A huge cyberattack hit dozens of countries over the past week. British National Health Services were hit particularly hard, leaving healthcare workers without patient data, which forced hospitals to cancel procedures. The attack used “ransomware” to get into computers, encrypt data, and then forced people to pay up in untraceable currency before giving the files back. Basically, imagine someone breaking into your office, putting a lock on your file cabinet, and refusing to give you the key until you leave money next to the stump in that seedy park you never see any kids at during the day. The attack is still ongoing, but if you’ve updated your Windows system past XP (which NHS hadn’t,) you’re probably fine.
Doctor: Unfortunately, you’ve been diagnosed with [insert scary disease here]. Call this number to schedule your procedure. See you in a month.
Patient: Huh? (shuffles out, looking bewildered)
New research is telling us that the above doctor-patient interaction is not what’s best for patients. Wuuuuuuut? No way. We’ll wait while you pick your jaws up from the floor… Data show that the more involved patients are in their health care decisions, the better. Presenting clear options, simplifying information, and making EMR data available to patients are ways physicians can involve patients in treatment decisions. Sounds to InsightCity like that leaves the ball mostly in the doctors’ court. Here’s hoping a little doctor-patient teamwork will leave patients feeling less like this.
Anyone who would routinely choose against two-to-one odds would have to be considered crazy, right? Well, at least a third of Americans regularly take their chances when it comes to diagnosing symptoms. In a recent study reported in JAMA that compared diagnosis accuracy, it was discovered that physicians correctly diagnosed a patient 72% of the time, whereas computer apps did so 34% of the time. One major factor in the difference was the ability for doctors to reference patients’ medical histories. So, what could computers do if armed with more electronic health records? Well, IBM’s supercomputer “Watson” solved a months-old, doctor-stumping leukemia mystery in 10 minutes. Look for more calls from private app developers to tie into EMR data. That shouldn’t make us nervous, right?
That’s not really the question. The Electronic Medical Record (EMR) train has left the station. The next question is, how accurate and complete are EMRs? Well, there are two different answers to that question. A recent study published in the Journal of the American Medical Informatics Association looked at physician notes from Beaumont Hospital in Royal Oak, Michigan, as they transitioned from a paper-based record system to an EMR system. The net-net: inaccurate documentation was significantly higher in the EMR by a rate of more than 5 to 1 (24.4% error rate with the EMR, 4.4% with paper), but omissions were far more likely with paper notes compared with EMR notes (41.2% vs. 17.6%). Have fun conducting your next RWE project and at your next doctor visit.
The FDA has put its two cents in regarding the use of electronic health records in clinical trials with the release of its draft guidance last week. This guidance contains recommendations of interoperability and best practices for use of these systems, including informed consent, data security safeguards, and well-documented, trackable audit trails. Something to consider is to use an EHR that is certified under the ONC Health IT Certification Program—when the FDA says this certification is “encouraged” and it will provide “confidence during inspections,” you don’t take this lightly. Sure these are just recommendations/suggestions for an EHR’s use in clinical investigations, but they come from the folks who hold the power to make or break a company and a product.