no special logistical or programming skills, and who described his organizational methods, which are far more advanced than those of any hospital emergency room, as ‘basic, common-sense stuff.’

‘We can even contact your insurance provider for you to see if you’re covered and for how much, which means we can get to work on what’s wrong without bothering you about it. The system not only saves me hundreds of thousands of dollars per year, but it saves my customers a bundle, too.’

And here’s the part that really hurts: “Lemke added that he also routinely and politely inquires about his customers’ health and well-being, which puts him roughly 145 years ahead of the medical industry.”

Of course things aren’t nearly as bad as The Onion makes them out to be.

Thanks to the efforts of cloud computing pioneers such as eMix and others, things are in fact getting better. And hundreds of millions of federal stimulus dollars are flowing into healthcare to get MDs’ office online and to computerize and interconnect hospitals’ records through PACS and other technology.

But as one wag said about The Onion story to blogger Neil Versel, the current status of medical industry It is “so pathetic that a bunch of young joke writers in NYC who almost never go to the doctor have noticed.”