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An EMR to Call Your Own?

I met a friend of a friend recently who was just back from deployment in Iraq. As a major in Special Forces, he saw firsthand the life-saving value of having a soldier’s medical information quickly accessible.

His experience in combat gave him an idea. Private healthcare providers don’t have anywhere near the number integrated electronic medical records for civilians that the Army maintains on one system for its soldiers. Even when organizations do have such information, records at various providers can’t “talk” to each other. So this Iraq veteran came up with Safe-Key—basically an inexpensive, standard USB jump drive that stores your medical history, medication allergies and previous procedures. The idea is that you keep it on you at all times—on a key ring or around your neck—just in case. The drive is preloaded with a few digital versions of paper forms that, once completed, show as much of your medical information as you’re willing to provide to anyone who happens to find you unconscious, say, after you’ve been hit by a dump truck.

It seemed to me to be an unusually simple fix in an industry that thinks more in terms of universal, impossibly expensive solutions. Why waste a few dollars on a flash drive that has some value when the ultimate goal is to spend billions on an interoperable IT infrastructure of electronic medical records? EMR champions, of course, point to the potential savings effective EMR implementation and networking could produce by cutting waste and medical errors. Calculations in a recent Health Affairs study suggest the nation’s healthcare bill could be cut by a cumulative $513 billion by 2019, measuring about 1.05 percent of aggregate health spending between 2004 and 2019, says author Clifford Goodman.

The standardized, portable EMR has tremendous potential value, but at a high cost. While the IT side of the healthcare industry debates over data standards and the advent of RHIOs, small solutions that have value may be getting left out. True, a flash drive is only as lifesaving as the eyeballs of the paramedic who spots it. And it is about as interoperable as the paper chart back in the physician’s office. A true EMR that pulls up real-time medical history is far preferable. But as we spend our healthcare dollars over the next few years, the debate will center less on top-line cost and more on value. The Centers for Medicare & Medicaid Services, payors and employers are looking for solutions that add bits of value wherever they can find them. The question over the next few years is not going to be, “What will it cost to fix it all?” but, “What can we solve for this amount?”

—Philip Betbeze