One thing that will be different in this Olympics as compared to all that have come before is that, for the first time, the U.S. Olympic Committee will be using electronic medical records (EMRs) to track the health of the 700+ athletes that participate in the games. Apparently they are also converting all of the data from about 3000 other athletes seen by U.S. Olympic Committee (USOC) physicians in recent years, according to an NPR article sent to me by Veronica Combs, editor-in-chief of MedCity News.
Apparently in each of the past Olympic Games, the U.S. and other countries have literally shipped pallets of paper files to the Games location so USOC doctors could have access to their medical histories. In other words, they did what most U.S. providers currently do, which is work with inaccurate and incomplete paper files spread all over the place and transported by hand. Of course this means that, as we speak, ten thousand squirrels are inputting the athletes current paper medical records into the new Olympics EMR by hand — literally. According to the NPR article, ’”members of Team USA will have their paper records digitally scanned or added manually to the collection” and into General Electric’s EMR called Centricity Practice Solution (CPS).
Supposedly this process will take 90 days, but if it’s like any other EMR installation known to man, these athletes will be participating in their first Medicare Olympics before it is truly complete. Good thing GE is one of the Olympics largest sponsors or one can imagine that the USOC might have to hock the Olympic cauldron at a pawn shop to pay for installation cost overruns. Wouldn’t it be awesome if instead of the usual propane-based lighting of the Olympic flame this year they could pre-fill the cauldron with all of those paper records, now no longer necessary. The flame would last not just through the Olympics but long after we are all dead, given the amount of paper they must have on these athletes.
In many ways, this population represents the perfect example of why we need EMRs. According to the NPR article, the average Olympian has 8 different clinicians involved in care, some affiliated with the USOC but many who are not. Athletes travel all over the country and world and are constantly being medication monitored, imaged, blood tested and drug tested at a rate far in excess of the average person. These athletes sustain injuries on a frequent basis that require constant attention and intervention. No one’s health and ability to perform is scrutinized more intensely than perhaps that of Lindsay Lohan. When the athletes show up at the Olympics, it would be ideal if the physicians and trainers charged with caring for them could know all that has come before, including whether they are taking legitimate medications that might show up in drug tests as questionable or what their various MRI images looked like before they partied just a little too hard after the medal ceremony and fell off the Olympic Village balcony.
Of course, as with all discussions about EMRs, the conversation quickly turns to predictive analytics, that idealized concept that everyone in the EMR business discusses as if it were akin to the Holy Grail. Predictive analytics is the means by which the reams of digitized data are culled and cross-referenced to produce meaningful new actionable information. There are a few good examples out there of this happening, but it is a field in its very early stages to be sure. Right now the primary use of EMR-based predictive analytics is probably for physicians to figure out which patients never pay them, but the promise of clinical utility is out there.
Jan De Witte, chief executive officer of GE Healthcare IT and Performance Solutions, was quoted in an article in Healthcare IT News saying, ’Over time, the medical record history that will be built into CPS, and the capability to interface with our database will allow the USOC to go into real performance analytics to understand what treatment plans have the best outcome for the athletes. The real value is going to be having the protocols and the treatment plans and the preparation plans, based on benchmarking data and historical trending of the athletes.’ In other words, data could help the USOC help athletes live up to that Olympic Motto to become swifter, higher and stronger.
Given some of the drug-related controversies of past Olympians, this predictive analytics opportunity must scare the hell out of the athletes and their sponsors. One might just be able to put together an algorithm that shows suspicious spikes in performance concomitant with visits to certain sketchy providers, BALCO style. If you are Lance Armstrong you might be very worried about the implications of having your data all in one place and easily analyzed for patterns related to increased bike speed. Of course, if you are Michael Phelps, the data stream might more likely point to significant reductions in water speed correlated to Olympics after-parties. After being photographed smoking marijuana after his last big Olympic showing, Bill Mallon, an Olympic historian, commented, ’He probably will take some hit with this.’ Actually, I think he already did, thus fulfilling the “higher” portion of the Olympic Motto.
In any event, the 2012 Olympics is an excellent opportunity for the EMR industry to find some positive spin to help them better promote their wares to the doctors and hospitals of the nation. Despite around $40 Billion in free money made available by the federal government to ensure all providers have active EMRs, only about 50% of all practices have made the leap (closer to 75% in hospital-based practices). As one of my colleagues recently pointed out to me, if the whole concept of ’meaningful use’ is subject to such intense discussion and debate, then that use starts to appear somewhat meaningless, does it not?
After Michael Phelps was caught getting his bong on in 2009, USA Swimming, the sport’s national governing body, issued this statement: “We are certainly disappointed in Michael’s behavior. . . . That said, we realize that none among us is perfect. We hope that Michael can learn from this incident and move forward in a positive way.”
This would be the perfect opportunity for the Office of the National Coordinator for Healthcare IT to say something similar to our nation’s provider organizations to encourage them to get on the EMR bandwagon after years of resistance, even in the face of subsidies to get them off the dime. EMR adoption has certainly accelerated in recent years, but the fact that 25% of large (>26 providers) entities are still operating with paper records is hard to imagine. Actually, it’s easy to imagine, just hard to accept.