The pandemic is putting electronic medical records to the test


To slow the spread of the coronavirus testing is hugely important, not just getting a test but getting the results back as quickly as possible. A recent survey found that the average wait time for results is four days with ten percent of the people surveyed waiting ten days or more a shortage of the equipment and chemicals needed to perform the test is part of the problem but the country. Also lacks bust electric medical records system which would allow information to be shared seamlessly. We wondered how much is that slowing everything down Julia? Adler. Milstein is a professor of medicine at the University of California San Francisco where her research focuses on electronic health records. I asked her if part of the problem is all the different software providers, companies like epic and Care Cloud and Athena health not. Playing nicely together I do think there's a roadblock there I mean that's really been an Achilles heel of the past decade where we've seen so much more digitisation of health information but not as much of an effort put on making sure that that information can move around seamlessly where it's needed and I think in an ideal world. Yes. Those large companies would have cooperated and figured out how You. Build their systems in a way that we're more compatible but we also didn't really create strong incentives for them to do that, and now we're working to try to correct that and I think covert has shown a really bright spotlight on the need to do that. But but it wasn't there from the start and I think we're really paying the price for that. Now What about privacy concerns? With information being shared more widely in more places I. Wonder if patients sort of opting out may be part of the the hurdle here. It is and I mean privacy concerns. You know go go hand in hand with greater ability to move and share information because you want to be sure that it does end up in the hands and not the wrong hands and that and that the patients are involved in that in the way that you know is appropriate until I think one of the issues that that is hard to know is sort of in what what level of of detail or granularity patient want to be involved in managing. You know who sees their information and for what purposes. into do that at scale is really hard because we know different people have different preferences over all and for specific types of information, as well as for whether it's a payoff for example, like what they might want to share with health insurer versus their doctor. So it gets very complex very quickly. So I think everyone agrees we should have the privacy protection, but actually implementing that privacy protection control is is where it gets pretty pretty complicated. I'm also wondering about the cost of all this I know the federal government has already spent tens of billions of dollars to encourage the adoption of electronic medical records. Do you have a sense of the price tag on what this effort could cost to get it? Right I don't think we've really seen good cost estimates because part of it is sort of what are we paying for I don't think at this point we're really paying for the infrastructure. This is really about linking up all of the digital entities and writing down rules of the road. I. Don't think anyone really has a sense of the Price Tag. You know my personal sense is that it would be lower than the investment that we've made so far because there's so much cost just the digitisation itself. But there's also some real costs in in in trying to figure out how to make all the different systems talk to each other, but potentially lots of savings to I imagine. Oh absolutely there have been some estimates of that and they've been in this sort of seventy to eighty billion dollars. A Year of potential savings if we really were to get to sort of fully standardize seamless information sharing a fact that hospitals are filling out spreadsheets with their covid testing data and sending it to the federal government, it's staggering to think that we're still doing that you know in the year twenty twenty. But then also to think about all the costs of all the people in those hospitals who are manually entering data into a spreadsheet, it's sort of hard to believe. Yeah, and if I never have to try to remember when my knee surgery was when I see a new doctor. It'll be too soon. How many of those health questionnaires if we all filled out again and again? Yeah. No. On the patient side exactly I mean, we haven't even addressed those costs and also just I think that the stress that we put on patients when it's clear that their doctor doesn't know their medical history and so if you were to show up today and you know tell your doctor that you've had cova test and then for that doctor to say, Oh, well, I don't have any way to access that information at his not delivering patient centered. CARE. Julia Adler Milstein is a professor of medicine at the University of California San Francisco. And now for some related links, another wrinkle in all this, just because you're test results are in the system doesn't mean your doctor we'll see them right away. These are busy people with lots of patients counting on them. Adler Milstein says so far. The solution is just hanging doctors with lots of alerts, which if you've ever had to mute a group text chat, you know can create notification fatigue, and while most hospitals now have some kind of electronic health records system public health departments are still far behind relying on. Phones and even fax machines to share information. That's the subject of an episode of the health podcast trade-offs from my former marketplace colleague Dan. Guerrero tiene molly had him on this show awhile back Dan found that technology and data gaps key public health officials dangerously out of the loop, the fight, the spread of Corona virus. We have a link at marketplace tech DOT ORG along with results from a survey from the Pew. Charitable trusts found that most Americans support to improve how medical records are shared between providers but have since. Concerns about privacy and accuracy and respondents were generally less comfortable with the sharing of sensitive information like Substance Abuse Mental, Health Issues and homelessness factors that can influence health but also potentially how patients are treated I'm Amy Scott and that's marketplace tech.

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