If you don’t live in Washington, you probably won’t care or might even be jealous, but Washington was recently ranked as the second best state, behind Hawaii, for healthcare in the country, according to US News and World Report. Why? Getting into more detail, my state ranked somewhat better in percentages of the residents with health insurance, but the greatest difference was in preventable hospital admissions, with 2,721/100,000, compared to a national average of 4,189/100,000. What exactly is a preventable hospital admission? First, the four metrics on which quality of healthcare was based were: Medicare quality, hospital readmissions, nursing home quality and preventable hospital admissions.
Preventable refers to either acute episodes which were due to human carelessness rather than disease, dehydration being an example, or better management of chronic diseases like diabetes. What is this attributable to? The report doesn’t say, but I have a theory. Here’s an example: I have lived in four Washington counties, King, Chelan, Snohomish and Spokane. Washington healthcare choices are based on the county in which you live. Washington is among the leaders, possibly even the leader, in healthcare organization consolidation. Providence Health and Services operates 35 hospitals, Multicare Health operates 7, and Confluence Healthcare operates one, so in the four counties that I have used healthcare, a total of 43 hospitals and probably hundreds of clinics and urgent care centers are operated by those three not for profit healthcare providers. What do three different organizations have in common? They all use Epic electronic records, and all Epic records of a particular patient can be can be accessed by both the patient and their providers.
I have been treated by all three organizations, which combined, along with Kaiser Permanente (also on Epic), probably treat the majority of patients in Washington. It used to be that whenever I moved, and found a new provider, they would start a paper chart on me and would have to order copies of my charts from other providers. Now, I can log into Mychart, the proprietary name for Epic’s patient and provider access system, and quickly find every test, visit, surgery, scan, and medications that I have had since 2003, when my then current healthcare provider, Confluence Health, started with Epic. Not only that, any provider on the system can find my entire record since 2003. Last week I saw an Ear Nose and Throat specialist at Multicare for an abnormal CT scan of my throat. He was able to call up the scan itself, the radiology report, and everything associated, even though a different organization did the scan and yet another interpreted it, right there in front of me. He even offered to burn a CD of the scan for me, if I wanted it.
So in summary, I would not be surprised if a major reason for the decrease in preventable hospital admissions has a lot to do with both patients and providers being able to get immediate comprehensive medical information. Other states use Epic too, but consolidation in Washington has been greater than most, and all of the biggest use the same system. I think that Providence is the largest single state medical provider in the country, Kaiser probably the largest multi state, and they use the same record system. Now dear readers, if you live in Washington and have used Providence, Multicare, Kaiser or Confluence Health, and have not signed up for Mychart, even though you received a link and an invitation to sign up, I won’t say you’re an idiot, but what’s stopping you??