Sachin Jain, MD, Chief Medical Information and Innovation Officer for Merck and Company was one of the keynote speakers at the MedCity ENGAGE Summit held September 30 to October 1st www.events.medcitynews.com/engage in Bethesda Maryland.
Dr, Jain suggests that today’s healthcare needs to come up with new solutions to provide patient care. He gave examples where several patients were treated but as it happens, the information wasn’t kept up-to-date or enough information wasn’t included in the notes.
Dr. Jain took care of a patient named Christine in a hospital emergency room complaining of back pain. After doing a physical exam, laboratory tests, x-rays, and prescribing pain medication, he studied her blood pressure and wondered why it was high as the patient appeared to be on the right medication to treat her blood pressure.
He found out after questioning Christine that she never took the medication to treat her high blood pressure unless she was going to see her doctor. So in the doctor’s office her blood pressure was usually lower.
Dr. Jain started questioning Christine and her primary care physician on her adherence to the medication and found out that she also never filled her medication routinely after it was filled the first time. This crucial information never made into her electronic record.
As Dr. Jain pointed out, “This shows how important it is to have the most up-to-date information in the system especially in regards to adherence issues so that the doctor will be aware and effectively be able to deal with the issue of medicine adherence.
In another case, a patient named Jimmy was overweight but generally had a happy personality. He went to a clinic where he was treated by residents at the hospital but the residents treating him changed every three years. Although the medical data moved from one resident to another, the information only described the broad picture but did not concentrate on new problems.
Over a period of time, Jimmy started losing weight and became anemic which after examinations, suggested the possibility of cancer. When this occurred, the information on his weight and anemia hadn’t previously been noted in his record, and as a result, his medical issues weren’t acted on immediately.
In a third situation, the patient Ledina under medical treatment for high blood pressure when her skin tone changed, and she was faced with abdominal issues. She underwent a CAT scan where it was discovered that she had a big mass in her abdomen which was confirmed after a workup was done.
Her daughter began asking questions and wanted to know the names of surgeons that had operated on this type of tumor before and what would be the best chemo regimen for her mother to undertake.
In order to find the answers, more data was needed in the EMR to drive the decision as it was a complex situation. Not only was more specific data needed for this patient but the data needed to be integrated into her record before the patient’s daughter could really find a surgeon with the right experience. The information was made available and by searching for just the right surgeon, the surgery was accomplished with Ledina living for an additional eighteen months.
Dr. Jain concluded, “We need to update our medical records to find all of the information that is available and to integrate the data into the workflow. This should be going on while building solutions and listening to the patients or caregivers so the information can be put into the hands of the right doctors. The goal is to use IT to push beyond the easy answers in order to provide the right care at the right time.”