Achieving Productive Information Exchange

The Direct Project is designed to revolutionize exchange of health information between providers. No longer will providers’ offices need to fax copies of patient charts between physicians’ offices. The Direct Project envisions a future where two providers can electronically and securely transfer patient data from one physician to another. It can be thought of as a HIPAA compliant email system.
The transition from current to Direct Project technology is like moving from using faxes to email to coordinate my work calendar. But is this enough?
Imagine I have three ways to coordinate an hour long meeting for my work calendar:
  • Via fax
  • Via standard email
  • Via an appointment
Option 1: I could send a fax to my colleagues explaining the meeting details. They would need to collect the fax, bring it to their desk, accurately fill in the meeting details on their own calendars and remember to attend. Rate of meeting coordination success would be low.
Option 2: I could use an unstructured email with the same details as the fax. Participants wouldn’t need to pick-up or carry the fax to their desks, but they would still need to transcribe its contents to their calendar and set a reminder for themselves. Rate of meeting coordination success would be medium, at best.
Option 3: I could send an appointment to my colleagues. With one click, my colleagues could accept my meeting, add it to their calendars, and be reminded of it fifteen minutes before it is to occur. Rate of meeting coordination success would be high.
Doctors currently use option 1 to share patient information and the Direct Project is akin to option 2. The rate of doctor coordination success will be medium, at best. This is an improvement over the current standard, but option 3 is superior. Why are we not reaching for option 3 when patients’ lives are at stake, productivity needs to be increased, and efficiency gains can only help to decrease health care costs? It is harder. Much harder.
There could be an option 3 for small practices. Practice Fusion currently has over 70,000 US physicians in its network and is growing rapidly. Rather than use an external system such as the Direct Project to act as a third-party message relay station between physicians, Practice Fusion could leverage its large network for secure messaging that is directly integrated within the EHR. Further, the system could use structured elements (similar to the time, date, participants, etc fields of an appointment) to ensure that data is transmitted among physicians instantly, effectively, and without error.
Option 3 could provide a more seamless user experience and achieve quantifiable productivity gains for providers. It would give small providers the ability to achieve not just basic data exchange, but true physician interoperability.
Now is the time to strive for option 3. Providers and patients deserve a system that accomplishes more than an e-Fax. Web-based EHRs provide the service, scope, and access to enable small practices to achieve the patient coordination that we all deserve.
Thomas McMennamin, MBA, MPH
Health Policy Manager
Practice Fusion EHR

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