This blog post is the sixth in the Supply, Demand and Medicine series on health care reform.
Over the past 75 years, few other industries or fields have advanced further faster than health care. Vaccines have been developed. Cures for diseases have been discovered. Life expectancy has risen by many years. It’s been like going from a covered wagon to a sports car.
Well, not quite, actually. While there have been breathtaking advances in medicine itself, until the recent move towards widespread implementation of an electronic health record (EHR), our sports car has still been operating with wagon wheels. That’s because the American health care industry is one of the last major sectors of the economy to digitize. Banking, engineering, architecture and manufacturing all went digital long before health care.
From both a health care provider and patient’s perspective, digitization has long made sense for three main reasons:
- Illegibility: While people sometimes joke about how bad physician handwriting can be, it is a serious care issue. Not being able to read a physician or another health care provider’s handwritten orders can cause delays or mistakes in treatment.
- Unavailability of Data: Not having previous tests and medical histories readily available has long been an issue that, again, can lead to delays in treatment or wrong treatment.
- Data Analytics: Examining population data to look for ways to improve health isn’t practical with paper. For example, if a physician wants to make sure all of his or her patients with high blood pressure are on controller medications, pulling that information from EHRs can be done with a few clicks—much easier than rummaging through thousands of manilla folders.
These are all important safety and quality issues that EHRs can help address. They can also help patients avoid the hassle and expense of having to have tests repeated because a health care provider can’t access a previous report, as well as the inconvenience of filling out the same paperwork over and over every time he or she visits a new hospital department or provider.
In 2009, physicians and hospitals got another carrot to digitize. The Health Information Technology for Economic and Clinical Health (HITECH) Act created financial rewards for physicians and hospitals to implement EHR based on “meaningful use criteria.” Meaningful use criteria centers on five principles that EHRs should help address:
- Improving quality, safety, efficiency and access to care
- Engaging patients and families
- Improving coordination between caregivers
- Bettering the health of patient populations/the public
- Securing personal health information/ensuring privacy
Soon, there will not only be carrots, but sticks (penalties) for hospitals who don’t implement an EHR as well.
Troubleshooting: Barriers to Benefits
Even if your physician has an EHR, and even if he or she has sent you to a hospital for a test or procedure that has an EHR, you may not have experienced many of the aforementioned benefits of digitization… at least, not yet.
You still may have to fill out paperwork with your medical history and insurance information. You may even had to have a test or procedure repeated. Why? Because there are hundreds of software companies with their own EHRs that physician offices and hospitals have implemented, and few, if any, have the ability to “talk” to each other. They each have their own language.
Data interoperability is a huge challenge, and has neutralized many of the potential benefits of EHR. That is, until recently.
Some health systems, like Baylor Scott & White Health, and physician networks, like Baylor Scott & White Health Quality Alliance, are implementing tools that will allow different EHRs to “talk” to each other.
This will mean that much of the information recorded in a patient’s EHR in a physician’s office will be accessible when a patient is sent to the hospital through a data exchange tool.*
If installing an EHR was the first step, then making information contained in the EHR available across many different care environments is the second step.
Your Health. Your Record.
Besides data interoperability, the issue of who “owns” a patient’s EHR is a hot topic. Your medical record may reside on a hospital or physician’s office server, but it’s your record and you should have access to it. Providing secure, readily available access for patients is something that I believe health care providers are obligated to do.
To this end, Baylor recently rolled out a patient portal called FollowMyHealth. FollowMyHealth provides patients with access to a portion of the medical record, including reports on laboratory studies and other test results, and clinical information such as allergies, immunizations and medications.
Not only is FollowMyHealth consistent with the HITECH Act’s meaningful use criteria for EHR, it’s the right thing to do for patients and another benefit of going digital.
And there is no turning back from the digital age in health care. Just like a bank that only offers checks and not a debit card can’t survive in this day and age, the quality, convenience and efficiencies offered through EHRs are rapidly becoming an indispensable part of my health care experience.
*This data exchange will exist between Baylor Scott & White Health—North Texas Division hospitals and Baylor Scott & White Health Quality Alliance practices.