An amazing man, e-Patient Dave, a pioneer in the movement toward empowering patients and at one point terminally ill with cancer ran a little experiment. One of the best hospitals in America, the hospital where he got most of his treatment, just enabled their patients to sync up the hospital’s medical records with Google Health.
Awesome!!!! Data liquidity in health care right??
Here’s what he got when he “imported” his records “seamlessly.”
And now, his description:
But WTF? An alarm: “! Requires immediate attention” Okay, yes, HCTz is my blood pressure medication.
But low potassium? That was true when I was hospitalized two years ago, not now. What’s going on?
Yes, ladies and germs, it transmitted everything I’ve ever had. With almost no dates attached. (It did have the correct date for my very first visit, and for Chest Mass, the x-ray that first found the undiagnosed lesion. But the date for CANCER, the big one, was 5/25/07 – four months after the diagnosis. And no other line item had any date. For instance, the “anxiety” diagnosis was when I was puking my guts out during my cancer treatment. I got medicated for that, justified by the intelligent observation (diagnosis) that I was anxious. But you wouldn’t know that from looking at this.)
The really fun stuff, though, is that some of the conditions transmitted are things I’ve never had: aortic aneurysm and mets to the brain or spine.
So what the heck??
I’ve been discussing this with the docs in the back room here, and they quickly figured out what was going on before I confirmed it: the system transmitted insurance billing codes to Google Health, not doctors’ diagnoses. And as those in the know are well aware, in our system today, insurance billing codes bear no resemblance to reality.
(I don’t want to get into the whole thing right now, but basically if a doc needs to bill insurance for something and the list of billing codes doesn’t happen to include exactly what your condition is, they cram it into something else so the stupid system will accept it.) (And, btw, everyone in the business is apparently accustomed to the system being stupid, so it’s no surprise that nobody can tell whether things are making any sense: nobody counts on the data to be meaningful in the first place.)
And of the three things it did transmit:
- what they transmitted for diagnoses was actually billing codes
- the one item of medication data they sent was correct, but it was only my current BP med. (Which, btw, Google Health said had an urgent conflict with my two-years-ago potassium condition, which had been sent without a date). It sent no medication history, not even the fact that I’d had four weeks of high dosage Interleukin-2, which just MIGHT be useful to have in my personal health record, eh?
- the allergies data did NOT include the one thing I must not ever, ever violate: no steroids ever again (e.g. cortisone) (they suppress the immune system), because it’ll interfere with the immune treatment that saved my life and is still active within me. (I am well, but my type of cancer normally recurs.)
In other words, the data that arrived in Google Health was essentially unusable.
And now, my comment:
And therein lies the absurdity from trying to integrate today’s technology into 1985-based proprietary pieces of dung cobbled together with 25 years of bazooka bubblegum billing machines. Thank you Dave. You rock my world. This will be linked to and referenced in all of my talks for many years to come. See you in Boston in April.