Dr. Lewis Marshall, Jr., chairman of Outpatient Services at Brookdale University Hospital and Medical Center and Brookdale BHIX representative, believes that the Health Information Exchange, “will have the biggest impact on improving healthcare and population health in decades.”
“It's still in its infancy,” said Marshall in a phone interview. “I think that health information exchange is going to be the biggest thing in patient care and coordinated care in the next few decades. I think as we learn how to use it, [it] will become a tremendous boost.”
In concert with the New York eHealth Collaborative (NYeC), pronounced 'nice,' BHIX is working to create a central database of health billing information throughout the borough to eliminate inefficiencies and redundancies in healthcare for residents.
Marshall explained that in the current healthcare status quo, there is little to no cross-institutional communication taking place and that it is costing patients, hospitals and insurance agencies.
He cited findings from a November 2011 article published by the Nashville-based Vanderbilt Center for Better Health, saying, “6.8 percent of emergency department visits had health information exchange access. That small number who did have health information exchange access resulted in a net savings of $1.07 million. Ninety-seven percent of those savings from reducing inpatient admissions.”
From a professional standpoint, Marshall, who operates a private practice in Queens, said that independent physicians stand to benefit greatly from single-source data. He recalled a time before he began to participate in health information exchange, when he would have to refer patients to local hospitals for further testing towards diagnoses, and it would take weeks just to get the information he needed.
“They did all these tests, but I don't know the results of them,” said Marshall. “I would have the patients sign a release form, wait two or three weeks for [the hospitals] to send me back the information, sift through 200 to 300 pages of terrible handwriting to find one or two pieces of information. That was the dark ages.”
During a panel discussion hosted by the NYeC at its annual Spring Summit on June 6, Marshall shared several instances when health information exchange led to positive solutions at Brookdale Hospital and Medical Center.
One such case involved a 78-year-old woman with diabetes and hypertension who was admitted to Brookdale’s Emergency Room, unresponsive and unable to provide details about her medical history.
“The first responders who had collected her name from a family member and medical personnel at Brookdale utilized BHIX to find her medical history, list of medications, and were alerted to the fact that she had sepsis,” reads a press release provided by Brookdale on the subject of Marshall's participation in health information exchange. “Because the patient had previously given consent to share her data, the critical information learned and the timeliness in which medical personnel were able to access the patient’s data enabled them to treat her swiftly and properly.”
Among the personal reasons behind Marshall's support of health information exchange, one is that like many modern Americans, he doesn't live his whole life under the umbrella of coverage provided by the healthcare facility that he patronizes.
“People are mobile now,” Marshall said. “I live in Jersey and I work in Brooklyn. I could be anywhere [...] and get sick and go into a hospital.”
At the most recent Advertising Week, held in New York City during the last week of September, Scott Howe, the CEO of Axciom, said that while the idea of single-source data is one that is attractive to many industries in a theoretical sense, it has not made much progress in the real world.
“Every country is better off if they trade than if they have silos,” said Howe, drawing on the free trade argument that we used to talk about in economics. Unless you bring all that data together, unless you get free trade you can't have an ecosystem where you can truly make the best decision.”
And while for many industries it may not make sense for individual companies to collaborate with their competitors, Marshall believes that the healthcare industry is different. While he admitted, “There is some resistance to it, […] that resistance is slowly going away.”
“Organizations fear of [Fair Information Practice Principles] violations, thinking that if there is something wrong with my data someone will pick it out and I will get in trouble for it.” Marshall believes that, “As they see the value of health information exchange, they will share more and more.”