Data in Medicine: Past, Present, and Future

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Dr. Angad Singh, from the University of Washington, shares his perspectives on what the promise of a more interoperable patient world will offer to clinical workflow. His post is highly relevant to health care innovation and bridges two focal points of Cambia Grove, interoperability and clinician workflow.

As a kid, I read a science fiction book in which the characters called each other using their futuristic video phones. What seemed so impossible then is now our new norm. Similarly, in medicine, we functioned in our own silos not all that long ago. Patient data remained stuck in half-legible handwritten charts with no crosstalk from system to system or clinic to clinic.

Through my work as a physician leader in clinical informatics at the University of Washington, I have had the opportunity to participate in the digital transformation of medicine. My focus has been on clinician burnout and optimization of the electronic health record (EHR) experience. Having trained hundreds of clinicians across nearly all specialties, I have seen firsthand how data has changed with the digitization of medicine—and certainly not always for the better.

Shifting Responsibilities

One of the key changes that happened with the digitization of health records was the delineation of who inputted patient data. Clinical data, such as medication lists or depression screenings, could no longer be simply photocopied into a paper chart. Instead, a licensed medical professional was required to input each entry line-by-line. Precious time previously used to care for patients was now being dedicated to simple data entry tasks. Combined with other burdens associated with EHRs, it was no surprise that new workflows like this contributed to the clinician burnout epidemic that medicine faces today. The role of a doctor is no longer dependent on medical knowledge alone. It now also requires computer literacy.

Interoperability, A Game Changer

While the learning curve with EHRs is full of challenges, it has not been all despair. Recently, I have seen tremendous improvements with interoperability and data exchange. Previously siloed hubs of data now flow easily, allowing practitioners to paint a fuller picture of a patient’s medical history. For example, I can seamlessly review records for a patient who has moved to Washington from another state, saving me (and, most importantly, the patient) from repeating costly tests. I can also review the state’s controlled substance registry data without leaving the EHR. These types of changes in interoperability, while still far from perfect, have led to great benefits for patients and clinicians alike. 

Synthesis as the Future

To date, just having data pull into the EHR has been a tremendous win. As our systems mature, we will be further flooded with information overload. Practitioners will have to review thousands of data points, from labs to X-rays to clinical notes, spending critical time parsing out relevant information from distracting noise.

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Just like the increased time burden with data entry, data analysis will become increasingly problematic. This is why I believe the next frontier in medicine will be our ability to synthesize information quickly and accurately.

I imagine a future in which digital tools rooted in machine learning and neural networks rapidly collect, collate, and synthesize relevant information so clinicians can easily use it at the point of care. This, in turn, would cascade into improved patient outcomes and lower costs of care while maintaining clinician wellness.

Changing the Way We Experience Care

Medicine is currently undergoing great transformation. New ideas to expand the digital experience are vitally needed to continue improving the way we provide care. As our technology matures, medicine will further transcend the four walls of the exam room. Soon, I hope to see a patient’s salient medical history without human intervention, to act on trends identified by an ecosystem of evidence-based home medical devices, and to engage patients in a shared electronic health experience. I look forward to a future medical world that still feels unattainable today.

 

About Dr. Angad Singh

Angad Singh, MD is a practicing physician at the University of Washington. He serves as the Physician Lead for Clinical Informatics at the UW Neighborhood Clinics and is the Physician Lead for EHR Optimization and Support across UW Medicine.

 

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