ePatient’s Experience Transferring Patient Data to Google Health

I just finished reading a 2800+ word post talking about e-Patient Dave’s experience transferring his patient record from his hospital PHR to Google Health. If you’ve ever been to the doctor, I think it’s worth a read to learn about how doctors are charting and a little bit about where we are in patients’ owning their own health record.

I will just share a couple quotes from his experience that really stood out. First a look at why the EHR billing centric software we have now is a major problem for the future of PHR:

The really fun stuff, though, is that some of the conditions transmitted are things I’ve never had: aortic aneurysm and mets to the brain or spine.

So what the heck??

I’ve been discussing this with the docs in the back room here, and they quickly figured out what was going on before I confirmed it: the system transmitted insurance billing codes to Google Health, not doctors’ diagnoses. And as those in the know are well aware, in our system today, insurance billing codes bear no resemblance to reality.

For the love of insurance billing codes. Nice way to ruin valuable data.

Another nice quote is about the data integrity of what’s being put into the EHR system:

And you know what I suspect? I suspect processes for data integrity in healthcare are largely absent, by ordinary business standards. I suspect there are few, if any, processes in place to prevent wrong data from entering the system, or tracking down the cause when things do go awry.

And here’s the real kicker: my hospital is one of the more advanced in the US in the use of electronic medical records. So I suspect that most healthcare institutions don’t even know what it means to have processes in place to ensure that data doesn’t get screwed up in the system, or if it does, to trace how it happened.

I know this is a major challenge for our clinic. Our medical records staff have been doing regular EHR chart audits of our providers and sometimes we’re just amazed that someone would electronically sign something in the record. I don’t know how many times we’ve said, “What were they thinking?” Certainly the same thing happened in the paper world, but it is often much harder to “fix” errors like this in an EHR.

What other methods are people using to ensure reliable data being added to their EHR system?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

3 Comments

  • Hi John – thanks for the mention. I hope folks will read what happened. It’s not a flame, it’s a discovery process. Please also read the comments, which have a lot of extra information.

    The interesting thing to me is that what I found in this first “button push” is just the first discovery: I only wrote about the data that was transmitted from PatientSite to Google. I haven’t started poking around in Google Health yet, and haven’t tried MS HealthVault yet.

    It’s clear to me that e-patients (“empowered, engaged, equipped, enabled”) who want to be responsible about their medical data should get educated about some IT basics. So last night I wrote a tiny starter post in that series. I hope folks will subscribe.

  • Good points raised in this post. How do we improve on the quality of data being entered by physicians into the patient record? This question is valid, regardless of whether the record is electronic (EHR) or paper (traditional).

    Most business processes that validate data do so by peer-review, audit, or some similar mechanism whereby different people from different perspectives look at the record. This simple accountability step catches lots of mistakes (though certainly not all of them). In hospital-based settings, peer review is part of the structure, though not usually very vigorous. In ambulatory settings, individual doctors generally don’t have much peer review, other than wanting to make sure that documentation is adequate to recover payments for services, or withstand litigation-based scrutiny. Sharing records with other practitioners taking care of the patient (consultants, specialists) also motivates physicians to make sure that the clinical record is adequate and useful-to-others.

    Insurance data, being another step removed from the point-of-care, is even more susceptible to garbage data, and is the least accurate – though, in a setting where most of the clinical data is on paper, the e-nature of insurance claims data is more available than the direct clinical information, and therefore is used as a data-feed into “connected” PHRs (with all the attendant garbage, as expected).

    PHRs offer an opportunity for accountability and validation of data, if the PHR is closely connected to a physician’s EHR. Free-standing PHRs will have the same issue of lack of cross-check and accountability as solo EHRs – but when a PHR is populated by a physician’s EHR, and there are two sets of eyes on the clinical data (the patient and the physician), and there is a method of secure communication between them to correct mistaken information, then the “two observer” method of cross-check can begin to take place. Until there is such a method, disconnected PHRs and disconnected EHRs will continue to have data-validation and data-integrity problems, as is noted in the article.

    Robert Rowley, MD
    Chief Medical Officer
    Practice Fusion, Inc.

  • We do a fair amount of peer review as well. It definitely helps, but you also have to have the right people in your office to do peer review effectively. Some people just aren’t good at giving or taking constructive criticism. Not saying that it’s necessarily an excuse, but just one of the major challenges of doing peer review.

    Also, it begs the question of how a peer review goes when the peer realizes the limitations of the system and accounts for the limitations in the peer review. Often you need to have outside peer review to really get data as clean as possible.

Click here to post a comment
   

Categories