It has been a long time.

I've been very busy doing a lot of things. My newest job is to serve on a task force by the National Governors Association regarding sharing of medical information across state lines.   Sounds exciting?  I think it means more to you than you think.

If I am in Great Britain or Australia, I can go to an ATM machine and get
money. My request from the ATM machine goes confidentially to my bank in the
US, checks a balance, makes the deduction, and give me the cash wherever I
am.

If, however, a patient goes to a local emergency room, they have no
information about previous prescriptions, visits to the physician, or visits to
other emergency rooms in town. The only means for information is through their
own system and by asking the patient. I have patients who go from ER to ER,
from doctor to doctor, and to multiple pharmacies and get multiple prescriptions
of narcotic medications.

The sharing of healthcare information is obviously something that requires
great care. Sharing of this information is full of risk. The benefit, however,
is huge. Not only can we prevent mis-use of the system; we can provide
incredibly helpful information at the point of care - especially for cases in
emergency circumstances. Information needs to remain secure, yet the securing
of the information does not need to stand in the way of sharing. Look at the
ATM system if you doubt that.

Even when the data are available, confidentiality laws can prevent access to
them. One case that highlights this is that of mental health patients in the
area affected by hurricane Katrina. Some of these people would have no idea
about their medications and were in very bad shape without them. The problem
was that even though the pharmacies and insurance companies had the ability to
share this information, laws prevented the sharing of this information, and so
these patients went without.

We absolutely need to go after organizing our system. Physicians' offices
are sadly behind on adoption of IT and so there is little chance for them to be
part of any organized system until this is accomplished.

This is not just the plea of an IT "geek," people are dying due to the lack
of information. Americans are not aware of this, but should call for a system
that is at least as good as our banking system. What's more important?