Thursday, January 22, 2015

For patients with chronic illnesses, EHR infrastructure must be improved

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Imagine having a bowel obstruction and going to the emergency room of a hospital you’ve never been to before. When you arrive, you first have to explain to the doctors and nursing staff that you have a debilitating inflammatory bowel disease (IBD) that many are unfamiliar with. Then you have to run down the list of what medications you take, what allergies you have, and all other pertinent information. The time it takes to share this critical information means that you have to wait longer to get treated, leaving you scared and in pain.

The evolution of Electronic Health Records (EHR) was meant to improve efficiency and quality of care for patients, but for many, the cross-communication between different doctors and medical facilities is lacking. In fact, according to a study by Premier, about 95% of healthcare providers and organizations cite interoperability challenges as a hindrance to transferring data to other medical facilities.

As the caregiver of someone with Crohn's disease, one of the two debilitating digestive diseases under the IBD umbrella, I'm used to having to regurgitate my husband's medical information. Thankfully, it doesn't happen often since most of his care takes place at a major university hospital in Connecticut where EHR is widely utilized. However, when my husband went to the emergency room in 2011 at a different hospital in the state, we had to fill them in on his medical history, and when he was released, his records were not automatically shared with his doctor. Instead, we had to get physical copies of his records and imaging to bring with us when we saw his doctor after he was released. That information then had to be uploaded into his EHR that his gastroenterologist maintains.

For the 117 million people in the U.S. living with one or more chronic illnesses, like Crohn's disease and ulcerative colitis, managing health care records across multiple offices and facilities can be time consuming and burdensome. Patients living with an inflammatory bowel disease experience many health issues in addition to the havoc that is wreaked on their digestive systems. Many suffer from arthritis, migraines, anemia, skin rashes, and other autoimmune diseases. This means that in addition to seeing a gastroenterologist and primary care physician, IBD patients may also see rheumatologists, neurologists, nephrologists, dermatologists, and, often times, colorectal surgeons.

Managing complete paper records with each specialist can be onerous. Prior to the wide implementation of EHRs, each specialist would have to fax or mail physical copies of test results, scans, and other pertinent medical data to the others, which was slow and inefficient.

Now, with 78% of office-based physicians using EHRs, the process should be smoother. Theoretically, a doctor in one office should be able to transmit the blood work of a patient to someone in a different office, allowing for a smooth continuance of care. Unfortunately, that isn’t the case and it shouldn’t have to be this complicated.

Congress recognizes the need to fix this interoperability issue and, in the combination long-term omnibus spending bill/short-term continuing resolution (Cromnibus) passed last month, instructions were given to the Office of the National Coordinator for Health Information Technology to “improve the interoperability of Electronic Health Records.”

Streamlining the EHR infrastructure to support information sharing among medical professionals will not only increase efficiency and save money, but it will also vastly improve the quality of care that patients receive from their doctors, nurses, and hospitals. For patients with chronic illness, improving EHR interoperability will allow them to be treated holistically instead of piecemeal by promoting communication and collaboration between specialists on their medical treatment.

This improvement isn't something that can wait. The Office of the National Coordinator for Health Information Technology must act quickly to tackle these major EHR infrastructure issues. The health and wellbeing of millions of Americans with chronic illnesses depends upon it.

About the author:
Rebecca Kaplan is a communications consultant, freelance writer, and blogger. You can read more about her life loving someone with Crohn's disease on her blog, on Huffington Post, or follow her on Twitter.
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