Sometimes we are asked:  Why should anyone care about healthcare interoperability?  Why should a community try to build a Health Information Exchange? 

We challenge any individual to reflect upon a situation in their own experience that could have been better had their comprehensive personal healthcare records, or those of a loved one, been more immediately available.  Examples are easy to find. 

Here are some of ours:

Age Does Not Tell the Whole Story

Our elderly aunt recently was rushed to the emergency hospital on a Sunday with intestinal problems and vomiting.  Auntie was 101 years old at the time.  She was diagnosed with a collapse in her intestinal tract.  Normally, surgery would be prescribed, but due to her age, this was considered out of the question.  The recommendation was to put her on intravenous feeding and wait for her to die.

The family was very depressed by this prognosis.  However, after recovering from the initial shock of it, they began to ask questions.  Why could Auntie not have surgery?  After all, she is not an ordinary 101-year-old.  She lives independently in a retirement community (not assisted living or a nursing home), has always had excellent vital signs, and has never had a major medical incident prior to this.  Why give up on her so quickly?

The family searched out Auntie’s primary care physician, who had to be reached at home, and asked him to call the hospital doctors.  He did so, assuring them that given her vital signs and overall health, she certainly could be a candidate for surgery.  However, before surgery even became imminent, Auntie recovered and, after about a week, was sent home.

Would a more complete assessment of Auntie’s medical history have given the emergency department doctors more to go on, causing them to hesitate before delivering such a depressing diagnosis?   What would have happened had she been without immediate family present to speak for her, or if her primary care physician could not have been reached?

Happily, Auntie recently celebrated her 102nd birthday!

Adult Immunizations

I recently traveled to India for the seventh time.  I received recommended travel vaccines prior to previous trips, which, for travel to India, were many.  This time, however, the nurse at the local travel vaccine clinic was herself on vacation.  The office refused to open my file in her absence, and suggested I consult the “yellow card” (paper record) I had given on previous visits.

Being a fairly organized person, I was able to find three pieces of paper, each recording a portion of the immunizations I had been given over a ten-plus-year period.  Not one of them was comprehensive, even though I received all my shots at the same clinic.  At least one visit was clearly missing. 

I made an appointment with a doctor at a more distant clinic, who sat with me for 20 or 30 minutes puzzling over the sketchy records, suggesting things that might jog my memory about missing vaccines.  We determined that since I could remember refrigerating vaccine before my last trip, I probably had received the live virus form of typhoid, and was therefore current.  I received a Tdap vaccine to make sure I was current on Tetanus.  The assistant spent 15 minutes or so consolidating my records onto yet another piece of paper, this time comprehensive.

Could electronic availability of this innocuous but vital information have saved the time and money of several parties, and have further reduced the possibility of over- or under-immunzation?

Happily, I recently returned from India in excellent health!

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