Electronic Health Reporter

By Brooke Faulkner, a writer in the Pacific Northwest; @faulknercreek.

Healthcare is in a constant state of updating. From new technologies to the latest scientific research, nothing stays the same for long. If it does, there’s almost certainly someone, somewhere, attempting to find a better way.

Right now, though, more than just the medicine is changing. The way we interact with our doctors and the way our doctors interact with each other is redefining what patient care looks like. Slowly but surely, the communication and management of healthcare data is joining the rest of us in the 21st century and going digital. Doctors are available on demand, medical records can be accessed without waiting for a courier, and the amount of information available to the public is growing by the second.

It’s not all so optimistic, though. Concerns about privacy exist in tandem with the benefits of increased access, and medical facilities can be vulnerable to a variety of cyber attacks. Whether you’re considering public health on a global scale or just going to the doctor for a yearly wellness check, digital health data is changing the way we see medical care.

Public Health Opportunities

Increased connectivity in the medical world makes more data available to more people. It’s easier than ever to track disease outbreaks, compare national statistics, and identify trends in global health. In the United States, the field of public health research is expected to spend more than $3.7 trillion in 2018 alone.

We have fewer communicable disease epidemics now than at any time in recorded history. Diagnosis and treatment protocols are more sophisticated, but more often than not, we don’t have to worry about smallpox, measles, or rubella thanks to vaccinations. Instead, many of the health concerns facing Americans are preventable, non-communicable diseases borne of unhealthy lifestyles. In 2017, more than 36 percent of the adult population was obese and 9.4 percent had type II diabetes.

With the data recorded by fitness trackers, electronic food diaries, and other health-focused devices, public health researchers can paint a clearer picture of the lifestyle choices that lead to illness. Public health campaigns can become more targeted and an emphasis placed on follow up and plan adherence through personal technology. By crunching the numbers generated from various populations, researchers can compare and contrast differences among nationalities, noting genetic trends and trying to tease out nature from nurture.

Facility Implications

While the global stage certainly provides opportunity to leverage massive amounts of patient data, the implications are more intimate at a facility level. For hospital systems with multiple departments and locations, have a centralized electronic health record revolutionizes patient care.

Because of HIPAA regulations, releasing health records from one office to another is a cumbersome process and often relies on fax or mail for communication. With an integrated health record, the patient can release their data to the entire health system, allowing multiple doctors to view the same record in real time. This eliminates the need to constantly update multiple paper charts with advancing information and allows teams of doctors to integrate care. Patient care outcomes stand to benefit from more doctors sharing the same data and making informed, cooperative decisions.

However, networks aren’t guaranteed to be secure, and mistakes can still be made when handling patient data. In 2017, UNC Healthcare compromised the personal information of more than 1,300 women by sending the wrong batch of forms to an external health insurance body.

Even when it’s not user-error, though, data isn’t always safe. Ill-intentioned hackers can infiltrate a medical facility’s network, lock providers out of records, and demand a ransom to restore access. Patient records can be intercepted during electronic transmission as well, potentially compromising patient privacy or revealing valuable information like social security numbers.

Personal Impacts

Having personal information exposed is certainly a potential risk of electronic health databases, though there isn’t really an option to tell your doctor you only want a paper chart. However, patients do have the option to decide whether or not to use wearable devices or take advantage of telehealth options.

The risks don’t necessarily outweigh the benefits, though. For individuals trying to lose weight or increase exercise, fitness trackers provide great feedback and can even be set to send reminders when it’s time to get moving. Arming doctors with this information can help create tailored diet and exercise plans for patients.

Telehealth allows patients to reach out to nurses or other providers via chat or video call, potentially determining if a trip into the doctor’s office is worth it. For rural populations, this step can mean saving the hours it would take to drive into town and back.

Remote medicine also creates opportunity for plan adherence software. Various practices across the country are experimenting with accountability apps to make sure patients are following through with the recommended course of treatment. Smart pill bottles serve a similar function, but they can also make sure medication isn’t abused, potentially creating a weapon against the overwhelming opioid epidemic.

Overall Responsibility

Technology and the patient data it collects provide a mind-boggling number of research opportunities for global and national health. Though speaking in such broad terms can make the process seem far-removed, evidence-based medical treatment only stands to benefit from having more data informing best practices. As the information database grows, the effects will trickle down to individual patient outcomes via teams of integrated care providers.

However, as the information database grows, it also becomes more vulnerable, and that responsibility is currently in flux. It may seem logical to say that facilities should be responsible for the data they collect, but historically, patient privacy has been regulated through legislation. Fitness apps with vague terms of services create grey areas for patient information, and it’s not always easy to read the fine print and control your information. While the potential impacts of technology are great, cybersecurity needs to grow with the industry, not after it.