Electronic health records provide an alternative to paper based records. They are also a source of information that can be used as part of other networks to address a wide range of healthcare issues. Here’s one example:
Congress has passed a bill requiring food processors to implement systems to track cases of food that may be related to outbreaks of food-borne illness. An estimated 76 million people contract food-borne illnesses in the U.S. each year, with 325,000 hospitalizations and 5,000 deaths, according to the Centers for Disease Control and Prevention in Atlanta. Those illnesses cost the U.S. economy $152 billion a year in healthcare and related expenses. Rapid identification of the sources of food-borne illnesses and their removal from the market could save thousands of Americans’ lives each year.
Under the required tracking system, farmers or other producers would scan individual cases of produce and keep records of where they are shipped. If a recall is ordered by the FDA, the records would be used to trace the current location of the recalled produce. The law does not address how the cases that are contaminated and need to be recalled can be identified. Here’s where an EHR system can help.
Most EHR systems provide for reporting of food-borne illnesses. By adding a few additional elements of information, the search for the source can be narrowed very quickly. When a doctor enters a diagnosis of food-borne illness, the system can ask for the type of food or perhaps several options that are suspect, e.g., eggs, fish, or spinach and the name of the market or restaurant where the suspected food was purchased.
An EHR can track doctors’ reports and when a target number of similar reports is reached an analysis can be launched. A single answer may not be helpful, but if the answers from several doctors list the same food and the same market or chain, that provides a place to start. Information can be forwarded to a public agency. Samples can be acquired, tests run, and the investigation focused on just a few likely sources. Once a case of food carrying an illness is found, the food processors’ system can be used to find all of the cases from a specific producer and they can be removed from the market.
There is one other piece to a complete solution and that is rapid access to a large enough number of electronic medical records to find what may be an isolated set of incidents. There are a number of organizations including the VA, Kaiser, and vendors of hospital systems that have large databases and could report to public health agencies or the FDA. There are also physician office systems like Practice Fusion that are database driven and can quickly draw information from millions of patient records today over a much more diverse demographic (location, age, socioeconomic status). An EHR front end could reduce the time required to identify specific cases of food to a matter of days instead of weeks.
The tracking process from identification of a problem to a solution would look like this:
This example provides an illustration of the way an EHR can be linked to other tracking systems to identify and facilitate the search for health issues such as some common types of sports injuries or automobile accident injuries. EHRs are clearly more than just systems to replace doctors’ paper records.
— Hal Amens
Hal Amens is a senior management consultant with experience in the design and implementation of computer system with a particular emphasis on “workability.” He is also a Practice Fusion Certified Consultant in Los Angeles.
