By MERLE BUSHKIN
I recently asked my primary care physician’s medical records department for copies of my records spanning the past eight months in which I had four office visits, five blood tests, and nine brief email exchanges. I should add that my PCP uses one of the two most popular DME systems.
To my surprise, I received 274 pages of digital documents (PDF). I heard about “record bloat” but it was a blast!
When I analyzed their content, I found that 59 pages were legitimate documents with “original” information and data. 22 pages were office notes – or what are often referred to as progress notes – applicable to my four visits; 14 were reports of my five blood tests; 23 included my nine email exchanges. In short, they were “normal” – what you would expect from the amount of contact I had with my doctor and his lab.
But the 212 remaining pages shocked me. They were totally unexpected and, in my opinion, totally unnecessary! It was a slicing, dicing and overhaul of the content of the 59 base pages! They included 82 pages of “Outpatient Visit Instructions” (which I was never given) and 62 pages listing my vaccinations, medications, problems, procedures, orders, and medical, social and family history – which are all covered by my providers. “Office notes!”
I believe these overhaul notes are a result of the effort to standardize medical records so that physicians and other healthcare providers can exchange patient records – you know, using FHIR, HL7, API, CDA, CCDA, etc.
But is this massive explosion of registrations and the resulting confusion and chaos really necessary to achieve interoperability? Moreover, all this repetitions and re-foundations of data and bloating does not guarantee that the standardized information sought is available as the provider often enters it in the wrong data field!
What scares me about all of this is that either the people who brought up this system are either unaware of these issues or they don’t care, which would be even worse!
A Texan would say these bloated systems “are all hats and not cattle!” Others would say “they confuse movement for progress”. I’m saying this solution is much worse than the problem and we need a different approach and system. One that is simpler, more complete, easier to use, less expensive and that meets everyone’s needs.
I suggest we take a page from search engines like Google, Yahoo, and Bing and focus on managing disparate records rather than trying to share standardized data that’s stored in silos – an approach we know we don’t. function.
We are doing this today and everyone can benefit tremendously from it! So let’s stop creating chaos and wasting time, talent and money!
Merle Bushkin is Founder and CEO of Health Record Corporation, creator of MedKaz®, the patient-focused personal health record you have in your pocket.