The Journal of mHealth Vol 1 Issue 2 (Apr 2014) | Page 53

Obamacare: Electronic Medical Records

Obamacare Paper Cut Leaves
Patients Hemorrhaging from EMR
Band-Aids
By Thanh Tran

Whether driven by simple technological advancements or Obamacare, the
digitisation of medical records and
data is a necessity. Almost 80 percent
of U.S. hospitals currently use some
type of electronic records software,
according to the U.S. Department
of Health and Human Services.
Approximately $2.05 trillion is spent
on these systems yearly, reports the
Healthcare Information and Management Systems Society.
What is still being debated is how to
mesh the almost daily mobile technology shifts, mixed with social media
and security concerns to enable medical professionals and patients to unite
in ending needless medical errors.
These errors cause 200,000 patients
deaths yearly, 40 percent of which
are directly related to information
omissions and miscommunications.
If the Center for Disease Control
reported a category for erroneous
medical deaths, it would rank 6th in
the U.S. These unnecessary deaths,
along with reducing duplicative tests
and procedures, waste billions needlessly on costs that drive up insurance premiums that are passed on to
consumers.

PROLIFERATION
OF REDUNDANT
ELECTRONIC MEDICAL
RECORDS
There are hundreds of Electronic
Medical Records (EMR) software
tools in existence today. Most hospitals, because of medical mergers and

acquisitions, have multiple EMRs in
place. Unfortunately, most of these
programs do not connect and they
all present the data they store differently, often in proprietary databases
with HIPAA creating a secondary set
of data in many cases.
The expectation was of EMR data
sharing through open architecture,
but instead hospital IT departments
were burdened with systems lacking interoperability. To address these
challenges, it is being suggested
that Health Information Exchanges
(HIE) use an additional consolidated
database on top of the existing EMR
software. However, the HIE database
not only causes data duplication, but
also requires additional database synchronisation and data privacy. These
requirements only add an additional
layer of difficulty rather than solving the actual data sharing that was
intended to support patient care.

INFORMATION RICH,
BUT DATA POOR
The focus on being data rich, but
information poor also creates gaps.
Differing sets of data between a
current care environment and the
previous care environment, such
as existing emergency room data
and new data at an outpatient facility, easily causes miscommunications. EMR tools need collaboration
between caregivers, and caregivers
and patients. There is also a lack of
real time medical information over
geographical distances.
When you add the lack of access to
the original records by the family

physician and the inability of EMR
systems to offer an analysis of the
impact of new medicine on a patient,
we are almost back to square one.
EMRs, as passive components, fail
the basic purpose of having paperless records. If the data is not moved
into the active environment, how can
care providers deliver on the promise
of better patient outcomes in 2014?
How many more patients will wind
up like Bill White who almost died
because an order to check his potassium level was never received by his
night physician after a shift change?
How about 12 year old Rory Stauton
who did die from lack of timely medical record communications between
a hospital and his family physician?

IT’S NOT THE BOOM
OF THE BEEP, BUT
THE SUCCESS OF THE
SIGNAL
EMRs also often fall short in patient
tracking by medical professionals
suffering from beep fatigue who turn
off their devices. Often the beeps
are not even going to the appropriate provider. What is critical is not
the beep, even though many times
coming from hand held devices, but
the signal. How accurate and timely
is the beeped information and does it
correspond with other current data?
Another form of fatigue is the additional time now needed for training on new, unfamiliar systems that
nurses’ must use rather than deliverContinued on page 52

The Journal of mHealth

51