Final Blog Post: Electronic Health Records

Introduction
The goal of this projection was to pinpoint the underlying issues that harm EHRs, and prevent them from their ultimate goal of making it easier for us to have knowledge of our own health. One of the biggest issues is the lack of interoperability between different EHR systems. The best way to transfer data currently is by e-mailing over a PDF, and then manually entering the data into the new system. With the amount of revenue that these companies pull in (Cerner $2.67B, Epic $1.5B), it makes sense why they wouldn't want interoperability. However, that's not in the best interest of the consumer, so something needs to change.

Data Sources
Starting with Dr. Ampel, who's 30 year career, spanning the V.A., Banner, and Mayo Clinic, gives him a great insight on how EHRs have changed over time and how they can be improved. He has also given me access to co-workers of his. Further, I surveyed patients and nurses (shoutout to Tinder for matching me with one). They gave me further insight into what they believed issues were, and what needed to be changed.

For this post, I just wanted to focus on a couple of the solutions that I found to be the most interesting, and the most intuitive. There are hundreds of solutions across the United States right now, and it would take novels to discuss them all.

HealthHeart
This is a new startup company whose goal is to simplify health records and bring a beautiful new user interface to them, making it easier for doctors to navigate them. Having a dropdown menu that quickly shows history, information from devices (like an Apple Watch or FitBit), along with any other piece of a data a patient wants saved, this new open source software aims to revolutionize how we view health with our medical providers. HealthHeart uses a form of Blockchain to create a decentralized, secure platform.


There are many companies like this currently trying to make EHRs more accessible, I just chose HealthHeart since they have been in the news very recently trying to simplify the EHR. Other companies include PriorAuthNow, which “works with EHR systems and connects directly with insurance carriers. Company executives claim it’s the fastest, most economical way to submit, monitor and complete prior authorizations” (Monegain). The last company I wanted to mention is Augmedix. This company utilizes Google Glass and a custom AI to automatically enter information into EHRs based on the conversation between doctors and patients, freeing doctors from having to manually enter data in a computer and miss important face-to-face time with their patients. With private companies like this working towards interoperability and exciting features, we may see improved patient care.

Open API
"The smartphone is really the device that we need to target to have electronic ownership of patient data,” said Rucker, adding open APIs are “about trying to get medical records and move them across town, getting their mother’s or their child’s MRI result from one place to another.” (HealthDataManagement). Open APIs allow anyone to program a solution into the existing framework, and have it interact seamlessly with another piece of software. This creates the atmosphere for interoperability. A patient having their phone contain their EHR, and being able to send it to a health care provider immediately regardless of EHR System would be huge.

Augmedix
This is a startup company that aims to use Google Glass to automatically scribe data to a system based on speech to text answers. During an appointment, the doctor simply turns on device for recording, and it should automatically fill out data in the system, freeing up the doctor to have a more personal and hands on approach. After the appointment, the doctor goes over the data and can edit it before it’s officially submitted to the EHR. Doctors spend too much time before, during, and after appointments entering data for EHRs into their systems, and sometimes truly can’t get into the meat of a patient’s issue. In trials at Dignity Health, it was found Augmedix saves doctors time in the data entry phase, while also allowing them to be more personable with their patients. Physicians saw on average a 23% DECREASE in time spent on administrative work. While Augmedix isn't ready for widespread use, the company has seen a steady stream of investors over the years.

Future of EHRs
Once the issues of interoperability and data entry are worked out, data scientists can get down to mining through the data to truly help the population. First, as data entry becomes more efficient and automatic, EHRs can collect more data. More data leads to more breakthroughs in analysis. The Geisinger Health System in Pennsylvania is looking to add gene scans to everybody's EHRs. These scans used to cost thousands of dollars, but is now down to about $300 per person. Once a large amount of people have their EHRs set up with gene scans, researchers can see what sequences in our genetic code are most predisposed to certain diseases and traits, which can help with early prevention. That has the potential to radically change healthcare as we know it, assuming that people actually take the warning their genetics can tell them about their health.