One of the hardest things about practicing medicine is that we don’t know what we don’t know.
We don’t know what information the patient is, for whatever reason, withholding during the clinical interview.
Maybe they’re embarrassed by some sensitive information. Maybe they don't see it as important, or worry that if they raise it, it might indicate something really serious, such as cancer, for instance. Best to stay quiet, right?!
Or maybe they just flat-out forgot an important detail that you, as a provider, genuinely need to know.
Yet we physicians rely heavily on electronic medical records—and even paper records—that are largely informed by the feedback collected during those fateful meetings.
Wouldn’t it be better if you could just know all of it without having to count on the full disclosure of the patient? Wouldn't it be even better if the information was presented in an easy-to-understand format, where you could both zero in on the information you need to know while also having the ability to derive an understanding of the bigger picture quickly and easily?
Consider a patient with cardiovascular disease who is still smoking despite your best efforts to get them to stop. Wouldn’t it be nice to know:
- That the patient’s already discussed a smoking cessation plan with a cardiologist, that you can emphasize the benefits of following that plan, that you don't need to offer your own plan that might differ in some small way, and that you can implicitly convey to the patient the bigger message that they’re being cared for by a team that has a plan and works together?
- That the patient annually visits relatives in Belgium—the country with the seventh highest per capita consumption of tobacco cigarettes in the world—so that you can suggest that perhaps that annual visit itself creates the temptation that’s long been sabotaging their cessation efforts?
- The details of their claims data, so if they’ve visited other physicians and picked up prescriptions since you last saw them, you would know what those prescriptions are?
- The findings of their WiFi-enabled peak flow meter, graphed and summarised so you can see how often they’re reaching their peak flow and whether they’re improving?
And wouldn’t it be nice to have all of this information displayed in a user-friendly manner, one that makes it easy to get to the exact information you want when you want it? A solution that, for instance, displays all the recent information you haven’t yet seen personally? Or that highlights all the information obtained from sources other than your EMR/EHR?
A complete picture of the patient—drawn from all the multiple, disparate sources of information currently stored in multiple separate data stores, including different hospitals, practices, labs, payer systems, and much more—is becoming the standard of care. Without it, we run the risk of “driving blind” and may even be practicing medicine recklessly. This view is bolstered by policy statements of medical boards, colleges, and professional societies the world over.
Of course, I realise that in some situations, perhaps in the ER, demanding a complete picture simply isn’t always going to work. Having said that, in every ER it has been implemented, the ability to access a patient's complete record electronically has been a real boon.
Let’s make it a routine practice to insist upon comprehensive electronic records. Let’s normalise it as the standard of care we expect in any decision-making clinical environment.
Are you ready to live with the consequences of contradicting other clinicians’ treatments, or with them contradicting yours, or managing a patient based on less-than-complete information?
Maine HealthInfoNet maintains a statewide HIE where healthcare providers can share patient information and deliver population health management. Read the case study now!