The Real Return on Investment: A story about the personal value of an electronic health record

When my father was in his early 60’s, he began to experience a mysterious, debilitating pain.   He initially thought it might be arthritis, but it kept getting worse.   It reached an extreme where my father could no longer move without discomfort.    Our family was devastated when we received the diagnosis.  He had a treatable cancer, that had moved past the point of treatment… it was in his bones.

We sought out specialists in our area and my father began treatment with a top of the line cancer center.   Like me, my father was a bit of a geek.  I can remember him becoming completely enthralled with the Electronic Health Record utilized by his team.   The oncologist, the urologist and pain clinic managed all of my father’s information from one organized and easy to use electronic document.   During the early stages of his illness, the computer in the room was something my father considered a “neat feature” of his care.  I would call to see how he was doing and he would talk about his latest visit and tell me about how the It wasn’t until later that we all realized how valuable that “neat feature” truly was.

Time progressed, as well as my father’s illness, but his incredible treatment never wavered.  There was a point where my father was taking more than 10 medications daily, in addition to the infusions and injections administered at the cancer center.  Even with a complex schedule of medications to follow and numerous underlying medical conditions to monitor, his quality of life vastly improved through the blending of the specialists’ knowledge and the EHR’s accessibility.  Once again, my father was able to enjoy life’s simple pleasures, like a walk through the woods or a trip to the market, without pain.  Life however, was not without its ups and downs.

It was a complex medical situation and we needed to be prepared for the possibility of emergency intervention.    I made an “Emergency Fact Sheet” that listed all of his Active problems, medications, allergies, phone numbers for all of his providers and immediate family members.    We taped it to the inside of the front door so that it could be easily found for a trip to the ER or if the paramedics needed to be called.

The day arrived when the paramedics had to come to the house and rush my father off to the local community hospital.  The experience of the local hospital was a stark contrast to the care of the cancer center.   The paper process for providing care was so unbelievably cumbersome, that the simplest of tasks took days, even with the detailed background information we given the hospital.   The time delay between visits from the appropriate physicians, ordering the correct medications, requisitioning the orders from the hospital pharmacy, and getting the medication to my father, caused a major disruption in his daily pain management schedule.  This delay ultimately resulted in the recurrence of that intense bone pain while waiting for the medication schedule to be re-established.

The next hospitalization we had his medication list and were ready to advocate for him as soon as we stepped in the door.   Advocacy was unnecessary as he had been admitted to the inpatient unit of the cancer center.   The EHR contained not only all the information from my homemade “Emergency Fact Sheet”, but it contained the actual orders for the medication that could easily be transmitted to the in-house pharmacy.   Dad didn’t miss a dose of his pain medication on that trip.    I saw beauty in the simple efficiencies that resulted in excellent patient care and comfort.

Everyday there are news stories on the politics and profitability of electronic health records, but it is less often you hear this story being told.   My loved one received better care, and because of that, suffered one less day of pain.   Somewhere, someone’s father is receiving better care, because an EHR generated a reminder to perform a prostate screening blood test, which resulted in the early detection and treatment of his Prostate Cancer.  Sometimes the Return on Investment is not about finances, sometimes it is about life.

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