I often write about things that directly affect our region’s healthcare providers and participants in Hixny. Today, though, I want to address all of the many individuals who trust us to hold and transmit health records through our health information exchange (HIE).
My friends, professional connections and even neighbors frequently bring up two issues about their experiences with Hixny and the healthcare system. Both scenarios are good reminders that every individual in our region has the ability to improve the use of health information for themselves and others.
In the first case, someone goes to a Hixny participating facility, but the staff doesn’t access Hixny during intake.For example, one of my colleagues has well-controlled asthma, so when her inhaler didn’t calm down a recent flare-up, she visited a local urgent care facility out of an abundance of caution. Afterward, she explained that the triage nurse conducted intake using the electronic health record (EHR) from her last visit to that particular facility—three years ago!
My colleague has had routine care through practices affiliated with the same hospital as that urgent care facility—and even had significant surgery and labs at that hospital—within that time. Yet none of that was available at triage, so she had to recall 36 months of information rapidly and under a certain amount of stress.
Knowing that all of her providers, both within and outside the hospital’s affiliate network, participate with Hixny, she understood that all of those detailed records could be in the nurse’s hands within 30 seconds. So she asked whether the nurse could access her Hixny record. “Oh, we don’t look at that,” the nurse told her, “The doctors do.”
Needless to say, my colleague wondered why she had signed Hixny consents for all of her providers if the providers weren’t actually pulling up the information when it could be relevant and helpful. How “urgent” was the urgent care she received, she wondered, if the intake process and the treatment process were so disjointed?
In the second case, someone visits a highly respected specialist, only to find that the provider is not a Hixny participant. That’s the situation a friend faced recently, when he was referred to a local orthopedist for the treatment of a shoulder injury. Although he’d already seen his primary care provider (PCP) and consented to have his information contributed to Hixny, he found that the specialist couldn’t access it. Instead, he had to repeat all of the information he’d given the PCP and all of the information the PCP gave him in return. Then, the specialist’s office had to call the PCP’s office and request copies of all of his files to verify what he’d said.
In my friend’s opinion, that led to a potential breakdown in communication by relying on him to convey all of the details of his earlier care—as well as a clear delay in treatment while the offices exchanged, verified and reviewed files and records.
While he trusted the specialist’s clinical knowledge, he wondered why such a respected medical professional wouldn’t want immediate access to his most recent and most complete records before his appointment. Would his treatment have been faster or more specific to his situation if the doctor participated in the HIE?
For years, you’ve been educated to take an active role in your own care. Not every person who enters into a healthcare facility or provider’s office as a patient takes this seriously, but many do. And so, if you know an HIE exists and you’ve consented to having your data shared, you probably expect your providers to use that information early and often. If they don’t, then even if a provider is a leader in their field, you may question the quality of care you receive.
In fact, in 2017, we conducted a provider and patient survey in partnership with a local hospital’s emergency department. It turned up a stark difference in expectations:
- Patients were asked if they wanted their emergency department doctor to know all of their medical history prior to treatment—and 83% said yes.
- Providers were asked if their patients thought the providers were accessing the patient’s complete medical history—and only 43% said yes.
- At the time, the doctors hadn’t yet integrated Hixny into their workflow. So they couldn’t access each patient’s complete medical history at the time of their interaction.
- The difference in answers shows that patients expect doctors to use the technology available—and doctors may not yet realize that expectation.
Ultimately, you are a healthcare consumer and the use of your healthcare information to support providers’ diagnoses and decisions about your treatment is your concern. If you think a provider should have your information in order to provide you with better care, ask them why they’re not participating in Hixny, or why they’re not accessing your Hixny record as early as possible in your interaction.
In many cases, Hixny participation or the insertion of Hixny into a workflow is a business decision. As a patron of a healthcare business, your voice matters perhaps more than any other.