A Visit to the ICU

I recently had the unfortunate opportunity to spend a full week in an intensive care unit by my mother’s bedside after an unexpected health emergency while on vacation, and was therefore transferred between several hospitals that didn’t have any of her medical history on hand.

She and my dad chose the final transfer hospital based on a number of factors, but one of the key factors was that they used the Epic EMR. My parents are huge fans of Epic…not just because I worked there for so long, but also because they are in LOVE with MyChart and participating in their own healthcare. So they felt strongly that transferring to this particular hospital would facilitate an easy transfer of data from her home healthcare provider to this one via Care Everywhere. While this is a huge shout-out to Epic for revolutionizing the sharing of healthcare data to a point where patients choose hospitals based upon the EMR they use, this technology was by no means a cure-all.

Within hours of sitting next to my drugged and mostly-unconscious mother, it became extremely clear to me how truly critical it is to have an advocate by your side while being looked after by healthcare professionals. As hours turned into days, I became terrified to think of the patients who don’t have a steady rotation of family members to ensure consistent care night and day. There is a lot to look at in the EMR…between the admission itself and the prior outpatient care and medical history, it is a ridiculous amount of data. In this case, Care Everywhere was at play, so some things from my mom’s past medical history were pulled in discretely. But many things were not…many things were faxed. Some things came over in a manila envelope from the prior hospital. Some things were discussed with medical providers over the phone and documented in notes. Then there were the many, many rounding notes.

The lack of consistency from one care team to another after shift changes made my head spin and my blood boil. They all have access to the same information, right? Then how and why do they keep asking the same questions (Do you smoke? Do you have a history of elevated blood pressure? Oh, you took Celebrex before?) And even more terrifyingly, why did my family and I (on a number of occasions) have to prevent a med that was about to be given or correct a healthcare provider’s memory of when something was/wasn’t performed?

I greatly respect what healthcare professionals do. They astound me on a daily basis. But at the end of the day… they are only human. If the right information isn’t in the right place at the right time, bad things can happen. So how do we get to a point where this is a reality and a missed piece of information is the exception rather than the rule? There are MANY factors including:

• simplifying the EMR

• improving data exchange across healthcare organizations

• improving knowledge transfer during shift changes

• getting more data into the EMR discretely

While I’ve never worked directly for a healthcare organization, I’m proud to say that I’ve spent the last 13 years working for two great companies who are making great strides to improve these very problems. At Extract, we are working tirelessly to get more data into the EMR discretely and marching towards ridding the EMR of the hide-and-seek for critical clinical data that is buried in scans, faxes, and unstructured blocks of text.

Can this solve all of the problems I witnessed during my stay in the ICU? No, not completely. But every piece of discrete data that can be shared between organizations and trended/accessed at the very moment it is needed is one less chance for a patient to be harmed by a well-intentioned healthcare provider without the right data at his or her fingertips.