Maine's HealthInfoNet

The first statewide electronic health information system, HealthInfoNet, was recently unveiled in Maine as reported here. This is a logical application of technology, an accelerating trend of making healthcare information--including prescriptions--available to clinicians, but also letting patients know who sees their information and why. Such infrastructure enables health information to follow the consumer: a revolution in medicine.

For the laboratory, electronic consolidation is good. In the blood bank, for instance, an accurate history is critical. Local errors may include transcription error, misfiled cards, or data corruption.

But the real problem is larger--how do we know another laboratory didn't detect a significant alloantibody? For small hospitals with limited surgical services, this may be more likely. And a patient interview is no guarantee.  A statewide system--and larger--will eventually help reduce risk and make transfusions safer.

For managers, sharing patient history is a first step in greater quality control. Imagine linking instrument data in real time--a logical extension of online access to patient and peer reports. Imagine delta checking across hospitals, tracking lot to lot variation, tracking regional shifts and trends, and real time review of abnormal results by pathologists. The end result--more reliable results--means better patient care.

Our concept of systematic error may change. We may see local, regional and wide area systems generating quality information to prevent errors. Biases in your laboratory that affect most or all results--temperature, water quality, humidity, human error--may be detected real time as the wider system updates. It is a tantalizing possibility.

Today's dreamers create the future. Think about the changes you have seen in the laboratory during your career. What is possible tomorrow?