Standards for EHR, Part 1

We take for granted that any device with USB connection will work with our computers. We owe this clarity to the IEEE (Institute for Electric and Electronics Engineers). This professional organization has been setting standards for lots of things since 1963, including the USB ports on our computers.

Electronic health records (EHRs, which includes "EMRs," where M is for "Medical") don't have similar clarity. There are standards, but they're currently competing for supremacy. (See this paper for a summary of the standards.) That is, there are standards, but no standard for standards like the IEEE.

Consequently, the system that my primary care doctor uses may not (in fact, probably doesn't) "talk to" the system at a hospital or even to the one used by the orthopedist my doc referred me to for ankle pain.

To be clear, I don't need my doctor and the orthopedist to use the same EHR, I just need their systems to talk to each other. The USB analogy is useful to illustrate what I mean. I can buy any brand USB keyboard--Logitech, Microsoft, Targus, Apple, etc.--and it will work with any computer that has a USB port. EHRs, however, have no such standard.

For this post, I just want to mention one disadvantage of competing standards: the orthopedist has to cover lots of things my primary care doc already covered. The redundancy is not just a hassle, it's costly and dangerous. The orthopedist and I both waste time and brain power that could otherwise spent on a more accurate diagnosis of my problem or on treating another patient. What's worse, if I'm unlucky enough to wind up in an emergency room, I may get treatment that fails to take into account important facts about my health.

More to come.