Health information exchanges (HIEs) are playing an ever-increasing role in making sure that the promise of healthcare information technology - more connected care that helps create better patient outcomes - comes true. Whether a patient visits different emergency departments (EDs) around a region or vacations around the country, HIEs help keep the patient's healthcare providers plugged in to their electronic health records (EHRs) , which can enable faster, more efficient care.
The ability to share patient data across regions, and even across state lines, is especially relevant during an era when the aging baby boomers are living longer and traveling more. Additionally, many older Americans live as "snowbirds" in winter months, meaning they may have providers back home and other providers near their warmer homes.
Not surprisingly, the American Hospital Association predicts that the baby boomers will represent 40 percent of all doctor visits by 2020. As these seniors retire, they're changing to new providers because of their shift in insurance coverage, which means the doctors they've known for years may no longer be their primary care providers.
As people age, they may develop more health conditions and require more diagnostic tests that involve medical imaging. But even as HIEs become more widely adopted and enable providers to share EHR data, relatively few healthcare organizations are able to share medical images electronically, which often leads to redundant testing. Current estimates suggest that more than 20 percent of all diagnostic imaging tests are repeats, occurring as patients move from provider to provider. The missing images create an incomplete picture of patients' health, preventing providers and patients from reaping the full benefits of HIE participation.
Enter the cloud
Cloud-based technology, coupled with vendor-neutral mobile viewers, opens up the possibilities for HIEs to integrate patient medical images into shared records. A centralized, cloud-based system stores images in a non-proprietary DICOM format.
HIEs can overcome the challenges of connecting disparate PACS and systems across health systems by accessing cloud-based medical images and reports securely and making available to any provider participating in the HIE, on any device, regardless of the PACS used to create and store the digital image.
Today it's common that when primary physicians refer their patients to a specialist, and the specialist needs to see existing medical images, disparate EHR and PACS systems can prevent the specialist from gaining electronic access to patient records or medical images - often resulting in diagnosis delays and re-testing and contributing to increased healthcare costs.
Contrast that to the following scenario: Roger, a 65-year-old male, arrives with symptoms of a stroke at 3 a.m. at the hospital in the small, rural beach town near his Florida vacation home. Even though the hospital is a far cry from the academic hospital in his home state of New York, which has an on-site stroke center and an on-call neurologist, Roger's physicians can rapidly access and share diagnostic images from his EHR while remotely discussing treatment options.
Accessing the images that save and improve lives
Not only can clinicians remotely share, review and discuss medical images with each other with cloud mobile viewing, they can share them with patients and caregivers as well. With mobile viewing in the cloud, clinicians can use a mobile app on a tablet computer to quickly access and show patients historic and current 2-D and 3-D images, so they're able to more clearly explain diagnoses and treatments. Access to patient medical images in historical archives lets providers compare new images to baseline ones, making it easier to see important changes that can clue doctors into conditions that have developed.
Even if Roger is thousands of miles away from his family, clinicians can remotely engage his children and caregivers in other cities and states to make fast, informed healthcare decisions. By enabling clear consultations with the patient, family or primary physicians, doctors can speed the time it takes to make a diagnosis and begin treatment that includes image enabled applications.
The time is right for HIEs to broaden their reach to include medical images. Hospitals will soon be striving to meet the proposed rule for Stage 2 meaningful use criteria that 40 percent of images be accessible in EHRs by the 2014 deadline, and HIEs are a critical enabler of that goal.
Plus, given that millions of Americans are expected to gain new insurance or change their insurance in the next few years because of the impact of the Affordable Care Act, HIEs have never been more important for ensuring patients' records follow them where they go. Coupled with cloud-based medical imaging technology, patients can rest assured that their medical images and reports - pictures some say are worth a thousand words - go with them.
Barbara White is Director, AT&T ForHealth Cloud Solutions.