The Fat Man of Healthcare

It is time to blow up the electronic medical record.

I realized this when I observed the chaos surrounding my father’s most recent admission. The hospitalist was buzzing around, ranting about how the staff had not called poison control when in fact they had.

Later, he was visibly frustrated because the nephrologist had not seen my father yet.

“He saw him in the ER,” I said.

“Really?”

“Yeah. I watched him question my father, and I had a conversation with him afterwards.”

The hospitalist stared at me like I was speaking a foreign language.

“He never left a note,” the hospitalist said.

That’s the moment I knew the electronic medical record was failing us.

As I pondered the role I just played because I’d been present with my father the whole time, someone rang my doorbell.

I was three hundred miles from my house, and I knew the furniture guy was at my door, ringing my high tech doorbell.

I looked down at the video clip of the guy at my door using my nifty smart home app, and smiled as I saw the solution to the hospitalist lack of information — we need to blow up the medical record with video clips of doctor-patient interactions in real time.

Had I not been a human video recorder for my father? How much easier had I made things by being the continuity factor between the healthcare team and my father?

Video has changed the world.

Think about how YouTube has impacted the news, the selection of the next Steve Perry, and governmental regimes in the Middle East.

Although I love words, and stories, I have to admit that not everyone reads books. How many times in healthcare is information not passed along because it was hidden in plain sight in the medical record?

We need to face reality. Some people are not reading the medical record. Furthermore, some people couldn’t tell a story to save their lives, in which case, it wouldn’t matter anyway.

Think about what video could do for medicine.

It could have an immediate impact on the quality of healthcare, the sharing of information with family members, and even medical education.

I see a day when healthcare providers (doctors, nurses, technicians) enter the room with sensors on their apparel that logs when they enter the room and when they leave, when the interactions between the providers and patient are recorded and made available via video clips in the medical record (and hopefully the patient portal as well). Those of you who have smart technology in your home know this is not a stretch.

This would help get rid of the bad actors. It would have a huge impact on the communication skills of doctors which is largely ignored at this point despite it being considered a core competency. It would allow us to better study patient literacy and communication strategies that are most effective. It would allow patients families to be informed without requiring doctors to circle back to have the same conversation. It would allow the patient to experience the same conversation in a different state of mind (think of the conversations where the doctor tells the patient they have cancer) — so they can absorb the critical information the second time around. It could provide the healthcare team access to previous interactions which could serve as a tangible baseline of the patient from the recent past, something that is sorely missing with current day medical records.

It is time to reach for a radical intervention. It is time to drop the bomb on the medical record — and add video.

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The views, opinions, and positions expressed here are my own and do not reflect the views, opinions or positions of the government, the Defense Health Agency, or the United States Air Force.