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Life on the Other Side (as a Patient)

April 30, 2013
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A real-world example of the impact of needless diagnostic exams

A week ago while on vacation in Florida I experienced another episode of vertigo.  For those of you who have never experienced vertigo, you are fortunate!  Long story short I ended up in the ER, and then admitted to the hospital.  The stay was necessary from the physician’s perspective, as they did a CT scan while in the ER, with inconclusive findings, which again in their mind necessitated admission and an MRI/MRA scan (which of course couldn’t be scheduled until the next day!).

I knew exactly why they felt it necessary to do the MRI/MRA, but with access to prior CT and MRI/MRA scans that were done several years ago, I am confident that they would have been able to avoid doing the MRI/MRA!

Hence, a personal example of the benefit of image-based health information exchanges.  If the physicians had the ability to access and download my prior CT or MRI/MRA exams, they could have made a comparison and ruled out their concern.  The lack of any ability to access my prior exams meant ordering and conducting an expensive exam for nothing, and cost me a day in the hospital!

Clearly, this event was outside the bounds of what would be addressed by a regional health information exchange, but it could have been met with a national exchange.  Conversely, having the ability to have my studies stored in a patient-oriented cloud such as Microsoft’s HealthVault would have been even better, as I could have easily granted the facility permission to access my prior exams.  Instead, I had to complete a consent form to have the exams forwarded to my primary care facility – a 10-15 business day proposition.  So, here I sit waiting on their transfer before I can follow up locally.  Fortunately, this is not a serious condition.  I can only empathize with those with serious health conditions that are caught in the same inefficiencies of snail mail-based healthcare!

Having experienced a real-world example of needless diagnostic procedures, I can wholeheartedly endorse the notion of cloud-based repositories, as they can save the expense and time of redundant procedures.  The only consolation?  It rained every day we were in Florida!



I had a private response to this blog stating concern over the implication that I suggested that newer exams might not be necessary if there were access to older exams. Let me state emphatically that I am NOT implying any diagnostic knowledge here that would suggest relying on older exams in lieu of new ones.

My reference point was my own experience, and in this respect, the reason for the suggestion was a known anomaly that was independent of the primary diagnosis.

The premise still stands that universal access to prior exams might impact the need for additional new exams, and I still believe that to be the case!