Kathy Anderson, 72, of Takoma Park, Maryland in the US, is a huge fan of electronic health records.

"I really like having the computer in the [exam] room. The doctor can look up any meds I ask about, and she can easily reference back to an earlier appointment," says Anderson. "She is focused on me, and she is on the same page with me all the time I am there."

Anderson also enjoys the easy access of the patient portal where her health information can be accessed from home. She can email her doctor, who responds promptly and see test results whenever she wishes.

"It gives me time to think about what the doctor says, and what the lab reports reveal," she expresses.

Today, most medical records are computerised into electronic health records (EHRs). Most EHRs aim to serve patients' needs and healthcare providers' needs as well. But more often than not, EHRs leave patients' goals and priorities out of the picture – failing to integrate or involve patients and what data they prefer to focus on.

Lack of communication between technologies


Extending EHRs to other technologies is where the problem worsens.

For example, critically ill patients that are supported by breathing machines can have their survival chances increased by 10%. It just involves programming the machine to deliver enough life-sustaining breaths; but not so much that it damages their lungs by overinflating them.

But fewer than half of patients, and in some hospitals, fewer than 20% receive this intervention, because hospitals purchase technologies that do not communicate with each other.

The optimal air flow is based on a simple calculation using the height of the patient. But height data, resides in the electronic health records, which typically does not communicate with the ventilator.

Physicians have to manually retrieve the information from the medical record, calculate (sometimes on paper) and enter the order. A respiratory therapist then takes the order and keys it into the ventilator, often relying on memory, creating space for error.

If the ventilator and health record communicated directly with one another, the whole process could have been automated, increasing the productivity of healthcare professionals.

Similar gaps exist between many other hospital technologies, and clinicians are asked to perform hundreds of small tasks each day to deliver evidence-based care, increasing chances for error and decreasing productivity, all while spending on technology extrapolates.

Hospitals focus too much of cost instead of interoperability


The safety and quality of healthcare has been compromised due to its procurement problem. Hospitals have invested in the most advanced technologies and IT systems but the technologies fail to share data, defeating its purpose of providing better support to clinical care.
 
The main problem points to the fact that the number of devices that work well with others is small. Manufacturers have not yet embraced interoperability to allow healthcare technologies to share data with one another.

In recent years, more companies have pledged to open their data to allow innovators to mine the data and use it to drive better care, but the progress has still been slow.

The widespread adoption of interoperability standards that govern formats and elements of data has still yet to happen. Without a standard, data cannot be shared and understood among devices.

Hospitals must also be involved to exert pressure as purchasers, encouraging manufacturers to embrace openness and interoperability, only purchasing devices that support this.

Too often, hospitals place overemphasis on the cost of the equipment, without looking at how it would integrate with a larger system. Therefore when health systems insist on interoperable technologies, the market will likely respond.

Advocating modular purchasing


Experts from John Hopkins University suggest taking it one step further by allowing hospitals to purchase modules, sets of interoperable products that work together to support an aspect of care, instead of assembling hospital rooms one product at a time.

They explain that many hospitals do not have the resources to design and manage all the connections between technologies, or to optimise how data is being used and displayed for high quality care.

However, the question still lies in whether healthcare leaders and hospitals will advocate for such a model as the survival of their patients, financial survival of their organisations and the ability to reduce healthcare costs may depend on it. MIMS

Read more:

Could technology be a bane to healthcare?
How nurses can utilise technology to improve patient care
EHR: Reducing medical errors, but at what cost to the doctor-patient relationship?

Sources:
https://www.forbes.com/sites/nextavenue/2017/06/13/can-doctors-keep-track-of-what-matters-to-you/#68073e606faf
https://hbr.org/2017/06/hospitals-are-dramatically-overpaying-for-their-technology