EHRs are an untapped, but almost impossible to use, health resource

We’re all familiar with the promise of “big data” in healthcare. Crud, I’m a huge fan of using data. I think the amount of information inside an EHR has the potential to do a lot of wonderful things, not only for healthcare in general but specifically for a pharmacist. How many kinetic consults have been done by hand, tracked manually, and refined by voodoo magic? Thousands, I can assure you. The number of things pharmacists still do manually is staggering. “Monitoring” should no longer involve rummaging through charts — electronic or otherwise — looking for tidbits of information that need to be “fixed”. The days of dosing medications like vancomycin, warfarin, phenytoin, and aminoglycosides — just to name a few — should be long gone. We can contemplate building a Hyperloop, but we can’t figure out how to get someone’s INR to a therapeutic level within five days? Seriously, think about that for a second.

FierceHealthcare: “For public health agencies, tapping into EHR data could augment the costly and time-consuming process of surveys….Data analytics has emerged as a key tool for providers to target high-risk populations with chronic conditions, although some have argued that health IT systems are still ill-equipped to adequately manage population health.” There’s the crux of the matter, data is valuable, but it’s tough to get. I’ve only recently started to request specific data from the EHR to look at some things I find interesting. Unfortunately, I’ve run into roadblocks. Apparently, the data inside an EHR — at least inside this particular EHR — isn’t easy to retrieve. At least that’s what I’ve been told. How hard can it be? Dude, just dump the raw data somewhere and I’ll build the queries myself. Again, apparently not that easy. 

In a nutshell, all patient data, from demographics and notes to labs and medication use should be easily accessible to anyone with appropriate credentials, i.e. a pharmacist that works for the hospital where an EHR is used, for example. Only when we, as healthcare professionals, can access data at will, and use that data to answer questions, will EHRs become valuable to patient care. At present, EHRs are full of potentially valuable information that no one can get. It’s like having a savings account that only allows deposits, no withdrawals. The balance might look great, but what do you do when you need a little money and the bank says “sorry, there’s no way to take your money out”? Throw in the fact that EHRs are a usability nightmare and you realize that we have a long way to go.

3 thoughts on “EHRs are an untapped, but almost impossible to use, health resource”

  1. What EHR are you using? I can get information out of ours but it isn’t all that user friendly as you have to know some SQL. But pharmacists are trainable, if slow sometimes. If the information is only retrievable in a SAP type system then it is even harder to get out, but again you can do it if you work at it. Most of the time when a pharmacist hits a road block as you describe it is because of silos within your facility. I mean the information is there but the tools to access it are restricted so they can only be used by IT. I hear that a lot. You have to make the right friends and as to get access or training as required.

  2. Hey Warren – Been a while. Thanks for stopping by. I’m not allowed to say which EHR. As I’m back to working as a staff pharmacist these days, I can only go by what I’ve been told. The facility I’m in likes to use “no” a lot…or the ever popular passive-aggressive response of not responding. The biggest problem with data in healthcare is exactly what you said, i.e. “…because of silos within your facility….tools to access it are restricted so they can only be used by IT”. I shouldn’t have to make friends with anyone to go traipsing through the data. I’m trusted enough to provide medication information and dosing to neonates and trauma patients, but not enough to compare patient demographics to some vancomycin trough levels? C’mon, man! That’s just stupid.

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