Redundancy, Business Continuity and Lessons for Healthcare from the Disaster Field Office

The business world has learned several hard lessons over the past decade when it has come to the need to preserve business critical data. Words like “redundancy” and “continuity” have become the watch words of the Information Technology professional and the corporate CFO. The time taken to perform daily and even hourly computer back-ups is no longer perceived as a waste, but rather as time well spent. Where once computer sales people had to argue the benefits of off site storage, now corporate buyers demand such service compatibility.

Corporate healthcare too has learned these lessons, but for reasons that are inexplicable to those of us who use the systems everyday, this level of security and redundancy does not extend to the most critical of healthcare data, the patient’s medical record. To be certain, electronic medical records provide a greater level of security and data redundancy than their paper predecessors, but the type of duel storage data verification used for the most critical business information does not exist for patient medical records. In the disaster field office we have learned that if a system is going to fail, it will fail at its weakest link.

In 1999, the Institutes of Medicine published a report titled; To Err is Human and the national debate on patient safety began. The Institute of Medicine report highlighted a number of areas of concern, chief among them were medication errors and wrong site surgery. Now Eight years and dozens of regulations later, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) CEO has revealed that wrong site surgery has not declined, it has increased.

Unfortunately, healthcare professionals, despite their best efforts, are failing to create the systems that will ensure your safety in the hospital. Few people are capable of remembering the complete and detailed treatment plan for every patient in their care. Medical records exist to ensure that critical information is at the fingertips of caregivers. The problem with today’s medical records is they are based on a century’s old technology, paper. The risk of a medical error or complication increases when the medical record is incomplete or absent. Unreadable handwriting and failure to cross reference medications for incompatibility only add to the danger.

Would you give your money to a bank that kept your financial records in a dusty handwritten ledger? Would you ride on an airplane in which the captain navigated with a paper map and sextant?
Technology has come to the aid of the patient both at the doctor’s office and in the hospital. Kevin Freking, of the Associated Press recently reported on the first major corporate sponsorship of portable electronic medical records. Applied Materials, BP America, Inc., Intel Corp., Pitney Bowes and Wal-Mart will enroll employees in a central database to maintain health records in an effort to eliminate duplication, omission and error.

This is a concept that is supported by President Bush and the National Academy of Science - Institute of Medicine. Not only with the system collect medical record information and reports to a central repository, but individuals will be able to provide personal and family information to augment the record. This type of system is envisioned by the Whitehouse as a national standard by 2014 and is a requirement for implementation by medial providers by 2008. The problem with this on-line repository database is that it is Internet dependent and while accessible only from an Internet portal, it is not truly portable. You cannot carry it self contained in your hand.

So how can the medical record undergo validation at every patient encounter, particularly when patients move from doctor to doctor as required by their disease, their job or their insurance coverage?

What if this vital data where contained in a watch, pendent or wristband you wear everywhere you go?

What if every time your electronic medical record was accessed, it was compared to the data you wore and any differences required that your healthcare provider reconcile the information?

W. David Stephenson of Stevenson Strategies made the fantastic suggestion that people carry their medical records on secure U3 enabled USB drives. According to Mr. Stephenson:

"This sounds like a real win-win technology that hits my sweet spot, and in a disaster, a literal and figurative lifesaver, because you'd not only have your medical records in hand, but also all of your critical applications and business files as well."

Thanks to the falling cost of computer memory and USB Flash drives, the first 1 Gigabyte Portable Health Record (PHR) wristband has arrived on the market. A Personal Health Record is a software/hardware solution used to store personal information, insurance data, medical records and medical images. In the event of an emergency, or even a routine medical visit, the healthcare professional places the drive in the USB port of any compatible computer. With a Personal Health Record, your medical information is available where you and your healthcare provider need it.

Currently there are 25 companies selling Personal Health Record solutions. Although all 25 companies claim password protection for the user interface, only one of the systems uses encryption to safeguard the data files from direct access by other software. Encryption is an essential feature for a Personal Health Record.

Also needed is the ability to ensure that the patient does not deliberately or accidentally alter the records, especially if they record includes notes from medical professionals as several of the systems do. Another nice feature would be the ability to synchronize with the Electronic Medical Record (EMR) at the doctor's office. With this type of synchronization capability, a central repository serves not only as a primary data source, but an ideal back-up for the USB data.

When choosing a Personal Health Record look for:

• An Emergency Information screen that appears immediately when the PHR is activated
• Password protection with encryption for information stored on the PHR
• Image import and storage for x-rays, EKG’s and personal documents
• Storage for a several emergency contacts (including local contacts and employers)
• Storage for all your insurance information (medical, dental, travel, vehicle, business, liability, worker’s compensation, etc.)
• Lists of both your primary doctors and your specialists
• Lists of both current and past medications
• Lists of Allergies and Reactions
• Lists of Hospitalizations, Surgeries, Past and Current Medical Conditions
• Journals where doctors, nurses and you can record notes for future reference
• Synchronization with your main computer and an online data repository
• Synchronization with Electronic Medical Records at the doctor’s office or hospital
• Tracking of Changes made to maintain data integrity
• USB Drive Capacity of 1 Gigabyte or more

Arnold Goodman, CEO of My Medical Records, LLC plans to give away a basic Personal Health Record on his company’s website (www.TheOriginalMyMedicalRecords.com) beginning in May of 2007. Mr. Goodman and his team have been involved in Medicine and Medical Information Systems for a cumulative 54 years. They developed both a “Lite” and a full featured “Pro” version of their Personal Health Record. Their “Lite” version has all the features of its 24 other competitors. Why give away what your competitors charge full price for? Mr. Goodman has a simple answer:

“We have seen the effect of not having critical medical information available when it is needed. The free “Lite” version of our software will ensure everyone has a minimal level of safety.”

In the coming seven years, all of healthcare will by necessity and regulation convert their centuries old paper technology to modern electronic medical records. The use of Portable Health Records for data validation is the logical next step in this evolution.

What a wonderful merger of form and function that could now save your life!

Comments

[myspace design]

Nice read. Very informative. Great job!

[Personal Health Records]

Personal Health Records provides benefits such as storing and sharing of patients’ health records ensuring the privacy and confidentiality of patients’ information. This wipes out all the errors, associated with the conventional paper based system. It collects and stores the patients’ health information data from all the sources like hospitals, laboratories, healthcare professionals, pharmacies and insurance companies etc.