Bijan has a post relating his recent overnight hospital stay to some of the big issues with healthcare today.  Bijan rightly complains about how hospitals are a black hole for patient data.  The stimulus package (PDF) contains a section 9202 titled “Investment in Health Information Technology” which states:

The Secretary of Health and Human Services shall invest in the infrastructure necessary to allow for and promote the electronic exchange and use of health information for each individual in the United States.

This is laudable, but as I have written in a previous post, as important as investment are changes in the regulatory framework.  This is very much the case for Healthcare, which is full of gatekeepers with entrenched interests, including not just the much maligned insurers, but also healthcare provider organizations (in what feels like a lifetime ago I had a startup selling to hospitals and integrated delivery networks).

So with respect to electronic medical records, I believe that we need a two pronged regulatory approach.  First, patients need be given electronic access to their own medical data.  This has to be made a requirement for all participants in the medical system by some reasonable date.  The government should invest it’s money in defining a standard for access that is easy to implement.  So no attempt to standardize vocabulary or anything else that would bog things down for another twenty years.  Simply an access protocol.

Second, there should be some requirements established for the operation of patient centric electronic medical record service providers.  These would access, accumulate, process, etc. the medical records on behalf of patients.  This makes the access problem a whole lot easier, because the access standard does not have to support authenticating individuals directly but rather only the accredited providers.  The accreditation standard should be high enough to avoid fly by night operators that would rip off patient data, but low enough to allow startups to compete.  One could think of these organizations as serving a role similar to the one registrars have for domain names.

I very much hope that the investment from the stimulus is made in establishing these two: access standard + patient record provider licensing.  This would crack the healthcare system wide open for innovation!