#in Vermont is good farm country. We like silos. They are as much a part of our landscape as the mountains. It seems that we are still building new silos here - information silos.
In a time when EHRs offer us the chance to share data across vaste geographic spaces with only a second delay, we are building too many EHR silos without interconnectivity or data exchange.
I spoke recently with a physician at one community hospital in Vermont. While admitting a patient from the ED, he has to surf through no fewer than 5 EHRs. The patient lives at a nursing home (EHR #1), sees a PCP in a local clinic (#2), and is now in the hospital ED (#3). The same patient was admitted to the same community hospital a month ago and was on the med/surg floor (#4) for two days before being transferred to the regional tertiary care center (#5). [And the local dialysis unit is on EHR #6, while the community hospital ICU remains on paper charting.]
With enough RDPs, gateways, virtual servers, tokens, and a dozen passwords, the physician can access all the data. Does that mean that access to patient information has improved with the implementation of all these EHRs? I'm not sure. When the allergy lists disagree, which is the source of truth? When unverified data from one EHR are copied into another blindly, do we perpetuate inaccuracies? We lose data integrity rapidly as we build silos.
I'm a big proponent of healthcare information technology. We must be very deliberate as we proceed. Only with information exchange, data sharing, and system integration can we improve care. Without such standardization, an EHR is only an expensive pen.
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