“The biggest waste in the healthcare system is not unnecessary treatment or duplicated test results; it is that we collect data and never use it again.”
That was just one of several thought-provoking comments from Chris Lehmann, M.D., a biomedical informatics professor who recently gave a presentation at the Children’s Hospital of Philadelphia Center for Biomedical Informatics on some new ideas about secondary uses of data.
The main goal of EHR implementations has been for documentation, Lehmann noted. Clinicians look at what they document and they don’t look at anything else. Here is another thought-provoking question Lehmann asked: Who is the only person who will read a patient’s entire medical record?
A. Physician
B. Nurse
C. Medical biller
D. Plaintiff’s attorney
Unfortunately, the correct answer is D, he said. “We use little of the data we create to make decisions, so we miss an awful lot of opportunities,” said Lehmann, who joined the faculty of Vanderbilt University as professor in pediatrics and biomedical informatics in 2012 and continues his affiliation with Johns Hopkins University as adjunct associate professor in the Division of Health Sciences Informatics.
Lehmann described some projects at Johns Hopkins that pull data from the clinical system but not necessarily for clinical purposes. For instance, by pulling orders from the clinical order entry system, informaticists created a dashboard that helps nurses in the pediatric intensive care unit do proactive bed management and better predict patient length of stay and discharge, based on data trends rather than human intuition.
Another example Lehmann gave from Johns Hopkins is a visual tool to help patients and families become more familiar with their care team. Called PHACES, for PHotographs of Academic Clinicians and their Educational Status, the system pulls information from the hospital’s clinical documentation system. If a patient sees a provider but can’t remember their name, he or she can click on a page that displays the person’s picture, name and title.
“Clinical decision support is no longer just for clinical purposes,” Lehmann said. “We need to think outside the box to address inefficiency, waste and patient’s needs. We have an incredible source of data available that we are not utilizing to make care better, to make it cheaper and to reduce costs. The opportunity is only limited by what we can imagine.”
