EMRs — The Time is Now
Electronic medical records (EMRs) are on the way, and not any too soon. The government is offering large incentives to healthcare providers to start using EMRs and for those who skip the incentive, there will be penalties to follow. Whatever you may think of the EMR, it is at our doorstep. I am not making a political statement about this – to me it is common sense and a technological imperative that will reduce costs, enhance healthcare quality, and improve patient safety. A reader sent me an account of what he and his family experienced two weeks ago and, with his permission, I am sharing this true story because I think it is one of millions of examples that justify the move to EMRs.
The reader is from California and I will call him Frank for purposes of this post. Frank’s 15-year-old son Alex was scheduled for non-emergency pulmonary valve replacement surgery on Friday afternoon. He was born with a number of congenital heart defects and had open-heart surgery at 30 days old 15 years ago. A recent MRI showed his pulmonary valve to be leaking extensively so it was recommended it be replaced with a new adult-sized pig valve. Before leaving for the hospital Friday morning, Frank received a phone call saying that Alex had been bumped from the schedule due to a critical newborn with heart problems.
Although Frank understood the bump, Alex took it extremely hard. As the day wore on, he got more and more upset and stressed out. Around 9 PM he mentioned that he was having shortness of breath and was having pains around his heart. Since he had a full pre-op earlier that week, Frank’s immediate thoughts were that this was a combination of extreme stress and possibly indigestion, but he decided to take Alex to the local hospital emergency room (ER). Once there, clinicians checked Alex’s vital signs and ran an EKG. The ER doctor did a quick echocardiogram. After reviewing the test results, the ER Doctor asked if Frank had any historical EKG’s so that a comparison could be made to Alex’s abnormal EKG.
Around 11 PM Frank signed the paperwork to authorize a search for the EKG — the nursing staff started calling hospitals where Alex had been a patient to see if they could obtain EKG data. They hit a brick wall. The large hospital where Alex had the pre-op wanted to help but had no access to data. A call to the cardiology specialist’s office got a recording — they were closed.
As Frank reflected on the data void, he realized that he can download an obscure piece of music from multiple sources on the web, but in spite of valiant efforts, he could not get a copy of Alex’s EKG. Isn’t it a collection of ones and zeroes, just like music? Although it was a stressful weekend for Frank, Alex began to feel better and was able to go back to school the next day.
On Saturday morning Frank did an extensive web search, and found that Medic Alert provides emergency information to caregivers if a physician sends them data. This is a great service, but shouldn’t it be an automatic by-product of healthcare by any caregiver? From Frank’s perspective, having access to someone’s past EKG could either save a life, prevent misdiagnosis or save time and money. To Frank, it seems like a basic for anyone with an affected child or if they themselves have a potentially serious ailment. Frank’s perception is that EKGs for the most part are still “paper driven” and nobody is thinking about getting them on the web as a standard practice.
Alex has a new surgery date in early November. Hopefully, Alex will be feeling better, and with the surgery delay he should get to finish his soccer season.
It is time for healthcare to catch up to banking, e-shopping, e-music, YouTube, and social networking. What could be more important that the health of our families? Privacy is a valid and important concern, but it can and is being addressed as part of the rollout of EMR systems.
Alex’s privacy was intact – his EKG results were in a manila folder somewhere – private, secure, and unavailable when needed.
Bertha Coombs at CNBC reported that there are two things Dr. Larry Nathanson can’t work without when he’s on duty in the emergency ward: his stethoscope and his iPad. Early adopting physicians have been embracing the iPad since day one and now the trial stage has moved to a rush. Not only can a doctor scroll his or her list of patients to be visited, but they can also share information with patients. Dr. Henry Feldman, a surgeon at Boston’s Beth Israel Deaconess Medical Center, told Coombs that when it comes to treating surgical patients, being able to pull up diagrams and x-rays at their bedside has been a real game changer. Feldman said that he has been told more than once “That’s the first time I’ve understood my disease”.
