Someone recently told me that they went to their dentist’s office for follow-up care and was in the chair being prepped when they were asked about some care options. It all seemed routine until the person was being asked about things to be done that they had not heard of before. They were there for something completely different from what was being presented. Something that, when asked, was not on the card that the dentist was reading from. After some back and forth, it was discovered that it was the wrong patient card. Two patients had the exact same name, and the wrong treatment protocol was being applied to the one in the chair.
After I listened to the story, I imagined if this were a situation where a hospital were to perform surgery and the mix-up in treatment possibly led to a detrimental outcome. Thankfully, the dentist was able to find the right card by examining other information – such as address of the patient – and a possible crisis was averted.
A situation like this could have been prevented with digitisation. There are two essential elements of digitisation that could apply to this scenario. First, the implementation of a unique patient identifier, and second, the digitisation of patient records. The unique patient identifier is usually a number that a person gets when they first interact with the health system. It would be similar to a taxpayer registration number, but for healthcare instead of financial transactions. In our context, it is called the UMR – unique medical record – and is currently being used at the University Hospital of the West Indies. This, once received, will be the consistent means by which a patient is identified over the course of his or her lifetime of interaction with the health sector.
There are several benefits to having a system that includes a UMR. The first and very obvious one is the removal of identity errors. Thankfully, the situation outlined above was adequately resolved, but that may not always be the case. Having a UMR would improve patient safety and reduce errors that could result from having the wrong file and diagnosis attached to the wrong patient. Patient care coordination would also be better managed when a medical practitioner can see a clear, consistent, and historical outline of all of the patient’s encounters with the health system, diagnoses, treatment plans, and current health status, which can inform as to how to holistically manage the patient.
DIGITAL HEALTH SYSTEM
A UMR is also essential if there have to be linkages of disparate patient data, especially through the connection of software through interoperability – the ability to link sections of the digital health system with each other and thereby share patient information across platforms. Among other things, this would ensure that access to medical care is not limited by geography and that each department concerned with the patient’s care and visit would be represented. Both government and private-sector patient visits would be recorded and accessible in one electronic format, enabling doctors to make the best evidence-based decision for their patients. It would also allow the patient the satisfaction of knowing that decisions about their care are being made with the complete data, saving time and reducing errors.
The second element of digitisation that would improve the accuracy of patient identification and data, which has always been a sticking point for us, is the use of paper files and the need for transitioning to digital format. We know the stories about lost or misplaced dockets and the fact that one patient can have even three files in one facility because of this. Not to mention the fact that it is rare for a person to only visit one healthcare facility throughout their life. Digitising patient records and allowing for interoperability and sharing across the care network would vastly improve the patient experience. Unreliable patient data is a major concern for many health systems, including ours, and can lead to issues such as inaccurate diagnosis, treatment errors, and flawed care pathways. Administrative issues are also likely and could include billing to the wrong patient as well as incomplete analytics, which could affect decision making.
- Doug Halsall is chairman and CEO of Advanced Integrated Systems. Send feedback to firstname.lastname@example.org.
Published: Sunday | May 23, 2021 | 12:57 AM