What’s in the way of achieving the best possible patient outcomes? It’s a question health practitioners ask themselves daily. In some cases, it’s reporting and paperwork, in others accessibility. Today we talk about why your electronic medical records -- where they’re available and how they’re delivered -- could be holding you back from receiving the best care.
Our guest on “Take Care,” WRVO’s health and wellness show, is Arthur Allen. He’s eHealth editor at POLITICO Pro. We drew inspiration for this segment from his article “Connecting your medical data could be the next big payoff,” found in POLITICO.
In a past interview with Amar Gupta, we were reminded that health information systems are not always compatible. Allen takes it a bit further, saying that there’s even more in the way of the best possible patient outcomes.
On the face of it, having medical records available electronically is beneficial. Think of the ease of access, portability and speed in sharing details about a patients history and care plan. But unfortunately, Allen says that hasn’t happened as much as people would have hoped.
“If you’re a doctor, the way you traditionally practice, you get paid for a procedure; you get paid for a patient coming,” Allen said. “You don’t get paid for sending them on or sharing the data. And your healthcare system that you’re part of might not want you to be freely sharing that information because then the patient starts going to another doctor and another system. They lose out on the money.”
Throughout our interview with Allen, one thing became clear. Putting in the work up front -- making sure medical records are universally accessible and freely shared -- might actually save hospitals and care providers money in the end. The way things are now, patients are stuck navigating the system on their own and ultimately costing hospitals much more, according to Allen.
Allen tells the story of one patient, Ronald Pressley, who didn’t have many options when it came to his care.
“He just found that his only home away from home, you could say, was at the emergency room,” Allen said.
Emergency rooms are expensive. Thousands of dollars for any kind of visit.
Pressley had some issues and didn’t have the means to take care of himself.
“A lot of it was the anxiety and also just this unstable living situation,” Allen said. “It’s worth saying we have these very complicated systems where patients often don’t know who to turn to. They don’t know what’s going to cost them what. And doctors don’t communicate with each other in ways that’s sort of surprising.”
He says bringing all of this together is an important thing for our health care system to do. Pressley made it into an apartment eventually, but his caseworker was laid off. He worries about navigating the system without her.
Pressley is what they call a frequent flyer to the ER. He was admitted often, usually for things that could be addressed with preventive medicine, but without stability in his own life, he couldn’t keep up his health.
In Pressley’s case, this was solved with a mixture of low and high tech.
The low tech
Pressley, and others who visit the ER on a regular basis, can be assigned a caseworker.
“Social workers or care managers -- the profession of the person isn’t as important as it is just them developing a relationship with this patient,” Allen says. “It’s kind of a mixture of high tech and touch and low tech that’s needed to keep these people out of the hospital.”
That mixture could result in improvements in their health, overall lives and could lower the cost we’re all paying for these visits (they’re often covered by Medicaid and Medicare).
The high tech
One way Pressley’s care providers were able to stay in communication was with something called PatientPing. PatientPing works in electronic medical records, but in a different way. For one, they’re much smaller than the big companies out there. And the information their system shares with health care providers in the ER is specific -- like how many times they’ve been admitted in recent months. And they share that information across hospitals that pay for their service.
“The big electronic health record vendors -- which are run by billionaires and have got vast amounts of money -- it hasn’t always been a big incentive for them to share data among each other,” Allen said. “These little companies, which have a fraction of the number of employees or the amount of money, have started providing these quick hit ways of linking hospitals and doctors in communities with limited but very key pieces of information.”
These new options for sharing patient data could make a difference when it comes to medical costs incurred as well as overall patient outcomes, Allen said. There’s no doubt we’ll see this field continue to evolve.