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Silicon Valley companies have proposed automating the arduous task of identifying people potentially exposed to Covid-19. They’re finding few takers.

Heres a small sampling of the problems caused by the lack of interoperability. All of that adds complexity and cost to an already overburdened health-care system.Physicians often find themselves ordering duplicate tests, which is a hassle for patients and a major source of unnecessary costs.Patients might see delays in care as their doctors try to aggregate their medical information.It keeps patients feeling captive in a system, because its a burden for them to go to another hospital that uses a different medical record system.Electronic health record vendors can also charge more to their clients, namely in the form of fees and services.It burdens physicians, who should be concerned with treating their patients.

But the pandemic highlights that the current health IT system is broken. The new rules on electronic health information are an important step in addressing the gaps in the system and setting the health care industry on a path to a future in which technology plays a greater role in connecting patients to care, whenever and wherever they need it.

But when I put on a clinical hat, there is actually an ethical dimension to our pacenamely that if we take too long to implement changes to health care delivery that we know will benet patients, we are withholding necessary improvements of care.

My medical records are stored in silos at different doctors offices, hospitals, labs and surgery centers. I have 23 different patient portals that all have different versions of my information, all of which are often outdated or incomplete. Only one of them lets me see the office visits from my doctors appointments.

“As Congress looks to enhance the nations capacity to respond to this pandemic, improving patient matching will be critical,” said Ben Moscovitch, project director for health information technology at the Pew Charitable Trusts.

She recommended that people keep a hard copy and their own electronic copy of their documents, because they don’t automatically transfer in electronic health records.

Over the last few years, our institution has been tracking amendment requests, and we have noted an increase in the number of formally submitted Problem List requests regarding diagnoses, wrote Amy Porter, MD, of the Rainbow Center for Comprehensive Care and the corresponding author. Amendment requests are not always clear-cut; clinicians and patients disagree over whether an amendment accurately reflects the patients condition.

In this issue of JAMA Internal Medicine, the study by Latulipe et al3 found that only two-thirds of the US hospitals they surveyed offered adult patients the option of granting portal access to a care partner, and among hospitals that did, the process for obtaining proxy credentials was often difficult and time consuming. Moreover, their findings highlight a long-standing practice that has troublesome implications for patient privacy: personnel in almost half of the hospitals suggested to the study’s interviewers (who acted as secret shoppers) that the care partner use the patient’s credentials to review health records.

More widely, patient confidence will also be an important aspect of any preparation for post-COVID healthcare, said Dr Dilruwan Chaminda Herath, executive medical director UK and Ireland for MSD, who also contributed to the Public Policy Projects discussion. The new normal for patient pathways will have been transformed. Collaboration between stakeholders and focus on the synergy between different disciplines will be central to services getting up and running again and the emphasis must be on the total patient.