In both the public and private sectors, certain healthcare services in the U.S. today are falling behind when it comes to the ready digital access of patient records and relevant documents, according to several reports and studies released recently.
Ten years ago, more than $30 billion in federal funding was directed to physicians and hospitals in a push to help them begin creating electronic health records of their patients' information yet today, providers face records-related issues that range from patient mismatching to a lack of recording oversight.
In two examples involving both a federal agency and private healthcare providers, EHR-related issues were found to have been the cause of extensive patient documentation backlogs and the creation of multiple duplicate patient files.
Five-mile backlogs and misdiagnoses
According to the results of a seven-month 2018 audit of multiple Veterans Health Administration facilities conducted by the Department of Veterans Affairs' Office of the Inspector General, 86 locations were found to have a collective backlog of physical patient documentation intended for digitization measuring "approximately 5.15 miles high."
Locations audited did not include those that did not have a means of quantifying their backlogs, such as those "without paper document or electronic file calculations."
Results explained that the backlog had been created "in part" due to the fact that staff did not scan and enter records "in a timely manner" and because facility directors did not adequately oversee the scanning processes ensure that "resources were available to meet scanning demand".
In the private sector, documented issues have stemmed from the lack of a national standardized method by which EHR vendors at hospitals and other health care facilities must adhere with regard to the collection and creation of electronic patient records, which has resulted in the use of "hundreds of different interfaces" around the country, according to Undark Magazine.
As a result of the lack of standardization, many facilities have been unable to integrate their patient records with those from other locations, which has created patient matching issues that include duplicate files and – in rare cases – the accidental merging of the information of two different patients who share the same name, according to Fast Company.
One recent example of a worst-case scenario in patient mismatching occurred in 2016 at St. Vincent's Hospital in Worcester, MA where a patient was misdiagnosed with a kidney tumor that required removal as the result of a mix-up with another who shared the same name.
"Seamless" digital medical records access years away
In 2017, a majority of U.S. home health aides and skilled nursing facilities made use of EHRs, according to a November 2018 data brief published by the Office of the National Coordinator for Health Information Technology.
Yet due to the lack of collection standardization, only 36% of HHAs reported that they were able to integrate patient data acquired from outside organizations and slightly over half reported having the ability to access information from outside providers, according to the brief.
A survey of nearly 1,400 health technology managers conducted by Black Book from the end of 2017 to the beginning of 2018 found that on average, 18% of patient records at healthcare organizations that had not used patient-matching technology were duplicates.
Research published in medRxiv on August 13, 2019 concluded that despite recent efforts to expedite the process, the full implementation of EHRs to provide "seamless digital access by patients to all of their health information" would most likely not be a "reality" for "years" to come.