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AI World Conference & Expo · Boston, MA · December 11-13, 2017

Paper health records lead to inefficiencies and big mistakes

There used to be a day you would go to the doctor when you were sick. The doctor would see you, examine and diagnose you, write out a prescription, hand it to you and send you on your way. If your doctor happened to be really busy and got distracted maybe he or she forgot that you had an allergy to something like penicillin and then wrote a prescription for something with it in it.

Of course, you don’t realize there is something wrong until you get the prescription back from the pharmacy and pull out the bottle to take a pill. It could be that the smell is overpowering or the color is distinctive. You know you are allergic and cannot have it and you wonder “how did this ever happen?” The reality is that this happens all the time. The rate at which this occurs used to be a lot higher, but it still happens. Also, it’s not limited to just doctor visits. It happens in hospitals, nursing homes, clinics, doctor’s offices, pharmacies and in the home. Paper medical records are archaic, disconnected and not convenient for sharing information.

With paper records, everything had to be done manually, often in different locations. This meant that people were constantly running all over the place for patient records, x-rays, labs or anything else pertaining to the patient. It is time consuming, a massive waste of time, always chaotic and one mistake from a malpractice suit.

When I was working in a large teaching hospital I remembered seeing slips of nursing notes on the floor all the time thinking to myself “how many trees are we killing today”? Our focus should have been on seeing patients and completing work, but so much of our time was consumed by shuffling papers. Clearly, the paper system does not work! There must be a better way and most people thought electronic health records were a panacea to all these problems.

With Health Records, Being Electronic Is Just The Starting Point

Electronic health records (EHR) has been around for the better part of a decade but the value has been limited. Evidence of this is that most healthcare workers are not very happy with their EHR systems. According to Healthcare IT News only about one third of doctors are happy with EHRs.

Doctors, nurses, and other care givers are dissatisfied as well as EHRs has meant an increase in computer time and less “face to face” time with patients, harming the patient relationships, and causing more errors. EHR systems offer digitized records but they are typically stored on independent systems that are isolated from one another. So patient records are one system, X-Rays another and so on. Clinicians would need to access these records and then correlate the information manually, which is no easier to do than with paper. In fact, trying to remember all the passwords and where the records are can often make EHRs less efficient than paper ones.

Despite EHRs being a mature technology and widely adopted in mnay facilities today, there is still an inability to see and interconnect with other systems, which limits the value of them being made electronic. Other problems with EHRs are with security, training, reliability of the systems, and application support. Clearly it is understandable why EHR optimization, including security, prevention of errors, improve outcome and costs is greatly needed today. This is why most hospitals are upgrading their EHRs. According to Health Data Management, over 95% of hospitals had already implemented their EHRs yet many are planning to invest on improvements or upgrades this year.

Cloud connected EHRs improve patient care

As the EHR systems get upgraded, they need to be connected to the cloud. This lets clinicians receive information faster. No more running for the chart, x-rays or labs. The healthcare team has all of this information at their fingertips when they need it. Cloud connectivity makes it easier to share information across systems. Also, the cloud is optimized for mobile, which lets doctors and nurses better use the tables and smart phones that most carry today. Another advantage of cloud based EHRs is that the systems can integrate with each other through application programming interfaces (APIs). This makes it much easier to correlate information between systems so errors like the example above of a doctor prescribing an erroneous medication, would not happen.

source: CloudTimes

In healthcare there is something called the “Five rights of medication”, which was put in place to reduce errors and harm to patients during the delivery of care and cloud connected EHRs can address each of these. These are providing the right patient, the right drug, dose and route at the right time. An example of when this is necessary is when a patient might be in the hospital or nursing facility and unable to speak for themself and the nurse is able to scan the patient’s ID band, medication and know the safety checks have been completed by the pharmacy, doctor, person who entered the orders into the system, and by the nurse administering the medication. If the patient has an allergy, it automatically comes up in the system if the system is working correctly. If the information is in the cloud, it becomes accessible anywhere. Juxtapose this with on premises systems that make the data available only in that location.

According to Becker’s IT & CIO Review, a study performed by KPMG shows 38% of CIO respondents state EHR upgrades rank as their top investment priority over the next three years. The biggest concerns the hospitals face in optimizing EHR’s associated with cloud are security, data loss, and applications not fully functioning with the existing architecture. There is still work to be done but the cloud solves many of the existing problems of isolated electronic records.

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Christine Kerravala, RN

Christine Kerravala is a Principal Analyst with a dedicated focus on the healthcare industry. Christine has deep expertise in healthcare having been a Registered Nurse since 2005 and currently holds licenses in Massachusetts and New Hampshire. She specializes in the area of medical surgery, cardiac care, school nursing, home care and Alzheimer’s.
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