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Nowadays, you don’t have to go very far to look at your medical records; you can probably pull them up on your phone right now. Though the use of electronic medical records (EMRs) is pretty widespread, providers still face some major challenges, and health systems aren’t yet taking full advantage of the technology. One way this is obvious to patients and practitioners is through the absence of collaborative tools — if patients’ EMRs are so easy to access and share, why aren’t doctors collaborating with their other providers for the best possible care?
As professionals, we have to ask ourselves if it’s worth the investment. It’s clear that physician to specialist or physician to psychologist collaboration would benefit clients. Arun Gupta, the CEO of Quartet Health, argues that this is especially true in the behavioral health realm. Technology that could close communication gaps between physical and mental health — Gupta argues that, in these two areas, “a mountain of evidence to suggest that a bidirectional relationship exists” — could make care more effective and more affordable.
But how do we find smart, secure tools to link all of our patients’ providers? Adoption should be a three-step process. First, and perhaps last, we need to embrace the collaborative approach. Understanding why provider-to-provider or department-to-department communication is so useful will help justify the expense. And for doctors and specialists who take a value-focused approach, that might be particularly difficult. Next, we have to look into actual tools that have been developed for this very purpose and figure out how to integrate them into our practices.
Embracing the Collaborative Approach
Let’s take a look at some reasons why making EMRs more collaborative can benefit patients and result in improved outcomes. In a 2014 study published in the AMIA Annual Symposium Proceedings Archive, researchers compiled data from five American electronic health record (EHR) systems and observed provider interactions for 60 hours.
The study determined that the EHR itself played four roles in collaboration: as a repository, a messenger, an orchestrator, and a monitor, but that due to poor quality documentation, there was decreased trust among patients. The study concluded that “both organizational and technical innovations are needed if the EHR is to truly support collaborative behaviors.” So, indeed, there’s no denying the need for a collaboration-focused EMR. But what about this bidirectional business?
As Gupta points out in his essay, the most glaring missed opportunity for collaborative health care comes in the gap between physical and behavioral health providers. Gupta cited a recent study showing that people with asthma are almost two and a half times more likely to screen positive for depression, and that those with type 1 or type 2 diabetes are more likely to suffer from depressive disorders.
But collaboration can be good for addressing the logistics and disconnection within health care, too. You may know that the Department of Defense instituted the Bidirectional Health Information Exchange (BHIE) in an effort to close the communication gap between the DoD and the Department of Veterans Affairs, primarily to study pre- and post-deployment physical and mental health.
The Louisiana Public Health Information Exchange (LaPHIE) is a similar program that links providers between emergency rooms, primary care departments, inpatient units, and specialty ambulatory clinics to help address a broken HIV/AIDS care continuum in that area. A 2017 study showed that in the first two years of the program, LaPHIE saw an incredible improvement in the HIV care continuum.
Upgrading to Smart Medical Devices for Every Visit
We all know that high-tech medical equipment is a necessity of contemporary care, but we often don’t consider how much even the smallest, most commonly used devices can contribute to a better patient experience and a more collaborative approach. Streamlining data, and making it effortless to record and share, is the most important way to create secure, collaboration-ready EMRs.
Take, for example, the humble stethoscope. Once limited only to whoever was in the room, audio recorded from a digital stethoscope can now be effortlessly recorded and transmitted via Bluetooth to a smartphone or tablet. Gone are the days of describing the audio with the written word. If you’re a primary care doctor who needs to share your patient’s results with a specialist or surgeon, all it takes is a simple tap of the touchscreen.
For patients where monitoring vital signs over a long period of time is key, recording data sets through a digital patient monitor that measures ECG, heart rate, blood pressure, blood oxygen, breaths per minute and temperature, can help tie large data sets up in a nice, little bow. They now make smart attachments for stethoscopes and other medical devices that turn them into connected, collaboration-ready tools, so you can still use your preferred model.
Weaving in Software and Apps
The last piece of the puzzle is the hardest one, especially for large medical systems. Implementing new software is a challenge for any business, whether it be a family medical practice or a massive hospital system. But finding the right collaborative EMR software is an important step in implementing this methodology. It’s arguably the most important one, because it, as the previously mentioned study suggests, acts as a repository, a messenger, an orchestrator, and a monitor.
But finding software that fits the bill isn’t all that much of a challenge; Even Google has its own tools for health care providers. Theirs is unique in that it emphasizes the collaboration factor by allowing health care systems to easily and securely share X-rays, CT scans, and voice and video files through Google Cloud. Of course, if you haven’t yet migrated your EMRs to the cloud, it’s an important step to ensuring that records don’t get lost.
But what about HIPAA? Naturally, this is an issue that has held the industry back from certain technologies for decades — it’s why you still see so many pagers in health care facilities! But HIPAA shouldn’t be a roadblock. Make sure that you’re partnering only with HIPAA-compliant software providers and medical tools (those providers willing to assume liability for any HIPAA violations for failures on their behalf), using secure messaging and file sharing apps, and taking all the necessary consent steps before sharing any of your patient’s data.
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