I've written extensively in the past 18 months about the importance of data to healthcare, but to date even simple measures like the digitization of patient records remains painfully slow. A recent study from the University of York revealed the slow pace of digitization of patient records in the National Health Service.
The analysis, which is believed to be the first of its kind, examined the progress made in transferring patient records to digital, and shows a complex picture best by poor understanding of IT implementation and an underestimation on the kind of changes digitization would bring. If nothing else, the review reminds us of the complexities inherent in implementing health technology.
“It is difficult for those outside of the NHS system to visualise the scale of this project; there are hundreds of departments and healthcare organisations, using different IT systems, trying to share important information about a patient,” the researchers say.
Barriers to digitization
One study suggests that doctors are a considerable barrier. It reveals that many doctors regard maintaining electronic health records (EHRs) a chore that undermines their relationship with patients.
The study quizzed doctors on their perceptions of the impact EHR had on patient engagement levels. It found that doctors were often anything but complimentary about them, citing higher levels of burnout and a depersonalization of their work.
“Physicians who are burnt out provide lower-quality care,” the authors say. “What this speaks to is that we, as physicians, need to demand a rethinking of how quality is measured and if we’re really getting the quality we hoped when we put in EHRs. There are unintended consequences of measuring quality as it’s currently being done.”
When examined from the patient perspective, privacy is another considerable hurdle to overcome. A recent study from the University of Buffalo found that worries about privacy prevent many patients from signing up to electronically share their medical records with providers.
The authors suggest that education will be key to overcoming these concerns. They believe that existing efforts to encourage patients to switch to digital have focused on the benefits of the technology, and given insufficient attention to privacy matters.
“When a patient decides not to share their records electronically, it can result in increased costs, medical errors, and undesired health outcomes,” the authors say. “But patients are more concerned about privacy, and health care providers should make it a priority to let them know about all the policies and security measures in place to protect them.”
Providers can do a much better job in educating patients about existing privacy policies and the security measures they have in place to keep data safe. Suffice to say, this kind of education effort needn't come purely from providers themselves.
Understanding Patient Data is an initiative from the Wellcome Trust that is designed to support better conversations about the use of data in healthcare. It aims to provide clear and objective evidence around a range of things, including:
- How and why data can be used for care and research
- What’s allowed and what’s not allowed
- What options patients have
- How personal information is safeguarded
The site aims to provide objective information about the way data is used, with the explanations given in such a way that everyone can understand, regardless of their medical or data science knowledge.
It also provides a library of case studies that give examples of the various ways in which data is used at the moment, and the outcomes of those applications. These range from evaluating the safety of vaccinating pregnant women against whooping cough, to understanding why diabetes rates vary between ethnic groups.
With smooth flow and access to digital health data so important, not only to efficient provision of care but also to effective medical research, these kind of efforts cannot come soon enough.