Health care data experts say improving, expanding and connecting electronic health record (EHR) programs could help the country fight outbreaks of diseases like Ebola.
Iyue Sung, director of the research arm of AthenaHealth Inc., a health care organization administration company, notes in a discussion of outbreak tracking that his company can already use its own customers’ billing data to track the spread of diseases like flu and create maps showing where flu is hitting hardest.
If health care providers were feeding EHR data to the Centers for Disease Control and Prevention (CDC), officials there would have a much easier time working with public health departments to monitor outbreaks, Sung says.
“The key to effective disease surveillance is the connected, open flow of data between sites of care and public health authorities,” Sung says.
The drafters of the Patient Protection and Affordable Care Act (PPACA) and an earlier measure, the Health Information Technology for Economic and Clinical Health (HITECH) Act, included many provisions that are supposed to increase the standardization of EHR systems, make connecting EHR systems to one another and central databases easier, and reward doctors and hospitals for making “meaningful use” of EHR systems.
Health insurers and employer groups have been enthusiastic supporters of the EHR effort. They hope EHR and electronic medical record programs can strengthen efforts to improve the quality of care and control the cost by producing huge new streams of easy-to-analyze health care data.
Dr. David Blumenthal, president of the Commonwealth Fund, a health policy research organization, argues in a commentary of his own on the Ebola cases in Dallas that Texas Health Presbyterian Hospital initially blamed a controversial patient discharge decision on its EHR system because EHRs make a good target. “They are harder to use than they should be, and the infrastructure to support their interoperability is underdeveloped,” Blumenthal says.
The U.S. Government Accountability Office has reported, for example, that federal EHR data standards are still vague and lead to problems with connecting the EHR systems.
But even critics see that good EHR systems can improve patient care, and no physician or hospital that has started using an EHR system really wants to return to paper, Blumenthal says.