Obamacare: Electronic Medical Records
Obamacare Paper Cut Leaves Patients Hemorrhaging from EMR Band-Aids By Thanh Tran
Whether driven by simple technological advancements or Obamacare, the digitisation of medical records and data is a necessity. Almost 80 percent of U.S. hospitals currently use some type of electronic records software, according to the U.S. Department of Health and Human Services. Approximately $2.05 trillion is spent on these systems yearly, reports the Healthcare Information and Management Systems Society. What is still being debated is how to mesh the almost daily mobile technology shifts, mixed with social media and security concerns to enable medical professionals and patients to unite in ending needless medical errors. These errors cause 200,000 patients deaths yearly, 40 percent of which are directly related to information omissions and miscommunications. If the Center for Disease Control reported a category for erroneous medical deaths, it would rank 6th in the U.S. These unnecessary deaths, along with reducing duplicative tests and procedures, waste billions needlessly on costs that drive up insurance premiums that are passed on to consumers.
PROLIFERATION OF REDUNDANT ELECTRONIC MEDICAL RECORDS There are hundreds of Electronic Medical Records (EMR) software tools in existence today. Most hospitals, because of medical mergers and
acquisitions, have multiple EMRs in place. Unfortunately, most of these programs do not connect and they all present the data they store differently, often in proprietary databases with HIPAA creating a secondary set of data in many cases. The expectation was of EMR data sharing through open architecture, but instead hospital IT departments were burdened with systems lacking interoperability. To address these challenges, it is being suggested that Health Information Exchanges (HIE) use an additional consolidated database on top of the existing EMR software. However, the HIE database not only causes data duplication, but also requires additional database synchronisation and data privacy. These requirements only add an additional layer of difficulty rather than solving the actual data sharing that was intended to support patient care.
INFORMATION RICH, BUT DATA POOR The focus on being data rich, but information poor also creates gaps. Differing sets of data between a current care environment and the previous care environment, such as existing emergency room data and new data at an outpatient facility, easily causes miscommunications. EMR tools need collaboration between caregivers, and caregivers and patients. There is also a lack of real time medical information over geographical distances. When you add the lack of access to the original records by the family
physician and the inability of EMR systems to offer an analysis of the impact of new medicine on a patient, we are almost back to square one. EMRs, as passive components, fail the basic purpose of having paperless records. If the data is not moved into the active environment, how can care providers deliver on the promise of better patient outcomes in 2014? How many more patients will wind up like Bill White who almost died because an order to check his potassium level was never received by his night physician after a shift change? How about 12 year old Rory Stauton who did die from lack of timely medical record communications between a hospital and his family physician?
IT’S NOT THE BOOM OF THE BEEP, BUT THE SUCCESS OF THE SIGNAL EMRs also often fall short in patient tracking by medical professionals suffering from beep fatigue who turn off their devices. Often the beeps are not even going to the appropriate provider. What is critical is not the beep, even though many times coming from hand held devices, but the signal. How accurate and timely is the beeped information and does it correspond with other current data? Another form of fatigue is the additional time now needed for training on new, unfamiliar systems that nurses’ must use rather than deliverContinued on page 52
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