Today, for your consideration, we have the tale of the Albanian patient who wasn’t Albanian. More broadly, I’m here to discuss the perils of adding an extra interface consideration to the workflow of busy EMR users, and the impact that has on data quality.
Scope, a blog published by the Stanford School of Medicine, shares the case of the Merced County, California physician who, exasperated with the requirement that he identify the ethnicity of each patient, chooses “Albanian” for all of them. Why? Simply because “Albanian” is the first item of the rather long list in the pulldown menu.
As a result of this interface issue, any attempt to mine this veteran doctor’s data for population health analysis is weakened, writes Anna Lembke, MD, asssistant professor of psychiatry and behavioral sciences at Stanford. And this physician’s choices should give the “big data” users pause, she suggests:
Misinformation in electronic medical records, whether accidental or otherwise, has far-reaching consequences for patients and health care policy, because electronic medical records are being actively ‘data-mined’ by large health care conglomerates and the government as a basis for improving care. This is an important downside to consider as we move forward.
Dr. Lembke’s observations are important ones. If government entities and health organizations would like to mine the increasingly large pools of data EMRs are collecting, it’s important to look at whether the data collected actually reflects the care being given and the patients being seen.
I’m not suggesting that we audit clinicians’ efforts wholesale — they’d rightfully find it offensively intrusive — but I am suggesting that we audit the interfaces themselves from time to time. Even a quarterly review of the interfaces and workflow an EMR demands, and results it produces, might help make sure that the data actually reflects reality.