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EMR Penetration Could Give Hawaii a Key Healthcare Advantage

Hawaii is already among the national leaders in lots of health care metrics. Cost of care and expenditures on health care in the islands, on a per capita basis adjusted to a regional COLA scale, is incredibly low - much lower than other areas of the country with comparable costs of living and economic conditions. But a new study came out yesterday that hints at the benefits of widespread use of Electronic Medical Records. Stanford scientists did some data mining and spotted something really interesting - that people who take the two popular drugs paxil (anti-depressant) and pravachol (a cholesterol suppressant) experienced markedly higher blood sugar levels. High blood sugar levels, aside from being a pre-cursor to diabetes, are linked to lots of other bad thing. They were able to make this discovery by mining anonymized Electronic Medical Records, something that would have been impossible in pre-EMR days 10 years ago (well, pre-widespread use). This implies that with EMR we can do lots of really heavy outcomes-based analysis without requiring clinical testing. Granted, you'll have to replicate in the lab but at least it gives us likely target areas. Hawaii hospitals already are ahead of the curve on EMR penetration and usage - we were blown away at how much better Kapiolani and Queens were compared to bigger, better funded Mainland hospitals. So I wonder if UH could put together some specific projects aimed at health care cost reductions and outcome improvements based on a similar premise - mining EMR data in the Islands.

On the Big Island,

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Comment by Nikolas Yem on July 5, 2011 at 10:09pm

There's actually a project on the Big Island that won over 16 million dollars from the federal government's Beacon Community grant, that was spearheaded by UH Hilo, to provide for Electronic Medical Records as well as providing better access to medical care to the residents of the Big Island.

 

Check out the news article here: http://www.hawaii.edu/news/article.php?aId=3600.

Comment by Marcus Sortijas on June 12, 2011 at 10:31am
On a related note, I came across this article: Making community health information as useful as weather data.  It talks about how Todd Park, Chief Technology Officer at Health and Human Services, is working with tech firms to release more health data to spur innovation.  Established companies like Google and nimble start-ups are mining that data to build new apps.

Although when I saw that headline, I had this absurdist vision of a health forecast: "Flu is up in Salt Lake, while heart attacks are on the rise downtown. On the bright side, arthritis is down in Mililani.  That's today's health report."
Comment by Branden Tanga on June 7, 2011 at 4:26am

It would be good for UH to put together more studies aimed at public health, but they'd better make sure their budgets can afford to pay for access to the data they need.

Comment by Alex Salkever on June 3, 2011 at 7:04pm
Marcus, that's really interesting. I didn't know about that. I think that the idea would be fabulous. But in America we can't even move to smart cards for Debit Cards - we rely on totally insecure magnetic stripes. Giving everyone a healthcare smart card that was highly secure and carried records and could be used to process payments would save a ton of money - and Hawaii could actually be a perfect place to try it out.
Comment by Sam Craig on June 3, 2011 at 3:44pm
Great concept.  Also keep in mind that Hawai'i is fairly unique in that there are very few major insurance providers, each of which has significant influence with the doctors and hospitals.  UH might be interested in the project, but so might some of the other on-island health organizations.  I agree that it's important to keep the actual "user" anonymous in that their health information isn't "owned" by the hospital, doctor, or insurer, and if they leave, they can take their information elsewhere.  Microsoft's HealthVaullt or Google Health are both options for providing some level of anonymity (as well as protection.)
Comment by Marcus Sortijas on May 26, 2011 at 11:25am

I like to track health care issues, thanks for writing this.  The keyword here is "anonymized."  People need to feel comfortable and in control of their personal information before they'll allow it to be available for large-scale data mining.

 

Nice to see Hawaii in the lead as well on using EMR.  It would be a boon to see more policy decisions driven by hard-headed analysis of accurate patient data.  I can see how this would really help with preventive care.  By catching trends early, health authorities can issue warnings and advisories to nip problems in the bud.

 

On the flip side, I wish there were more mechanisms for reviewing doctors and hospitals.  For example, it's ridiculously easy to look up reviews of restaurants.  I could get recommendations of good pizza places from a million sources.  Even easier to find ratings for movies.  But for critical decisions like choosing a personal physician, the existing options online are meager.

 

A couple years back, there was an excellent documentary by PBS Frontline called Sick Around the World.  The reporter visited five countries to inspect their health systems. 

 

Taiwan issues smart cards to all its citizens for record-keeping and payment processing.  Here's an NPR story on it by the same journalist who did that PBS film: Taiwan takes fast track to universal health care.  The smart cards work incredibly well--Taiwan's administrative costs are under 2 percent. 

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