And to Epic, why wouldn’t they (or any other vendor) worry first about connecting networks of their customers? They control both ends of the interface, and can easily establish trust. The NHIN project raises so many issues about privacy and control of personal information that its going to take years to sort out the legal issues and then deal with a major percentage of patients that opt out anyway. All for the seldom seen use case of the interstate out-of-network accident.

I wish I could see my medical information and decide who to give it to. I’ll worry more about doctors when that is possible. (and I mean all of it, not just the personal Microsoft filtered version)

When your unconscious patient has a heart attack in Florida, how, exactly, are we going to get positive, unique identification of this patient to pull his or her medical report down from these exchanges? And when (not if) we have medical mistaken identity — how, exactly, am I (as a patient) going to tell this health information exchange that this visit wasn’t mine – it was for a different patient, not me. I’m not on these meds. I don’t have this condition. (etc etc).

How long before Congress has to pass a law for “myfreemedicalreport.com” to give patients the right to even see their medical information in an exchange, and fight with the exchange to try & get it corrected.

At least some enterprising company will be able to come up with some complicated formula to take our medical information and generate a score for medical insurance agencies to use to justify charging higher & higher rates (or denying coverage altogether).

What could possibly go wrong?

For example the Midwest Fall Technology Conference in Grand Rapids, MI, put on by a handful of local chapters (IA, MN, WI, IL, IN, MI) drew around 400 recipients, and even had John Halamka video conferenced in as a keynote!

These local chapters are soliciting sponsors, to the point where National had to force the local chapters to not use the same named spsonsor levels (platinum, gold, and silver) that they used to prevent confusion among the vendors.

So one has to wonder if a company has a choice to send people closer to home, with education sessions/conferences that duplicate the topics at National, but have a more regional flavor, for a cheaper price tag, what choice they might make. Or for those conference or HIMSS sponsorship dollars, where is the biggest ROI.

Second, patient exchanges have the opportunity to reduce costs, improve patient outcomes, and enhance patient – physician relationships. Dan’s example, above, of an unconscious patient unable to provide consent to share information is a question of the value of patient privacy vs. patient care. It is absolutely not a question of the inherent value of being able to share patient health information such that care providers can make good choices. Please pick the right argument. In this case, the argument is privacy vs. patient care – not the value of exchanges.