After reading Moneyball by Michael Lewis, I came away with an important lesson. A lesson easily applied to medicine from the realm of baseball scouting. Michael Lewis followed Billy Beane, the revolutionary baseball manager who changed the way that baseball organizations look at baseball prospects. I realized while reading Moneyball how available for anything involving sports. Want statistics on your favorite shortstop from your favorite baseball team? The stats are readily available by simply going to your team’s website via a Google search.
During any sports broadcasts, announcers are quick to rattle off mindboggling stats for players and teams. We see this everytime we settle down to watch Monday night football, Baseball tonight, ESPN, or Sportscenter. The sports gurus quickly inform us of statistics based on years of culminated data. Watching Monday night football, you might hear about an upcoming quarterback and his completion percentage, the number of sacks he’s taken in a game, his touchdowns and incompletions, his number of rushing attempts on how much yardage he gains each time he passes the line of scrimmage, how many completions he’s had for 40 plus yards, his favorite receivers, his distribution throughout the field, and so on. They might even go further to relate how the quarterback compares to others in the past, or even his own past in college and high school. They might compare his team in wins at home versus on the road, versus AFC teams, NFC teams, losing records, winnings records, the last 20 games, last 30 games, a specific temperature or geographical area… you get the idea. But if I want those same types of statistics on a patient in correlation to their past medical history and data, what their vital signs looked like 1,5,10, and 20 years ago, their lifetime history of vaccinations, medications, surgeries and procedures, or the socioeconomic progression of the patient, the information is scattered among 10 to 20 areas and takes hours to compile. My point is this, electronic medical records will be a beautiful thing. We have to make them more accessible and HIPAA must get in line with making allowing us to compile this information is a readily accessible format that simulates the simplicity of what we see when we visit ESPN.com. The reason is that this information allows us to make life or death decisions when these patients cross the threshold of the ED or hospital. Obtaining medical information on a patient via charts and paper records is frustrating as hell, and prevents us from doing our jobs efficiently and effectively. The frustrating truth is that it’s easier for me to run a fantasy football team with free software from ESPN, FOX sports, YAHOO, etc and a look at a multitude of stats and analysis than it is for me to access our EMR system at the hospital I’ve been rotating at.
I imagine at some point, or rather wish, that we’ll one day have a system with real time information distributed to an ipad I’ll have in hand that notifies me of real time patient information. Imagine making physician orders via my ipod, ipad and iphone with an electronic thumbprint signature. Imagine receiving real time CT scan, X-rays, Standardized H & P’s input by the patient themselves from their home computer before they even set foot into the office, laboratory reports, cultured organism susceptibilities to allow real time decision making in correlation to antibiotic administration, etc.
An ipad and iphone can operate an Apple TV device to allow live streaming of events, music, shows and movies. Fedex can track a package across the globe with real-time updates on that package’s location. Yet, it takes 30 minutes to track down a patient who is missing from their hospital bed. It takes 2 hours to discharge a patient from the hospital. It takes an hour to get stat orders through. Only fifty percent of hospital’s meet JACHO’s core measure for myocardical infarction (chest pain) work-up within the required 90 minutes. My argument is that we should look patient medical information and records like fantasy football managers, and demand that information be real time so that we can be effective and efficient as possible in the healthcare arena.
During any sports broadcasts, announcers are quick to rattle off mindboggling stats for players and teams. We see this everytime we settle down to watch Monday night football, Baseball tonight, ESPN, or Sportscenter. The sports gurus quickly inform us of statistics based on years of culminated data. Watching Monday night football, you might hear about an upcoming quarterback and his completion percentage, the number of sacks he’s taken in a game, his touchdowns and incompletions, his number of rushing attempts on how much yardage he gains each time he passes the line of scrimmage, how many completions he’s had for 40 plus yards, his favorite receivers, his distribution throughout the field, and so on. They might even go further to relate how the quarterback compares to others in the past, or even his own past in college and high school. They might compare his team in wins at home versus on the road, versus AFC teams, NFC teams, losing records, winnings records, the last 20 games, last 30 games, a specific temperature or geographical area… you get the idea. But if I want those same types of statistics on a patient in correlation to their past medical history and data, what their vital signs looked like 1,5,10, and 20 years ago, their lifetime history of vaccinations, medications, surgeries and procedures, or the socioeconomic progression of the patient, the information is scattered among 10 to 20 areas and takes hours to compile. My point is this, electronic medical records will be a beautiful thing. We have to make them more accessible and HIPAA must get in line with making allowing us to compile this information is a readily accessible format that simulates the simplicity of what we see when we visit ESPN.com. The reason is that this information allows us to make life or death decisions when these patients cross the threshold of the ED or hospital. Obtaining medical information on a patient via charts and paper records is frustrating as hell, and prevents us from doing our jobs efficiently and effectively. The frustrating truth is that it’s easier for me to run a fantasy football team with free software from ESPN, FOX sports, YAHOO, etc and a look at a multitude of stats and analysis than it is for me to access our EMR system at the hospital I’ve been rotating at.
I imagine at some point, or rather wish, that we’ll one day have a system with real time information distributed to an ipad I’ll have in hand that notifies me of real time patient information. Imagine making physician orders via my ipod, ipad and iphone with an electronic thumbprint signature. Imagine receiving real time CT scan, X-rays, Standardized H & P’s input by the patient themselves from their home computer before they even set foot into the office, laboratory reports, cultured organism susceptibilities to allow real time decision making in correlation to antibiotic administration, etc.
An ipad and iphone can operate an Apple TV device to allow live streaming of events, music, shows and movies. Fedex can track a package across the globe with real-time updates on that package’s location. Yet, it takes 30 minutes to track down a patient who is missing from their hospital bed. It takes 2 hours to discharge a patient from the hospital. It takes an hour to get stat orders through. Only fifty percent of hospital’s meet JACHO’s core measure for myocardical infarction (chest pain) work-up within the required 90 minutes. My argument is that we should look patient medical information and records like fantasy football managers, and demand that information be real time so that we can be effective and efficient as possible in the healthcare arena.
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