A story I recently heard about a 4-year-old boy in Kentucky has reinvigorated my thinking about the need for a national clearinghouse of healthcare data. The model is already successful in the financial industry; we just need to implement it in healthcare to benefit patients.

When you apply for a credit card, buy a house or take out a loan, the first thing your financial institution does is look at your credit report. It’s a check of your financial health to make sure it’s in your best interest – and the bank’s – to give you a line of credit.

Your credit history is available because all financial institutions (with a few exceptions) send standardized data to credit reporting agencies. They cooperate because as an industry they know it benefits all lenders and consumers to make good decisions about credit worthiness.

Data sharing turns sad story into a good outcome

Why can’t we do the same thing in healthcare? Here’s where the story of Johnny (not his real name), the 4-year-old boy in Kentucky, really brings the point home.

After a reported fall from a tree house, Johnny was helicoptered to a nearby hospital for treatment.  The head of the pediatric ICU was on duty and immediately accessed Johnny’s records in the hospital’s Electronic Health Record (EHR).

Because the hospital was part of a network of hospitals that shared EHR information, the physician was able to see Johnny’s Medicare Admission, Discharge and Transfer (ADT) records. In his short life, Johnny already had multiple visits to many different emergency rooms and providers. In the past year alone, he had one visit for a bump on his head, then he sustained a concussion and needed some stitches, next he had a broken leg, then another visit for extensive bruising.

When added together, these little bits of information told a very real and disturbing story. With the assistance of proper authorities, Johnny’s child abuse was confirmed and he received the protective services he so badly needed.

Do you remember your last Tetanus shot?

Johnny’s story is a dramatic example of the benefits of data sharing. Day to day, the power of a national HIE is connecting providers to a complete picture of your health history before making vital decisions about your care.

Instead of relying on you to remember the when, why and where of your health history, the stored data can provide important missing details such as PSA level, LDL/HDL, date of your gallbladder surgery, etc.

You’re still in control of your data

Privacy is certainly a concern anytime you share data. For the system to work, you would need to give your permission to share the data.

The risks of not giving permission are great. Denying your doctor access to your health history limits decision-making capabilities. Without a complete picture of health, you’re likely to use more healthcare resources, have more tests, get an extra Tetanus shot.

It’s not wise to take out a loan you can’t pay back. That’s why financial institutions check your credit history. A national HIE puts care providers in a better position to make better decisions about your healthcare. Just ask Johnny in Kentucky. It works.

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About the author

Stanley Crane is Chief Innovation Officer for Allscripts. In his more than 30 years of healthcare and consumer-related software experience, he has led the development of award-winning software programs including electronic health record, electronic prescribing, web-based medication sales, online physician education, resource scheduling, financial systems, materials management, medical translation software and voice recognition dictation systems. Previous to his healthcare experience, Stanley was involved in Silicon Valley, where he held positions with many well-known software companies. As the General Manager of Lotus cc:Mail, he created the first remote mail products. He was also the Vice President of Engineering at WordStar International, and Director of Applications at Ashton-Tate, managing their Macintosh products as well as dBase IV. Before that, Stanley was a founder of two Internet startups – MaxMiles, an automated frequent flier mileage aggregator, for whom he built the first versions of the product; and Shopping@Home, a company that was acquired by Allscripts in 1999 to support medication sales.

3 COMMENTS on The Case for a National Healthcare Information Exchange


Lilah says:

10/23/2012 at 4:12 pm

I am completely on board with electronic prescribing and medical records after my mother-in-law was hospitalized and the doctors did not have access to her medical records it really delayed her recovery until they were able to get that information. So I know first hand how important this technology is to our healthcare industry.

Stanley Crane says:

10/25/2012 at 10:12 am

Hi Lilah,

I hope everything worked out for your mother-in-law. Eventually, things probably work out most of the time – but eventually implies a delay. We’ve been brow-beaten for years about the importance of “Early Detection of…” which really is all about “Early knowledge” – moving the knowledge to much earlier in the process.

Besides helping your mother-in-law get out of the hospital quicker (hopefully & probably), it means she, and millions others of us would have used fewer of our healthcare resources – fewer days in the hospital (maybe), fewer tests (maybe), fewer meds (maybe). But aggregated over 300,000,000 Americans – it adds up. These are the savings we have to find.

When is correct information, at the point of a decision a bad thing?


Brock Heinz says:

10/26/2012 at 9:10 pm

Stanley, while although it (likely) wouldn’t have helped Johny in this case, how do you see PHRs being a driver for the implementation of HIEs? As more patients are engaged with their health (perhaps through payer incentives), it seems as though this wealth of health data will be in the cloud… even if not initially dictated by the Fed. Thoughts?


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