Regional and Community Health Information Exchange in the United States

Introduction

Imagine a situation where a patient is sitting in a medical office for a visit. The doctor arrives, greets the patient, logs in to the electronic medical record and accesses the patient’s medical chart on a computer in the room. After verifying the full name and date of birth with the patient, the doctor proceeds to a screen that provides a historical view of the patient’s medical visits. “I see that you live in the neighboring town, and you have been seen by a medical group there for the past 5 years. I also see that you have transferred your care to my practice today, and your doctors have provided a summary of your condition for me to review. You have a history of high blood pressure, diabetes and high cholesterol. Looks like you have had laboratory testing performed in the past 3 months and all your numbers look great! Your recent chest x-ray and echocardiogram show no abnormalities. You are on several medications for your medical conditions and have been regular in picking up and refilling your medications. I also note that you experienced chest pain while visiting your daughter in another state last year and, fortunately, the hospital admission and testing there revealed no damage to your heart. According to your personal health record that you maintain and have given me access to, you have been feeling well and are quite active. Your local public health department identifies you as an early recipient of the new H1N1 swine flu vaccine. Let’s pick up from here. Please tell me how you are feeling today…”

This elaborate introduction signals the start of an excellent medical visit that is both satisfying and time well spent for the patient as well as the doctor. If you look carefully at this visit, the patient’s medical history, detailed medical records, laboratory testing, diagnostic imaging and pharmacy records from several different unaffiliated providers and healthcare systems were available to the doctor instantaneously at the point of care. This held true whether the prior visit was in the neighboring town or another state. The new doctor would not need to repeat any of the testing recently performed nor would he/she have to “reinvent the wheel” in caring for this patient. The personal health record was a bonus feature that provided information on current and ongoing health issues as reported by the patient. The result is increased patient satisfaction, preserved patient safety, improved efficiency of the healthcare system and overall decreased expenditures.