Brian Wells’s job is to make big data and technology issues disappear for the researchers at the Perelman School of Medicine. He is building the technical infrastructure needed to achieve the goals of personalized medicine regarding biobanking and genetic sequencing. This associate chief information officer for Health Technology and Academic Computing at Penn Medicine recently spoke with MedCity News about some new developments at Penn including his thoughts on the challenge of sharing electronic medical records.
What have been some of the unforeseen consequences of the growth of information technology in healthcare?
- We don’t have enough IT people who understand medicine, healthcare and computers together and so I imagine we will see implementations at some enterprises that will have to be revisited because staff made the wrong decisions from a lack of real-world experience.
- Healthcare is very difficult to learn. It takes years and years in the trenches, learning what works and what doesn’t work before you get a feel for how to make the right decisions.
- Patients are beginning to expect that their info is all electronic but we are not fully there yet.
There will be increasing desire to provide access to all that information ’ the problem is we don’t have unified standards for access. So the exchange of real data discretely is very difficult today.
What we call a white blood cell count at Penn is probably different than what Geisinger calls it and that’s just one lab test. The exchange and utilization of data that can be acted on electronically is pretty constrained. We have many ways to record information, but not as many common ways to share information.
For example, there may be as many as 10 coding systems. LOINC is the industry standard for lab tests. In the world of drugs there are three to four different systems. For diagnoses, a 70-fold explosion in the world of codes is on the horizon. We’re about to shift from ICD-09 to ICD-10 (the coding system tied to reimbursement).
It’s a complicated piece of our industry and it’s a holy grail that will take a lot of time to reach.
What have been some of the biggest challenges faced in implementing EMR to meet Meaningful Use criteria?
We are in very good shape for stage 1. Stage 2 is a little more difficult. CMS will want us to be able to exchange data with other hospitals without the same software. And it must be a facility that has at least 10 percent of our patients. That may be daunting for a tertiary care facility like Penn.
What about personal health records?
The whole personal health record industry came and went and failed because patients are busy. It’s a lot of work to constantly update a PHR. The concept of a tethered PHR in which records are linked and tethered to Penn (such as mypennmedicine.org) is having more success in the industry.
And the new standard the FCC has just announced, Medical Body Area Networks, or MBAN, will allow devices to transmit data without wires. It’s a protected bandwidth the FCC will preserve and I’m sure vendors are jumping on that technology and will make it easier and more reliable to transmit that data.
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