| Innovation |
december , 2020 | The Health
A life and death situation
The availability of a patient ’ s medical records in an emergency can help doctors save lives
BY DR RASHID KHAN
As 2020 draws to a close , we have
seen unparalleled growth of digital healthcare services like telemedicine , e-pharmacy or online physiotherapy .
The Covid-19 pandemic made every country painfully aware of the limits of their healthcare system and they immediately sought after ‘ digital ’ solutions to overcome the physical barriers .
Unfortunately , one digital solution to a chronic on-going problem in both public and private healthcare is not getting much attention - Electronic Medical Record ( EMR ).
Let me share an incident that occurred while I was working as a district hospital medical officer . A 50-year old Indian male rushed into the red zone of the emergency department .
He had severe chest pain , was sweating and breathless . An ECG showed a heart attack . I had to ask him questions before I could start my treatment and was pretty sure I had asked him whether he was allergic to any drugs .
He was in severe pain , so he shook his head signaling “ NO ”. I ordered aspirin to be chewed and prepared to send him to a cardiac specialist hospital for an emergency angiogram . His wife , who just finished registering the patient , rushed in and shouted “ Stop !” as my staff nurse was about to serve him the aspirin .
The wife said he was allergic to aspirin and had intubated two years ago due to severe anaphylactic reaction . My heart stopped for a second . I would have “ killed ” him instead of saving him .
A miscommunication that occurs between treating doctors and the patient would cause more harm than good . However , it would be naive for doctors to expect patients to answer an essential question like allergies correctly while they are in severe pain or panic . Doctors can ’ t blame the patients for not memorising medical jargon or scold them for not bringing with them their old medications .
Why implementing an EMR structure is essential
On the other hand , doctors in a hospital face difficulty in getting medical records during an emergency . Sometimes the medical records are not up-to-date and it would take almost an hour before the doctors get them from the medical records department , especially in the middle of the night . Worse , doctors sometimes can ’ t read what their peers wrote on the documents due to unintelligible handwritings .
Before the Covid-19 pandemic , the Malaysian government was expected to
implement the Electronic Medical Record ( EMR ) structure , a systemised collection of patient ’ s health information , by the end this year . Unfortunately , the Covid-19 pandemic put an abrupt hold on the initiative . Apart from that , the government is also facing strong opposition from various stakeholders .
Although we are living in the digital era , not all the doctors are tech-savvy ; thus , they not keen to use the keyboard to key in the medical records . Some doctors are afraid that they will expose themselves to medico-legal issues if they use EMR .
Ever since Singapore had suffered two breaches of its government health database in 2019 with hackers stealing the personal data of 1.5 million people , including Singapore Prime Minister Lee Hsien Loong ’ s data , most doctors doubt the security of EMR systems .
So , it would take years for various stakeholders to come on the same page and agreed on the implementation of an EMR system that allows a patient ’ s information to be shared quickly and easily among multiple touchpoints .
But why we have to wait until “ someone ” takes the initiative ?
Importance of PMR
We are privileged to live in a digital era . With the cutting-edge technology , everything is just at the palm of your hands ; online banking , flight or accommodation bookings , etc is just a click away from your smartphone . We can have every information on our palm , including information about our health . We can record allergic and past medical history in the smartphone .
This would come in handy when the patients have a medical emergency . The attending doctor wouldn ’ t have to waste time asking patients to scratch their brain to recall the colourful medicine name and its dosage .
Doctors spend most of their time in history taking - past medical and surgical history , family history , medication , etc . The same question is repeatedly asked every time the patient visits different hospitals or clinics .
On average , a doctor spends 15-25 minutes of consultation time in a primary care centre . Almost half of the consultation time is spent on history taking !
This precious time could be well spent on the current presenting illness if the patients are able to share their previous medical records and list of medications in a well-organised manner .
Further , doctors in a primary care centre can spend more time with their patients on the first visit to explore presenting complaints accurately , prescribe less and offer more preventative advice . In short , the total time a patient spends in a clinic visit can be reduced remarkably !
We must admit that our smartphones have become an irreplaceable resource that we can ’ t live without . Our smartphones give us everything we need to communicate quickly , get through the day and to entertain ourselves .
We can keep our valuable documents in a safe and secure cloud-based app like Goggle drive , Samsung cloud or Apple iCloud storage . Besides , health record apps which are secure and Health Insurance Portability and Accountability Act ( HIPAA ) compliant are readily available in smartphones app storage .
It will therefore be a shame if we don ’ t use our smartphones to keep essential information like our very own medical records . — The Health
Dr Rashid Khan is a Medical Officer at CVSKL
Although we are living in the digital era , not all the doctors are tech-savvy ; thus , they not keen to use the keyboard to key in the medical records . Some doctors are afraid that they will expose themselves to medico-legal issues if they use EMR . ”