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TR+-+Dec+2009+-+Prescription+Networking - Prescription...

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FEATURE STORY 34 TECHNOLOGY REVIEW NOVEMBER / DECEMBER 2009 health centers that are most remarkable. The health centers aren’t owned by BMC, so there were plenty of institutional barriers to their sharing patient data. And what this group of institutions has started doing to break down those barriers is an example of what the entire U.S. health-care system needs to do to make the best use of information technology. “In terms of a hospital taking the initia- tive to do what they have done—link together, using national stan- dards, a set of individual physician-based medical records—it’s not all that common,” says John Halamka, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center, who serves on regional and national bodies advancing health IT. “BMC is a leader in health-care information exchange.” The effort is especially sig- nificant because BMC serves so many low-income patients—who suffer disproportionately from chronic diseases and often have fragmented histories of care, making it all the more important for information to be shared among care providers. Inside the BMC emergency room, Sinue’s vomiting did not stop. The attending physician, Aneesh Narang, was understandably wor- ried. He asked if this had happened before; she muttered that it had happened only in childhood. A sudden and acute bout of vomiting might indicate appendicitis or ischemic bowel disease (the death of intestinal tissue), either of which would require speedy surgery. In the absence of more information, most emergency-room doctors would order a CT scan (at least $2,100), and possibly an abdominal ultrasound (another $500), to see what was going on. But Narang called up the electronic records from Codman and found lab data and physicians’ notes that spelled out her allergies, medications, and history of medical problems. These records were certainly not cutting-edge medical IT—no genomic data, not even any images. But they would make a big dif- ference. Narang quickly saw that Sinue hadn’t told the full story. In fact, vomiting was a chronic issue; it topped her list of medical A crow flying from Vera Sinue’s apartment in Boston’s Roxbury neighborhood to her job as an insurance rep- resentative near the Charles River in Brighton would skirt the edge of the Longwood Medical Area, a district of medical institutions including Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, Children’s Hospital, the Dana-Farber Cancer Institute, and Harvard Medical School. These institutions are among the nation’s most respected. They supplied some of the experts now leading the Obama administra- tion’s effort to reform the nation’s health-care system. Yet it’s lucky for Sinue that when she began vomiting uncontrol- lably one day last August, she didn’t end up at any of the Longwood hospitals. Sinue, who is 35, gets her routine medical care at the Codman Square Health Center, in the heart of the low-income neighborhood of Dorchester. Her Codman Square records would
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