When a coronavirus develops, it becomes difficult to collect important electronic medical record data.

When President Donald Trump began to advertise hydroxychloroquine as one of the “biggest changers” to treat COVID-19, researchers said that electronic health records would soon be on the right track if he was on the right track. I expected I could inform them.

Still, pooling data from thousands of hospital digital recording systems has so far proven a technical nightmare. This is primarily because software built by competing technology companies is often unable to obtain and share information that helps physicians determine which coronavirus treatments are helping patients recover.

“I’m surprised that EHR vendors can’t consistently pull data out of their systems,” said Dale Sanders, Chief Technology Officer. Health catalyst, A medical data analysis company. “It completely impedes our ability to understand and respond to COVID.”

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Over the last decade, federal authorities have spent about $ 36 billion switching from paper to electronic medical records (EHRs), and above all, a large amount of medical data to uncover which treatments are most effective. I expect to use it.

The EHR documents all the steps doctors and other healthcare professionals take to treat COVID patients, from prescription medications to signs of progression or regression. Data collected from a large number of patients can provide immediate answers as to which treatments are successful.

But a pandemic critically says how far a country is from achieving its promised profits.

Dr. Richard Cook, a research scientist and medical safety specialist, tracked down data problems leading up to the EHR rollout that started in earnest in 2009, and has been a controversial issue since commercial players bought a hospital. I am brewing. It has proven to be more suitable for billing than public health. “This was a boon to beginners and promoters knew it at the time,” Cook said.

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While some healthcare systems are beginning to use EHR data to identify trends and beneficial treatments for coronaviruses, most healthcare providers across the country cannot do so easily.

“If we have a national database, [COVID-19] Dr. Eric Topol, director of the Scripting Research Translational Institute, said:

Medical researchers support studies testing drug efficacy in formal clinical trials, and trials of drugs that may combat a variety of COVIDs, including hydroxychloroquine, are ongoing. However, the results can take months or more, and doctors treating critically ill patients have few options in the meantime.

Topol says “real-life” evidence drawn from computerized records of COVID patients is less reliable than clinical trials, but “still very useful” to help guide medical decisions. It was

Medical data has been difficult to decipher because much of it resides in electronic “silos.” Government officials have not demanded that tech companies be opened and removed.

“We see a small number of fragmentary reads from individual healthcare systems,” Topol said, “but we don’t have the critical data we need.”

Sanders whose company is a member of COVID-19 Healthcare CoalitionFederal health officials lost valuable time by not being able to meet this need in mid-January, said a group sponsored by companies that promote data sharing and analysis of coronaviruses.

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The Federal Centers for Disease Control and Prevention (CDC) should devise a COVID data collection plan using standardized terminology to allow hospitals with incompatible EHRs to compare notes on fast-paced pandemics. Said.

CDC did not respond to written requests for comments. A spokesman for the Health and Welfare Department, which coordinates the Health Information Technology Policy, said: “Because this is a new disease, we are learning that the healthcare system did not know what data to collect, so we needed to build reporting information. For multiple clinical features.”

Still, some of the leading EHR manufacturers are participating in the Data Sharing Union and are pledged to fill at least the information gap. This group has access to COVID data from approximately 24 healthcare systems and plans to add more.

“ This is the first attempt at this where I am aware of where essentially competitive EHR vendors have come together to collaborate with clinical researchers, ” said MITER Corp., a non-profit technology group. We formed a coalition at the end of March.

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Anderson said the coalition is “approaching” because it will be able to share some of the findings from reports of treating people with convalescent plasma recovered from patients who survived COVID-19. . Group is also looking at therapeutic data on drugs Rem decivil This is to solve some technical problems that complicate the analysis of hydroxychloroquine. Last week, the Food and Drug Administration Warned Hydroxychloroquine can cause heart problems and should only be used in hospitals or clinical trials.

There are other signs that the EHR industry is easing visibility into medical data in response to emergencies. Cerner Corp., a leading EHR vendor, sponsored Researchers have access to several types of COVID-19 data, including “outcomes that may help drive clinical complications and important medical decisions.”

In addition, some medical systems have begun to publish the data obtained from the EHR. 1 Investigation Released this month, for example, followed the outcomes of 5,700 coronavirus patients treated at 12 New York City health system hospitals and found that 88% of ventilated patients died. . All hospitals shared the same record vendor.

“People want data, and authorities demand it when they’re at risk,” said medical safety expert Cook. But he said, “it’s impossible to build such a system on demand.”

Ross Coppell, a professor at the University of Pennsylvania and long-time EHR safety expert, said the COVID-19 pandemic represents both “strengths and disappointments” for digital systems.

Although healthcare systems using a single vendor were able to pool the data, the industry fought with regulators trying to adopt common standards, a practice known as interoperability.

“The failure to mine these highly valuable oceans of data reflects the ability of vendors to prevent government requirements for data standards and interoperability,” he said.

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The limitations of electronic data collection systems also hinder COVID-19’s public health and surveillance efforts.

Authorities say they waste valuable time because they may have to manually fill out some forms and fax them. Some information cannot be sent electronically and must be printed from the EHR and re-entered by public health authorities.

Specific CDC FormIt may take up to 30 minutes for the COVID case report of the surveyed person to complete. Other forms exchanged between hospitals and laboratories often miss important information, leading to delays in contacting and contacting patients. According to Janet Hamilton, executive director of parliamentarians and territorial epidemiology, in some states, 85% of demographic information about race and ethnicity is missing, and patient addresses are lost in half the time. .

“We use yesterday’s technology for the greatest public health emergencies of our lives,” Hamilton said. “COVID has shown people what we have long known. We cannot leave public health at the end of the line.”

Government Health IT Manager Manages New rule It takes time to change behavior to promote interoperability and ensure that EHR makers do not block the flow of information

“If this were to happen when interoperability was realized in three or four years, it would be much better here, but unfortunately not, we’re still working on it. Said Donald Rucker, national coordinator of medical information technology, on April 15th. Meeting.

Kaiser Health News A non-profit news service that covers health issues. This is an editorial independent program of the Kaiser Family Foundation, not affiliated with Kaiser Permanente.