Dan Bernstein, M.Arch., Chronology.MD Technical Partner, Medic8 Manager
Before a team of clinicians can develop and deploy a good treatment plan, they need the best available information in order to correctly and quickly diagnose a patient’s condition and status.
In the past, many people saw the same doctor for most of their lives. At the time, paper records were the best option we had; that’s not the case anymore. Now, patients move and travel, see multitudes of health care professionals throughout their lives, and use several pharmacies and labs. Today, although electronic health records can make patient health data portable, information liquidity is not happening.
Almost every use case in health care should have the patient at its center. But most of the diagrams I’ve seen that illustrate how information flows in health care show patients as a byproduct, as an afterthought, or don’t even document their existence.
Today’s EHRs are not leveraging the power of intelligent data management. In fact, they are used in much the same way as paper records have been used traditionally.
This reminds me of my time as an architect. Even though most firms had begun using what were then considered state-of-the-art CAD systems, I soon realized that moving to digitized systems hadn’t magically allowed them to work smarter (e.g., they hadn’t created symbol libraries of common building elements or building systems broken out into individual files for re-use and global updates). That was 20 years ago. Ad while architecture firms and CAD systems have evolved, health care and EHR systems seem to have been dragging their feet.
Organizations need to jump feet first into the patient-centered digital realm. Today, supporting both paper and digital systems is inefficient.
It’s a travesty that in a modern society patient health records are stashed away and only made available to the patient or a physician at another hospital through a process that hasn’t changed since the early part of the last century. Here is what I experienced in my recent interaction with University of Chicago Hospital when trying to get my own health records:
- The hospital mails me blank forms to document my approval to release my records. These forms are not available to be faxed or emailed or on their website for download.
- There are charges for me to get a copy of my records.
- Even though the University of Chicago Hospital uses an Epic EHR system, I can’t access my own information via an online patient portal.
- I have records at three different hospitals that all use Epic EHR systems, but it's not easy to share my health information between the systems.
It’s a backward system that requires a patient to jump through hoops to request information from his providers, hospitals, labs and pharmacies. Any organization that impedes the appropriate transfer or sharing of patient health information should be penalized.
If the best available information is to become available to both patients and providers at the point and time of care, then it’s going to require lots of changes and all of our support.