Electronic Health Reporter

By Ryan VanDePutte, associate director, Bits In Glass.

Each day in the U.S., about 10,000 seniors turn 65. By 2050, there will be 83.7 million seniors in the country, representing about one-fifth of its population. Even with the growing awareness of health and fitness, it’s a hard reality that about three-quarters of these older Americans live with multiple chronic health conditions, ranging from diabetes to dementia, meaning that ongoing care and monitoring is simply a fact of life.

The way we deliver senior care has been evolving, and more patients are seeking to “age in place,” which means that they opt to remain in their own homes for as long as possible while receiving any necessary medical care.

This desire to remain at home is driven by many factors including a desire for comfort, access to friends and family, familiarity and privacy. Not to mention the economic benefits – with the cost of nursing homes easily topping $70,000 a year.

Because of this, home healthcare services have been growing in popularity, despite the fact that patients who receive care at home are more likely to experience a higher 30-day readmission rate after leaving the hospital, compared to those in nursing homes. Still, the lower costs and comfort make home care an attractive option.

Your Doctor is Only as Good as the Information They Have

One challenge that home healthcare providers face is consistency in tracking and communicating information to the patient’s primary doctor. Not only information from care at home, but also information from clinics or hospital visits. This lack of insight into patient data can significantly increase the cost of care for patients because without access to the full history of the patient, unnecessary tests may be run, wasting both money and the doctor’s time. It is reported that a whopping $210 billion is spent annually on unnecessary medical care each year in America. Put in perspective, this is almost twice the U.S. 2019 federal education budget.

Further, there can be even more serious consequences to this lack of information and tracking. Without access to accurate patient records, medical errors are more likely because, for example, the patient may have an allergy unknown by the care provider. Medical errors are in fact the third leading cause of death in the U.S. Each year, approximately 250,000 patients in the U.S. die due to such errors.

To prevent these tragedies, an up-to-date, accurate patient file that is updated at each point of care is crucial. This can be most efficiently accomplished via electronic records that are patient-centric and follow a patient wherever they go to receive care, keeping specialists informed throughout an individual patient’s journey. This bridges the gap when a patient switches providers or sees a new physician because each professional has a patient’s detailed medical history, already available to them.

The HITECH Act and Where Electronic Health Records (EHR) Can Go Wrong

Despite the obvious benefits to the implementation of Electronic Health Records (EHR) – it alone is not the answer. The HITECH Act – or Health Information Technology for Economic and Clinical Health Act was signed into law by President Barack Obama in February of 2009. A key aspect of the Act was to promote and expand the adoption of health information technology, specifically, the use of EHRs by healthcare providers. Prior to this, only 10% of hospitals had adopted EHRs.

Unfortunately, after more than $36 billion was spent on the project, and most doctors have indeed moved to electronic health records – the solutions were implemented in such a way that they are not interoperable with one another. So while one hospital may have impeccable electronic patient records – there was no way to efficiently transfer that information to another care provider, blocking the effectiveness of the initiative.

Further, some of the independent EHR systems were difficult for doctors to use and could cause dangerous mistakes, such as recording a child’s weight by default in kilograms rather than pounds, leading to the prescription of incorrect doses of medication.

Why Patient-Centricity is at the Core of Comfort, Care and Cost

As this next major demographic shift takes place, and the population increasingly relies on these electronic systems, it will be crucial to close the information gap between points of care. A patient-centric model that follows the patient, rather than putting the provider at the center of care, can help to avoid the interoperability challenges of so many modern EHR systems.

Systems such as Epic, which are popular with hospitals nationwide, have the ability to be integrated with a number of home-based monitoring systems. This could include monitoring vitals using wearables, activity trackers, sleep trackers or any other number of devices.

The added benefit of electronic vitals monitoring is that it can improve accuracy in record-keeping, and also reduce the frequency with which care providers are required to visit the patient at all. Many of the electronic systems can alert the care team if any of the patient’s vitals move out of the safe zone or pass thresholds set by the team.

Looking Forward

As we move into this next chapter of home healthcare, clearly there are many options and many different ways to leverage technology to support the aging population.  It will be most important is that we implement these new solutions thoughtfully, and with an eye toward improving communication and reducing redundancies that drive costs up. Finally, the ultimate goal should be to seek to move closer to improving not only longevity patient’s lives, but the quality of those lives as well. Efficiently using technology to enable patients and care teams to access vital data supports the trifecta of comfort, care, cost