Digital Health Gaposis

Digital Health Gaposis

The Annual Meeting of the Health Information Management Systems Society (HIMSS) is meeting in Chicago now so you'll be hearing a lot about digital health and electronic medical records over the next few days. The bugaboos are well know, but, it seems, there is more momentum to plug the gaps, particularly since taxpayers have spent billions to subsidize digitizing healthcare information.

As a result, patients, doctors and, now the US government, are putting more and more pressure on the HIT industry to get it right. They want these gaps closed:

1. The technology development gap, where designers don't communicate or collaborate with end users.
2. The access gap, where both providers and patients get access to enough bandwidth to manage the increasing amount of data.
3. The manpower gap, where we don't train enough clinical infomaticians or data scientists in  a reasonable amount of time, instead of requiring an MD, MBA and Masters in Information Systems or Computer Science.
4. The interoperability gap, where information can be globally exchanged from one patient or provider to another. Protect but share has not worked.
5. The data security gap, where almost every day we read about another hack of patient data.
6. The censorship gap, where some think EMRs are a threat to academic freedom and free speech
7. The EMR data ownership gap, where patients want to "own" their data not relinquish it to vendors , doctors or hospitals.
8. The usefulness gap, where electronic records are billing and collecting and profit generating instruments not designed to maximize patient care and  reduce costs.
9. The aim gap, where the triple aim omits the experience of the healthcare users. There should be a quadruple aim.
10.  The cost gap, where, particularly for small, independently owned practices, the costs of electronic medical data systems has  become prohibitively expensive and another federal unfunded mandate further threatening private practice.

Doctors are spending too much time as data managers overseeing patients as data points using dysfunctional systems. As a result, we are getting the garbage out we would expect.