By Mario Chao
Wendy C. was born in the year 2000. At that time, computer chaos threatened because of the change of a digit. Nothing happened and now no-one remembers the first great global technological psychosis.
Wendy was born in Chile and was a strong, healthy baby. Like any other child, she got the flu in winter, and this accentuated problems with asthma and pollution in Santiago, the Chilean capital. She was thus taken to the emergency room twice at the modern clinics in the city.
Wendy’s parents moved to Barcelona, Spain, where the girl had another pediatrician. A year later, the family went to Valencia, which is just 350km away from Barcelona but, of course, she got another pediatrician. Six years later the family moved to Bogotá, Colombia, where they lived for 11 months. Today they live in the beautiful Mexico City.
4 countries, 5 cities, 5 pediatricians and over a dozen medical specialists visited during that time filled Wendy’s clinical history with many documents. The file is fragmented, dispersed and on paper.
So her parents accumulated paper, some of it now yellowed with age, and often without clinical validity: diagnoses, procedures, vaccination schedules, medical images and any other information that might be relevant to their daughter.
In every country, in every city, whenever they have had to go to the emergency room or a specialist, they have had to repeat time and again the answers to the same questions: age, family background, diseases, surgery, etc., etc., etc. Even when Wendy has been lucky enough to go to clinics with electronic systems, they do not communicate with each other even within the same country, not even in the same city, neighborhood or even when they’re on the same street.
During the age of connectivity and social networks, this situation seems almost irrational.
Wendy’s case is not an exception; unfortunately it is the standard. Our healthcare information is fragmented, isolated and kept in dozens or hundreds of medical cabinets in the offices we visit in our lifetime. On paper. A lot of paper.
However, medical science and technology is progressing at record rates; today it is possible to obtain images of the body that would have seemed like science fiction 20 years ago. We can also undergo surgery by robots and even have our DNA decoded.
The great paradox of the healthcare sector is that 21st Century medicine is being practiced according to 19th Century procedures, in which paper is incredibly the most common means by which information is recorded and exchanged. This is irrational and illogical!
There is no reason for things to be like this. I repeat: no reason at all. The technology exists and the enormous benefits of an Electronic Health Record are clear and have been proven without a doubt in numerous studies. So not only is the lack of informatization in the sector irrational and illogical, it is also incredible.
Informatization in the sector ensures efficient processes and especially access to the right information at the right time; basic elements in any decision making process. The Electronic Heath Record leads to more and better healthcare, more comprehensive monitoring of health problems, a reduction in waiting times for information, an increase in diagnostic accuracy due to multidisciplinary exchange of information and it also helps to control and manage costs.
Perhaps a simple example can demonstrate the importance of the EHR. If a patient arrives at the emergency room unconscious and needs rapid clinical treatment, an electronic health record can warn us about the patient’s allergies or intolerances of certain medications, improving the safety of medical treatment. The allergy might have been detected by another hospital or the patient themselves a long time before. Having the right information at the right time can make an enormous difference to clinical case.
Furthermore, when the EHR is implemented in numerous hospitals and clinics across a city, state or country, clinical information can be exchanged between different centers and service provider networks, such as laboratories, insurers, etc., allowing the information to follow the citizen/patient, making it accessible anywhere in the country quickly and securely.
Electronic Health Records can also considerably reduce medical errors. Recent reports show statistics that should not go unnoticed. Attention: according to a study by the prestigious Institute of Medicine (IOM) from the United States, published in February 2013, more people in the country die from medical errors than traffic accidents, breast cancer or AIDS.
In this area, information technologies can make great strides toward avoiding the mistakes that no medical professional wants to make. It will make it possible, for example, to reduce errors deriving from erroneous interpretation of handwritten doctor’s notes, a simple, obvious point. It will also make it possible to check for reactions between medications, maximum permitted doses, and to provide automatic alerts when anomalous readings are detected from a relevant clinical indicator. And all this as a matter of course in the routine of each and every patient!
The lack of informatization in healthcare is not just irrational, illogical and incredible, it is also unacceptable given that it will significantly help to save lives and improve patient care.
At the same time, to point out even more contradictions that exist today, we are taking great steps in the intelligent use of information for clinical purposes. So the genetic information of patients is being analyzed to predict the probability that they will contract certain diseases or for a specialist to recommend a certain medication or procedure that fits the personal status of the patient. These intelligent algorithms will of course improve their performance the more data is available to be analyzed for patterns and to take full advantage of the science as applied to each individual, unique case. The science and technology for processing this information is already available, but we need to start to use the Electronic Health Record on a large scale in order to make the dream of connected and intelligent healthcare a reality.
As in other sectors, the role of the citizen/patient/consumer will be decisive at this stage. If in other sectors we are demanding, informed consumers, there’s no reason not to be with what we value most for ourselves and our loved ones: health. The ‘consumerization’ of healthcare is a new phenomenon from which there is no going back. More and more people are researching and seeking information on the internet about their health condition, or connect to specific social networks for people with the same disease, or use apps on their smartphones to identify or record their medication and/or monitor their eating, or physical condition in general. The citizen who cares about his or her wellbeing, starts to question whether their diagnosis is correct or whether the treatment they are receiving is the best; they seek second and third opinions. This citizen doesn’t understand how their head doctor, the hospital specialist, their insurer and the government to which they pay their taxes are incapable of exchanging the information that is generated by the multiple interactions they have with each of them. Some, the most committed, start to use Personal Health Records to keep their medical information organized.
The demands of citizens, which are as yet generally new and underdeveloped should become the definitive drivers behind the introduction of healthcare information, even before laws or the clear will of the international organizations who have been recommending their use for years. It is a challenge for every actor in the sector: from the patient to the insurer, by way of the hospital, the GP, diagnostic laboratories, pharmaceutical companies and governments. A challenge that may be difficult and will take time and effort, but that must be met.
