Fasano, Looney Op-ed: Connecticut lags in health information sharing and patients pay

Op-ed by Senate President Pro Tempore Marty Looney and Senate Minority Leader Len Fasano, as it appeared in the New Haven Register

Regardless of political affiliation, it is clear that our fragmented health care delivery system, which promotes quantity over quality, is inefficient and unsustainable. The system needs to be modernized, and that includes instituting electronic health records. Specifically, Connecticut needs an electronic health information exchange system that allows real time access to patients’ critical health information.

The federal government has invested over $26 billion, including over $300 million in Connecticut, to support the adoption of electronic medical records systems by hospitals and physicians. The goal is to save money and improve quality by reducing duplicative testing and medical errors, and to create a system that allows health information to follow the consumer and fosters quality-based competition.

To effectively coordinate care and improve health outcomes, providers must have timely access to a patient’s full medical record. While your primary care doctor knows that you are allergic to a certain drug, the ER doctor does not. The result, should you arrive unconscious in the emergency room, could be both costly and fatal.

Yet, despite long-term bipartisan investments, meaningful health information exchange continues to be elusive. Doctors aren’t always informed when patients are hospitalized and, therefore, can’t manage their care properly to avoid re-hospitalization. Patients with chronic conditions are seen in hospitals just miles away from each other, yet often have to undergo unnecessary duplicative testing.

Why are there still so many gaps in the system? According to a report from the Office of the National Coordinator for Health Information Technology, the simple answer is money.

Some IT vendors and large institutional providers have taken federal incentive money and built proprietary systems that promote profits more than patient or public health. The report confirmed many of the practices complained of in Connecticut. Findings showed some large health systems engage in “information blocking” to “control referrals” and “enhance their market dominance.” IT developers use licensing and pricing schemes “designed to deter connectivity or exchange” with competitors. Examples of anti-competitive information blocking include hospitals refusing to use their IT systems to refer patients or transmit information to unaffiliated providers, or an IT vendor that charges $100,000 to allow its system to communicate with another vendor’s system.

This misuse of taxpayer subsidized health IT systems undermines the goals of health reform and jeopardizes patient health. As the report states, “when health information is unavailable, decisions can be impaired — and so too the safety, quality and effectiveness of care.” In our opinion, such activity amounts to taxpayer fraud and falls short of expected standards of patient care.

These findings support our bipartisan efforts to prevent unreasonable health information blocking and to support a neutral publicly accountable statewide health information exchange. Our proposed Senate Bill 812 begins and ends with a simple concept: patient health records belong to the patient and should be made available to patients and their provider of choice. Providers should be expected to facilitate the electronic exchange of information. Our bill would discourage providers and vendors from imposing barriers on sharing information by making such activity an unfair trade practice subject to civil penalties.

Ultimately, any system that depends on thousands of independent providers using proprietary systems will waste resources, leave many patients out, and be subject to manipulation. Only a statewide publicly accountable neutral system will ensure that we (1) empower patients to make informed decisions, (2) improve the efficiency of our delivery system, and (3) promote public health through timely disease monitoring and response.

States that have implemented health information exchanges are reaping the benefits of reduced costs, increased quality and improved public health. In one state, research found the use of “Hospital Alerts” reduced readmissions for Neonatal Intensive Care Unit infants by 50 percent another study found savings of $2,000 per emergency room patient by using electronic medical records. Not only is money being saved, but people’s lives and health are preserved as well.

Taxpayers have invested hundreds of millions of dollars to put electronic medical records in Connecticut hospitals and physician offices, yet we still face a fragmented costly system that undermines patient care. Closing these gaps and ensuring patient and physician access to vital health information is an investment we cannot afford not to make.

Senate President Martin M. Looney, D-New Haven, represents New Haven, Hamden and North Haven; Senate Minority Leader Len Fasano, R-North Haven, represents North Haven, East Haven, Wallingford and Durham.