More is Better When It Comes to Patient Information

"Healthcare delivery systems around the world face disruptive macro socio-economic forces of change. Demographic shifts, altered patterns of disease, changing patient expectations, and rising political demands are putting pressure on the ability to deliver cost-effective, quality patient care," according to a recent white paper from IDC Health Insights.

Access to complete patient information could help meet these pressing challenges that are being felt around the globe. In this first installment of a two-part series, Daniel Pidutti, Senior Director of Healthcare Solutions in the Information Intelligence Group at EMC Corporation, Pleasanton, Calif., discusses the need for complete patient information and how an integrated patient record could help in the quest to cost effectively deliver high quality care.

HIMSSwire: Can you explain why there is this universal need for an integrated patient record?
Pidutti: Let me give you a simple example to illustrate the point. I don't remember the last time I had a tetanus shot, although I know I have had them in the past. I recently cut myself doing some DIY at home. I went to get treated and I opted to just have the clinician give me the shot. If the clinician would have had access to my complete record, I might not have needed the shot as a DTaP vaccine protects against tetanus for at least 10 years. The simple fact that the information was not there forced the provider to administer what might have been unnecessary treatment. While a single tetanus shot might not be expensive, it is costly if you consider the hundreds-of-thousands or millions of shots, tests, or procedures that are delivered and performed unnecessarily each year. To that point, we know that an incomplete view of a patient’s medical record can be disastrous, both for quality of care and patient safety. And as the IDC Health Insights white paper concludes, some 18% or more of medical errors are the result of not having appropriate access to patient information. This includes such critical information as lab results, medication history, allergies, even blood type. So you can really start to see how these omissions can lead to increased costs for the healthcare system, and on the flip side, how they could lead to better patient outcomes and greater efficiency if they were at the clinicians’ finger tips.

HIMSSwire: Specifically how would an integrated patient record help solve problem?
In a hospital, for instance, patient information is typically trapped in siloed healthcare IT systems, paper-based documents and processes, and even documents that are not machine-readable. With an integrated patient record, structured and unstructured data from multiple disparate systems are united to provide clinicians with a complete, longitudinal view of patient history, diagnosis and treatment, which they often lack at the point of care. This patient-centric view makes it possible to view all essential information beyond the electronic medical record -- regardless of source, location or format -- internally throughout an organization and externally across the continuum of care. An integrated view of the complete patient record helps immensely in terms of reducing costs from avoiding unnecessary testing and treatment, but also from the delivery of more efficient patient care and care coordination. In other words, it enables clinicians to better serve their patients, which correlates directly to better outcomes.

HIMSSwire: Do current EMRs provide this integrated view of patient information?
Not really. The systems that most providers are using are very focused on encounters and billing. When a patient visits a provider, the EMR is used to capture the encounter. The system, however, does not really care about what is going on in cardiology or radiology or other areas, nor does it easily integrate with the individual systems these departments are using. What this creates is volumes of patient information, in multiple formats, locked in numerous systems and document repositories. But more so, it creates a situation where there is no easy way to access or facilitate electronic sharing of this information. As a result, this fragmentation and disparity among systems prevents clinicians from seeing a complete view of patient history, which can lead to quality, regulatory, and privacy issues -- all things that effect patient outcomes and contribute to increased costs.

As more healthcare organizations implement EHRs, more clinicians will realize that a significant amount of patient information remains in silos, and needs to be integrated into one consolidated view to support care efforts. The next installment of this two-part series illustrates how U.S. healthcare organizations can move toward making integrated patient records a reality by following the lead of healthcare providers in Europe.