Electronic medical records (EMR), like health insurance, benefit from being spread over the widest pool possible. A system that aggregates and cross-references data from hundreds of millions of patients can find statistical evidence far more efficiently than today’s statistical modeling for health problems and solution improvement.
Allowing for non-identified EMR sharing across the system creates a universal pool of data in which drug side-effects, treatment failure or success rates, disease history, specific organ damage or healing, and all sorts of incidence of drug interactions and health specifics can be cross-referenced, spurring a massive amount of data-rooted research and improving quality of care and treatment success rates.
Pres. Obama has consistently touted the potential for a widespread or even national standard of EMR to help spur innovation and bring down healthcare costs, but the issue has been very little explored by mainstream media and has been consistently opposed by some critics who fear “nationalized healthcare”. The first thing we must understand in exploring EMR and its potential is that it does not mean a nationalization of healthcare.
Unbelievably, a provision in economic recovery legislation signed into law by Pres. Obama was vehemently opposed by some in the opposition on the grounds that EMR would bring about a situation in which the government “punishes” doctors who don’t comply with federal mandates. No such punitive measures were in the bill and no specific mandates for doctors either.
But it’s worth considering the degree to which the private insurance industry, so committed to its right to deny treatment, does actually take punitive measures against doctors who don’t comply with its demands. EMR can be a great efficiency booster for healthcare in general, and could actually be part of the all-important process of reducing the urge of insurers to spend money denying treatment.
But the burden to practitioners is a serious concern, so an effective EMR standard should require as little work as possible for doctors and nurses, ideally zero additional clerical work. Medical professionals should not be able to notice the “labor” involved in EMR upkeep. The best way to achieve this is to make sure the best possible tools are used universally to make EMR upkeep equivalent to or simpler than paper-record upkeep.
A letter-sized e-paper tablet touchscreen device would be ideal for fluid management of medical records in a new EMR universal standard. A flexible full-size letter-format touchscreen could be easily folded into a doctor’s pocket, taken out at any time for on-screen chart updates, and linked to an onsite or remote server that synchronizes with a universal EMR database in which all personal patient information is filtered out but medical data is stored.
Individual patient records could be accessed through the system as well, in order to maximize the delivery of relevant patient history to any doctor across the system, when needed. This would optimize the quality and precision of patient care choices, preventing unnecessary complications, reducing the incidence of human error and addressing health problems with the optimal course of treatment, ideally also reducing the number of interventions required and the long-term costs over time.
Privacy protection and the banning of data sale or resale are absolute essentials. The system must be informational and function-centered, free and open to the public as well. The benefits to be derived from opening non-identifiable pooled medical data to independent analysis are vast: speeding innovation, judging quality of care, and creating fact-based statistical analyses, not best-guess synthetic limited-pool studies (using either perfectly healthy, one-malady-only or terminally ill patients, to the exclusion of anyone reflecting a more common complex of health issues).
The EMR research database would be open and never, under any circumstances, searchable by individual patient or specific treatment centers. Personal medical records would be part of a sealed atomized patient-specific database accessible only by doctors or medical professionals authorized by virtue of providing actual treatment to that patient, in the moment or in consultation with other physicians.
Separately, an evolutionary quality of care effect could be achieved, if success rates for certain types of treatment were available in relation to specific treatment facilities. This database might need to be less wide-open, perhaps with peer-review and a kind of official rating system, so doctors are not pressured to withold information or buck or trick the system.
If this 3rd function of EMR could be implemented with optimum effectiveness and benefit to all involved, then the best centers would be elevated for their successes and others would be forced to learn from them and improve their care or else change specialty or close. Ideally, this would eliminate substandard care, and therefore medical errors, excessive complications and other costly inefficiencies.
EMR can also allow for better-targeted monitoring of individual health, even in cases requiring constant targeted screening. One of the main reasons for prolonged hospital care is continuous monitoring, doctor-assessed dosing and crisis response times. EMR can allow for far more effective at-home monitoring, reducing hospital stays, optimizing IC-use and helping to limit the overburdening of skilled healthcare professionals, thus bringing down costs.
The question now about EMR is how to make a viable national system of electronic medical records function for the benefit of everyone. First would be getting everyone covered. Second would be incentivizing the relevant technologies. Third would be showing doctors a real benefit to their own workflow and quality of care.
Then comes the big task of making sure the system works as intended: allowing patients’ medical records to arrive as they do or before, with no effort required of patients or patients’ prior doctors in the moment of record retrieval… protecting patient privacy to 100% effectiveness… allowing the pooling of non-identifying medical data across the system… and using EMR to improve quality of care and treatment options, and in the process, save and prolong lives.
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