Suppose that the next time you go to a doctor's office, you would not have to balance a clipboard on your knee, write down your medical history, remember the five syllable name of each medication you are taking, and list all your allergies. that your smartphone can simply access the computer system of the office, where you could upload your complete medical history in a safe, secure and accurate manner.
Such an application could alleviate the frustration patients feel when they fill out forms for a new doctor. More importantly, it could help solve a serious but lesser-known problem that affects hospitals and clinics: while the increased use of electronic health records has helped expedite record keeping, providers can not always gather Reliably records for the same patient. which are carried out in different hospitals, clinics and doctors' offices.
That was the scene in Boston in 2015, when the emergency room doctors were struggling to treat a patient named Maureen Kelly, only to discover five different electronic records of Maureen Kelly, each with the same birthday and zip code . They had no way of knowing what record matched the patient in front of them. Was she Maureen Kelly with diabetes? The Maureen Kelly who only had one kidney? And if they decided to send their registration to a specialist outside the hospital, how would they know which of the five they would send?
Fortunately, Maureen Kelly recovered. But to make the best medical decisions possible in cases like hers, doctors need immediate access to accurate patient data, including records from other centers. Digital systems must be able to match perfectly the records of a pediatrician in Pittsburgh or a surgeon in San Diego each time. The inability to do so, which could mean that doctors do not have important details, such as allergies to a patient's medications, chronic diseases or past surgeries, can mean the difference between life and death.
It is quite difficult to keep records within a single large hospital system; transferring them between different doctors' offices and other hospitals is even more challenging. As digital health care systems have proliferated, they have used a variety of formats to record essential information, such as addresses and dates of birth, that are not easily transferred from one system to another. And, of course, patient identification information is not static: dates of birth do not change, but people move, names change through marriage or adoption, and more. Matches between different systems have also been hampered by data entry errors.
And while harm to the patient is the main risk posed by inaccurate records, the cost is not a minor consideration. The Office of the National Coordinator of Health Information Technology reported that each instance of an erroneous record cost the Mayo Clinic approximately $ 1,200, and that is only within the Mayo system. These administrative costs are magnified when the data are exchanged at the national level.
No solution can solve all the problems of patient matching. But The Pew Charitable Trusts is researching several ideas. Pew recently asked the non-profit organization RAND Corporation to evaluate solutions that allow patients to exercise greater control over how their records compare. RAND examined a variety of options and concluded that the growing use of smartphones offers a particularly promising opportunity to improve record matching in two ways.
First, smartphones could allow patients to verify their phone numbers at the point of care, perhaps by responding to a text message, a strategy that is already being used in banking, travel, retail and other industries. Once the patient confirmed a number, the hospital computer could use it automatically to compare other records with that number with a greater degree of certainty.
Second, patients could use an application to enter their information, such as an address or even a driver's license number, and send that information directly to the hospital when they register for their visit. This would allow patients to update their information and voluntarily provide more accurate data to facilitate comparison. Smartphone apps could eventually add and transfer even more information, such as drug lists or health histories, and replace the paper in the clipboards used today.
The smartphone approach will not solve this problem on its own. There are potential limitations: patients would need to have their own phones and know how to use them, and the system might not work in emergency situations when a patient did not have or could not operate a smartphone, but the Pew Research Center at the beginning of this year, more than three-quarters of Americans now use smartphones, including almost half of people over 65.
To address the larger problem of patient comparison, interested parties should look for a variety of solutions, including applications for smartphones. Technology developers should move forward and start pilot projects now of smart phones and a variety of other solutions, and demonstrate how they could be used to save lives, improve care and reduce health care costs.