By Jack Cumming
We’ll start with a story. Kaiser provides our healthcare. Do you know Kaiser? If you don’t, it’s as close to socialized medicine as you can get in a country like the United States. Although Kaiser is big enough to develop its own state-of-the-art digital presence, it buys its electronic health records and care management system from a vendor, Epic Systems.
Epic Documentation
This is where our story begins. About six months ago, I visited my primary physician and asked him about a report I had read about Epic’s artificial intelligence preparing medical notes. He told me then that he had tried that feature, but that it hadn’t helped because he had to rework the result, and it was easier to do it right in the first place.
Today, as I write this, I was with the doctor again, and it was a different story. The topic was sensitive, but the doctor maintained eye contact throughout the visit. He never once turned to type on the computer. Eye contact can be the most important thing a physician does to establish a relationship with someone seeking counsel. He never typed as previously had been common. He concentrated fully on the matter at hand.
So Much Better
I asked how he was going to remember the prescriptions, lab tests, and referrals that resulted from the consultation. The answer surprised me. He was using Epic’s AI. He added that Epic had greatly improved it over recent months. It was awesome, and it changed what was cumbersome into something natural.
After a visit, Kaiser members are given a summary of the results. They were quickly available and fully lined up with the conversation. The only difference was that in one place it read “Atenolol 25 mg Oral tab, take 0.5 tablets by mouth daily,” while in another place it stated, “Start on Atenolol ½ tablet 2 X day and repeat BP in 2 wks.”
While medication errors are not trivial, the difference would not be consequential in this case. Epic may want to build a resolution step into its systems when there are inconsistencies.
Why Not Senior Living?
There are at least four prominent electronic health record systems that are relevant to senior living. PointClickCare and Matrix Care are popular with assisted living and skilled nursing providers, while Cerner is reported to be popular with hospitals, and Epic is anecdotally popular with physicians and other direct care providers. All four claim to offer similar artificial intelligence features to help with recordkeeping.
Epic’s LTC or SNF EHR modules are aimed at senior living. Cerner’s CareTracker product is likewise designed for long-term care facilities. Cerner is now part of Oracle. PointClickCare offers PAC Management for Hospitals to connect hospitals with post-acute facilities. MatrixCare has no hospital component, though it claims interoperability with hospital systems.
Irresponsible Procrastinating
It’s been over 15 years since the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act was passed. Even before HITECH, the value of a uniform cradle-to-grave EHR was evident. The Social Security System offers a simple path to achieve that minimal improvement to American healthcare. Everyone knows our healthcare is more costly and less convenient than that in other nations.
It’s shocking that all these years later, EHR vendors have failed to come up with a solution, such as attaching an agreed uniform record to Social Security Accounts. Instead, patient welfare still depends on local efforts to provide connection. Where I live, that local effort is called San Diego Health Connect, and you can listen to Health Connect’s Dan Chavez describe it by clicking here. His interview was eight years ago. Laura Young has since succeeded him. This dilly-dallying with people’s health seems inexcusable.
My encounter today with the benefits of forward-thinking automation shows what we Americans can achieve if only we put our minds to it and unleash the latent creative capabilities among us. Wouldn’t it be a turnaround if senior services were at the forefront of this coming revolution instead of being seen as a laggard?
