Cloud companies move from photo sharing to medical records


If you have access to regular medical care, you have probably had the experience of filling out – by hand – your medical history with each provider.

Sharing medical records between doctors and hospitals can be quite difficult. This is because there is no universal digital system in the United States to share these documents. Several companies are trying to change this.

The tech giant Oracle recently acquired Cerner, an electronic medical records company, for approximately $ 28.3 billion. Oracle says the move will make it easier for healthcare professionals to access patient information from the cloud, which could help lower healthcare costs and improve patient outcomes.

To learn more about what this deal will mean for patients and the pandemic, I spoke to Julia Adler-Milstein, professor of medicine at the University of California, San Francisco, where she researches health records. electronic. She said it’s still unclear how much a merger like this will help consumers or even improve data sharing. The following is an edited transcript of our conversation.

Julia Adler-Milstein (Photo courtesy of UCSF)

Julia Adler-Milstein: Part of the problem is whether large space technology providers feel they are better off when they are part of an open ecosystem and that data can be shared smoothly and easily, or s ‘they feel they really have a competitive advantage by accumulating their own data and using it for their own purposes. And for patients, you know, if you only get your care from organizations that are on Cerner, you might be doing better. But if, like most patients, you move through the health care system, then if you see a doctor who uses a Cerner electronic health record, then you see a doctor who uses an electronic health record from another. supplier, it is not clear that the Oracle merger will help solve this problem.

Kimberly Adams: How well does the operation of our current medical records system reflect how the pandemic is currently unfolding?

Adler-Milstein: It’s enormous. I mean, really, the ability to access data in a timely manner is essential to inform decision making, and what we’ve seen is that we just aren’t able to get the data. where they need to be to inform those decisions.

Adams: What happens instead?

Adler-Milstein: I mean instead we see, frankly, a lot of workarounds where hospitals, for example, enter data into spreadsheets and then that has to be compiled manually. So it’s just a very laborious and inefficient process. It also means that there is much more risk of introducing errors into the data, if people do not understand exactly what data they are supposed to enter.

Adams: Yeah, I mean, it seems a little obscure to focus on how recordings are handled. But what are the health consequences of those systems that are so clumsy right now?

Adler-Milstein: Yes, there are a lot of them. I mean, I think, again, for an individual patient this means that decisions that are made about their care are made without full information – with gaps in understanding their medical history. And again, from a broader population or public health perspective, that means we can’t necessarily allocate resources to the places that need to go there for public health officials trying to take decisions. decisions about the public health behaviors they wish to adopt. . And you know, there is so much controversy, but do you have to reinstate masking in some places? If they don’t know the number of cases in particular places, it is very difficult to make those decisions.

Adams: Has the pandemic created a sense of urgency about improving the management of medical records in the United States?

Adler-Milstein: Undoubtedly. I think it really emphasizes that our data is not able to move smoothly and efficiently. And I think what it really brought in that was invaluable was a real focus on lab test results in particular, and how do we move that kind of data between hospitals, doctors’ offices, Laboratories ? I mean, this is a caregiver that we don’t think about often, but they have part of our medical record. And that’s kind of another stakeholder that we need to be sure can also kind of contribute and move the data. So I think in some ways it really focused us on one type of data, and how do we get the lab test results out there, but it also widened the openness around the types of stakeholders that need to be. be involved in data sharing.

Adams: I think that for a lot of patients, they will be annoyed to learn that their doctor’s offices still use fax machines, or that they still have to fill out a form by hand when they go to the doctor. But there has been a lot of progress in this space.

Adler-Milstein: There has been a really concerted effort at the policy level to try to facilitate the sharing of patient health information where it is needed and appropriate. It takes time for these political efforts to have an impact and ripple through every doctor’s office and every hospital. And so I think what we’re seeing is that we’re sort of in that middle space between the policy and the policy frameworks that exist, and those that actually need to be implemented on the front lines of health care. on a daily basis. The appeal of faxing is that it is easy. It’s really easy to use, and in fact it’s quite complex to get electronic health record systems to communicate with each other. We’ll just need some time to make sure this technology is in place so that it can be used on a routine basis when a patient presents to a doctor’s office.

Related Links: More information from Kimberly Adams

My colleague Amy Scott spoke to Adler-Milstein last year about electronic recordings during the pandemic, when we were probably all too optimistic about how long this would be an issue.

We also have a link to a story of The Wall Street Journal with more details on the Oracle-Cerner acquisition.

And a piece of Bloomberg highlighting how, although most patients now have access to their personal health records, even though we do get them, most of us still have a hard time understanding what is in them.


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