We have so much at our fingertips in a technology-driven era that is filled with every electronic organizational tool imaginable. However, when we look at our medical histories and records, we find paper records filled with multiple dates, numerous medications, a myriad of procedures, and confusing physician entries. Wouldn’t personalized electronic medical records be an obvious technological advancement? Imagine a world where there are complete and organized medical information exchanges between healthcare providers.
A sensible solution
Smart cards are programmable computer chips, similar to ATM cards, that enable users to store and transmit clinical insurance coverage, biographical data, and medical information specific to the cardholders. Everyone has had the experience of visiting a new medical care provider and filling out endless questionnaires about his or her healthcare history. Ultimately, the development and implementation of electronic health records (EHR) will eliminate or at least diminish duplicate information-gathering (Healthcare Informatics. 2003;20). Smart cards are portable medical records that can streamline the continuity of care among healthcare providers in real time and decrease wasted time and repetition of data.
Like ATM cards, smart cards will grant access to electronic transfer and storage of insurance, statistical, and clinical data. On arrival at the healthcare facility, the patient presents the card and verifies identification information by photo ID, personal identification number, or even thermal thumbprint. Once the card is inserted into the card reader, the patient’s medical history, including insurance coverage, clinical imagery, and demographics, is instantly available for review, and updated information can be stored either on the card or remotely through an Internet connection.Computers are set up in each room so the flash drive can be updated at every patient visit.
Flash drives in pilot
The Lymphoma Division at the John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, N.J., is piloting the use of flash drives, computer storage devices that are approximately four inches long, which are used to collect and collate patients’ medical records. Similar to smart cards, the flash drives will be updated at each patient visit to include history and physical, plan of care, and radiology scans.
The plan to implement this technology was developed by Andre Goy, MD, deputy director, Lymphoma Division chief and director of the Tumor Bank at the John Theurer Cancer Center. He says that he decided to use this tool in his practice because “I want patients to take a more proactive approach in their care. Eventually, I would like to have patients review them at home and give them to other healthcare providers involved in their care.” Computers have been installed in each exam room in Goy’s pod to facilitate the use of flash drives and to promote and ensure patient privacy of information. Flash drives connect into the USB port of any computer and do not require additional equipment, as smart cards do.
Alexandria Campaiola, RN, BSN, nurse coordinator with the Lymphoma Division at the Cancer Center, says, “The thumb drives allow for a seamless flow in continuity of care among healthcare team members.” Because the use of this technology is in the early stages, patients are not being given the thumb drives to take home. However, the Lymphoma Division plans to safeguard the tool so it is encrypted and give it to patients after each visit.
The idea for this modern-day technology is not new; Europeans have been developing and using this technology for more than 10 years. Several European research projects have been funded with the main objective of creating systems for personal healthcare monitoring; these wearable, implantable, or portable systems serve as diagnostic devices from the home that detect or prevent diseases such as cardiovascular disease and diabetes (IEEE Eng Med Biol. 2007; 26).
Despite the convenience of these technologies, they don’t come without risks. These risks include identity theft from lost or stolen cards and viruses from contaminated external devices.
To address these risks, the Department of Health and Human Services (HHS) created “federal expectations.” HHS suggests that healthcare providers be compliant with the Privacy and Security Rules under the Health Insurance Portability and Accountability Act (HIPAA). Providers need to —
Assess their need for the use of portable devices and off-site access of patient information
Develop risk-management strategies
Prepare or revise the corresponding policies and procedures
Train staff members about expectations in the use of portable devices and off-site transmissions of patient information (J Am Coll Radiol. 2007; 4).
As we work to develop a portable electronic health history system, we need to also develop measures of protection. There is no doubt that our society is driven by technology and that soon our health care will be as well. Although this technology is not ready yet, there may come a time when smart cards will be as common as ATM cards, and flash drives are on everyone’s key chains.