When I began practicing medicine, the medical record was a paper chart. The chart typically consisted of a manila folder with color coded stickers on the side, indicating the patient’s date of birth and the first few letters of his or her last name so staff could file it alphabetically in the chart room.
If you are a clinician who is 35 or younger, paper charts have probably been a rare sighting during your career. If you are a mid- to late- career, however, you may yearn for the days when they were part of your routine. Perhaps it seems like simpler times when staff put each chart on the exam room door, and you thumbed through it before seeing the patient.
Although that routine may seem simple, a paper chart came with many limitations, including:
- it could be used by only one person at a time;
- there was no way to access it from home or the hospital;
- clinical data reporting required manual abstraction, many human hours, and because of this - often a grant;
- you had to rely on your memory and a manual review of the Physician’s Desk Reference (PDR) to avoid drug-drug interactions;
- once the patient left the exam room you essentially hoped for the best, because there was no practical way to manage the patient’s condition or track progress remotely.
Nostalgia and EHR frustration aside, most physicians would agree that the proliferation of healthcare technology - from electronic health records (EHRs) and telehealth to computerized patient order entry (CPOE) and remote monitoring tools - has been a boon to patient care, quality, access, and efficiency.
Here are 5 reasons why technology is such an important part of healthcare today.
1. The efficiency of one, real time record, accessible to everyone, all the time
No need to “check out” the chart from the chart room now that nearly all medical records are electronically available in the cloud, on a secure shared network, and via all kinds of digital devices. The comprehensive, real-time data in EHRs and other platforms, along with communication features, safety alerts, reporting capabilities, and accessibility from remote locations has improved our ability to take action on critical patient data in ways that would be impossible without them.
2. Significant clinical data for analysis and treatment
Technology produces a robust amount of data to use in patient care management. Pacemakers and stents send automatic updates over the Internet. Devices enable patients to transmit weight and blood glucose levels. Wearables send exercise and sleep pattern statistics.
Further, much of this data, as well as data from the EHR and other platforms, is being synched with Big Data to produce reports and analytics that spot population trends and care management gaps. Technology combined with analytics has provided the ability to sort out best practices for optimizing outcomes, both clinical and economic. Although some of this data deluge can be a double-edged sword for clinicians - at least until reimbursement, liability, and capacity challenges are resolved - there is no doubt that the collection and integration of it is enabling the ability to deliver better, more individualized care.
3. Improved medication safety
Technology has brought a host of digital checks and balances that alert clinicians when they are about to prescribe medicines that could interact, or that patients are allergic to. From computerized physician order entry (CPOE) systems to the alerting features in EHRs, technology features have replaced books and human memory with automated safeguards that save lives.
4. Better medication reconciliation
EHRs offered one of the first automated, electronic reconciliation tools; a way to create and maintain an accurate medication list that can be easily “checked” and reconciled at each step of the patient’s journey. These first generation platforms were a right step, but they don’t include medicines from outside the system or network, and their accuracy depends primarily on patient memory, or the patient bringing in a bag of pills. Emergency department visits are especially tricky when it comes to identifying a complete and accurate list of the medicines a patient takes.
Newer technology tools, such as Cureatr’s Meds360, are more comprehensive and accurate. Meds360 compiles pharmacy pick up and dosage change data from real-time data feeds, and delivers it in a visual display. The platform doesn’t have to rely on EHR data, patient memory, or the prescriber being in network. Data comes from pharmacy fulfillment feeds, and includes actual pickup dates, missed refills, and dosage changes. When technology can deliver a transparent, accurate picture of patient medication regimens like this automatically, adverse drug events decrease and adherence can be better managed.
5. Higher quality communication and connectivity
Technology has also made it possible for physicians and care managers to communicate with patients between doctor visits and after hospital discharge. For instance, some apps send automated reminders that ask patients to answer questions after surgery or during healing, and algorithm-driven alerts identify patients at risk for hospital readmission or infection. Patient portals give patients online access to their medical record and medication histories, and provide features such as registration, online scheduling, and bill payment. And telehealth platforms allow clinicians to conduct post-op visits, follow up after hospital discharge, or discuss medication adherence issues, all without requiring the patient to come in to the office - a significant advantage for patients who have mobility or cognitive issues, or who live in rural areas.
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