EHR: The Missing Connection

In the United States, we are very far from finding a solution to the health care crisis as there are two polar opposite views of the role of government and in recent years, these views have shifted further and further apart. Regardless of your personal views on health care, I think as future health care professionals, we can all agree that the electronic health record (EHR) should be unified under one system in order to provide our patients the best possible care and reduce our overall healthcare cost. 

With our current insurance set-up, depending on individual plans, patients are able to visit any health system available in their network. Unless their plan mandates they stay in one system, this means patients can see providers in multiple health systems. On the surface, this looks promising as patients can shop around for the best providers in each area they need care. For example, a patient can see a primary care provider (PCP) at Michigan Medicine, but visit Henry Ford to see their cardiologist, and go to Karmanos for their cancer care. From a provider view point, this is problematic because the PCP at Michigan cannot see the information available in the EHR from the other two systems and vice-versa. Sure there are programs that attempt to connect these records, like "care everywhere", but are not always the most user friendly. Having all of this patient health information siloed in separate areas forces the patient to try and relay the different information to each of their providers. If patients do not have someone privy to the health care system as an ally, they may not be aware they should be sharing their health information between providers. Lots of patients assume all of their providers can see every test or medication they've ever been prescribed. 

In order to relieve the patient from being their own EHR, one of two things needs to happen. Either systems like "care everywhere" that connect EHRs need to be improved upon or an institution, whether that be independent or government backed, needs to create one EHR that all health systems can use. Both of these options would allow all providers to see all information about their patients. This will reduce the burden placed on patients to act as the relay between EHRs and will also reduce the amount of unnecessary testing and waste produced by the healthcare system. For example, in our patient utilizing three different health systems, if Karmanos ordered a basic metabolic panel, Henry Ford or Michigan, wouldn't have to order their own panels, and could utilize information Karmanos already has to make clinical decisions. This reduces the number of pokes required from the patient, provides them better care, and reduces the amount waste created by duplicate tests. By reducing waste, we could reduce our overall healthcare cost and try to make a dent in the cost portion of the healthcare crisis while simultaneously improving patient care.