EHRs- why arent they linked nationally

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I am doing a paper on technology in the nursing field and it made me wonder..why aren't electronic medical records linked on a national level? So, if you live in Missouri, but have to go to the ED in California, or, lets say that my doctor is in clinton missouri, but I go to the emergency room in warrensbuerg missouri. that is not going to show up in your records unless you tell your doctor about it and they request the information.

I had a family member who had a PCP, cardiologist, nephrologist, hemotologist, endocrinologist, gastroenterologist, and finally an oncologist. She also went to various EDs depending on the expected wait time. She passed away recently and I cant help but think that if the medical records were all linked that maybe she wouldnt have fallen through the cracks and the different members of her medical team would have had a better understanding of what was going on with her other doctors.

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Specializes in Urology.

Two words. Proprietary Technology. Company A doesnt want to interface with company B, they are competitors after all. If you have used several EHR's you would understand the nightmare that it would be for them all to communicate to each other. The idea is nice and maybe someday we will have it, until then, were stuck with what a facility wants to run.

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Specializes in BMT.

The two words that come to my mind are big brother. If we have a uniform EHR, who would regulate it?

It's a great idea, in theory, but it unfortunately comes with ethical dilemma.

I also think of Blue Shields data breach, or UCLA's data breach. Imagine if that happened with a national EHR? That would be a disaster.

Also, a note to expected ED wait times: patients in the ED are seen based on acuity. If it's a true emergency, you don't pass go, you go straight to the back.

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Specializes in ICU, LTACH, Internal Medicine.

The "official" reason is HIPPAA and risk of security breach. This is what you would be told if you ask why a hospital cannot just release medical information so that "traveling" patient would be able to provide access to it.

Second, non-official but nevertheless real reason, is technology. A computer running this amount of information and not mixing John S. Smith from Michigan with 1001 other John Smiths will dwarf the cluster running EuroTransplant system.

The last (and, IMHO, most real) reason is the greed of companies producing EMR software and of hospitals which charge for keeping and providing medical information.

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These are really good responses and some I hadn't thought of.

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Specializes in Nephrology, Cardiology, ER, ICU.

Hmmm... Epic has this "care everywhere" option in our area so that when you go from one hospital system to the other, we (providers) have access to all records. Very helpful.

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Look up meaningful use, the government is paying hospitals to have a common language it is coming

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Specializes in ICU, LTACH, Internal Medicine.
Look up meaningful use the government is paying hospitals to have a common language it is coming[/quote']

It will mean, as the best outcome, using the same EMR system by everyone. This will eliminate "language barrier" but agencies still can keep whatever they want as "private".

The case of Mr. Snowden showed clearly what an idiot considering himself to be the World's savior can do with data "protected" by what was thought to be one of the best security systems currently available if he got a password and programming skills of an average 11-grader from computer science AP class. Here we are talking about database much bigger and needing much better protection. So, it is definitely coming, but not in the next 10 years as a bare minimum, just as technology develops. And that is before all the political outcry about "goverment know'in all that about everyone" even starts.

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Specializes in orthopedic/trauma, Informatics, diabetes.

This is why I am getting into the Informatics specialty. There is SO much work to be done and it is hard to keep up. They need nurses so things like a "coronary artery bypass graft" does not show up as a CABBAGE on the documentation.

There are about 10 major EHR companies, the big 3 being EPIC, CERNER and MediTech. Some smaller practices use a cloud based system. It is going to be interesting how this all plays out. I love that the EHR is supposed to be in place for reimbursement yet I don't believe the VA system has one in place yet.

Lots of opportunities in this field.

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If we as a nation moved to a single payer system, would there likely be a single medical chart or record accessible for every hospital?

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Specializes in orthopedic/trauma, Informatics, diabetes.

I am not sure anyone has thought that far ahead. Not that I think will happen anyway. who knows!

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Do you really want all the personal data in your medical records to be as easily hacked as your financial records are? I don't. As far as I'm concerned, my personal info is far too accessible already.

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