Friday, October 9, 2015

“One Patient, One Record”

This healthcare IT tagline has been around for a while. Software vendors and healthcare provider IT groups, touting this slogan, are definitely aware that it over simplifies a patient’s information trail. There are many unknowns that could splinter that “one record” goal. For example, what if a patient goes to a different hospital? What if the patient’s insurance changes, what if any number of issues could happen to the many systems used to keep track of a patient’s registration, appointments, orders, results, ED visits, discharges, etc.

Patient is a person not a chip

Patients being human can inadvertently cause havoc on their own information. It could be as easy as changing your baby’s name or moving to a different healthcare provider. The information that follows the patient me get split into two separate buckets, orphaned by glitches in the systems. Regional information exchanges can help, but typically do not house all of a patient’s record, only the current, actionable data. What happens when patients move and then return to the same hospital years later? I can tell you that merging patient information can be very tricky.

Release of Information—can you be specific?

When a patient requests all of their health record data, do you really think all of it is collected? If so, how is this verified? Are there any regulations that state this type of request has to be complied with fully? Essentially, the patient has to fill out a form and select which information he/she wants, with an “other” line for her to fill out. This could leave many documents behind because the patient has no idea how many types of documents are in a healthcare ECM system: hundreds, if not thousands.

Every Visit to the Doctor’s Office

Every visit to a provider generates thousands of records. There is the registration which gathers insurance information, signatures for consent, appointments. There’s the nurse who enters current information about allergies, weight, body temperature, blood pressure, etc. He may or may not have paper forms as well for the doctor. The doctor opens another form on the computer, shows test results maybe, enters in clinical notes, writes a script, enters in a diagnosis code, and so on. Many of these entries are split up and branch to other systems for further processing.

From One Record to Many

A patient’s healthcare record will never be “one” record, it will always be a tree of information, or many trees of information, connected by one or many medical record numbers. A regional exchange will hopefully help to cull a patient’s information trees together. Maybe a national register would help as well, but this is way in the future. Sharing health information transparently would lower healthcare costs, however it would lower profits, so there will be lots of feet dragging before “One” record is achieved…

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