Data, Data Everywhere, and not a Drop of Information
Accessing the right clinical information at the point of care truly changes everything. Here’s a real-world example: An elderly patient came in for glaucoma surgery. During the pre-op exam, the care team detected a cardiac issue. Normally, the surgeon would have cancelled the surgery and written a referral to have the cardiac problem checked. The elderly patient, now worried about a heart problem, would have been shipped off to see the specialist. However, this care team had a health information exchange (HIE), and they were able to see that the cardiac issue was well-known, having been well treated by her providers across other care settings. With this knowledge, the care team was able to spare the patient the worry and expense of an unnecessary cardiac consult and proceed with the surgery as planned.
This is just one example of how having the right clinical information accessible to clinicians at the right time can improve care and patient convenience. Studies of emergency departments (EDs) have shown that when longitudinal clinical information is available, great things happen. On average, patients are triaged into the ED 55 minutes faster and are admitted approximately 40 percent less. Duplicative testing is cut in half, depending on the nature of the testing. Patients are treated faster, better, and for less expense. What’s not to love?
To take my theme and make it personal, when I was caring for my mother as she was dying of chronic obstructive pulmonary disease, I often felt like I was her primary care physician. She went to a multispecialty clinic that had a leading electronic health record (EHR) system. All her information was there, but it didn’t fit the organization’s workflow. The staff was expected to dig through screens and screens of information to find what they needed, which wasn’t realistic. When my mother was admitted to the hospital with an acute gallstone attack, they almost sent her to surgery until I pointed them to her compromised pulmonary function. It’s not about simply having information; it’s about having it in a way that’s accessible, understandable in the context of the situation, and appropriate to the clinical workflow at hand.
Physicians are overwhelmed with data that often are not relevant to them, and that can quickly seem like clinical spam. The problem has quickly shifted to too much data and not enough contextual information. The good news is that with current technology, we can put physicians back in charge by giving them access to very specific information about their patients, when and where she needs it. It all comes back to workflow and empowering clinicians with the right information.
Here’s one more point to consider, regarding the critical human element of why having the right information at the point of care is so important: We often focus on enhancing clinical efficiency by coordinating care with improved technology, while striving to obtain cost savings. Although that goal is incredibly important, we also have a social responsibility to demonstrate empathy for the most vulnerable patients in our healthcare system who need our help.
Consider that a typical Medicare patient who is seriously ill might see as many as 10 physicians, have 25 prescriptions, and experience a huge number of encounters with the healthcare system each year. If one physician doesn’t know what the other nine are doing, how can any of these physicians avoid waste in duplicative testing, clinical errors, and non-reconciled medications and protect the patient from the hassles associated with such problems? Better access to clinical information will dramatically help that Medicare patient who is apprehensive, perhaps culturally unable to communicate, or even fearful of asking a question. Great technology allows clinicians to deliver better care and to evolve our approach to care. Ultimately, technology gives us the ability to show more empathy and compassion in treating our most vulnerable patients. It’s not a “nice to have,” anymore—it’s a critical part of the future of health care.