The New York Times recently published a succinct but meaty article on New York City’s new electronic health record system. Planned and promoted by the Bloomberg administration, the system includes about 1000 primary care physicians, focused primarily on three of the poorest neighborhoods, and the data they generate about their patients. As I read it, I found myself counting all the different functions of the system. I found at least ten:
• Clean up outdated filing systems;
• Enable a doctor to compare how one patient is doing compared with his or her other patients;
• Enable a doctor to compare how one patient is doing compared to patients all over the city;
• Enable the city’s public health department to monitor disease frequency and outbreaks, like the flu;
• Enable the city to promote preventative measures, like cancer screening in new ways;
• Create new financial incentives for doctors to improve their patients’ health, on measures like controlling blood pressure or cholesterol;
• Provide reports cards to doctors comparing their results with other doctors’;
• Improve care by less-experienced doctors with advice and information based on a patient’s age, sex, ethnic background, and medical history, including prompts to provide routine tests and vaccinations and warnings on how drugs can potentially interact;
• Allow doctors to follow up more closely with patients, like reminding them of appointments through new calling and text-messaging systems and being notified if their patients do not fill prescriptions; and
• Allow patients to access their own records, make appointments electronically, and monitor their own progress on health targets (should the doctor decide to do so);
Pretty amazing, isn’t it?
Data is like that. Once you collect it, the possibilities are endless. Reading about this one system for health records made me realize why it’s so hard for me to describe CDP’s goals in one sentence. We’re not trying to do something singular, like “enable a doctor to compare patients’ data.” We’re trying to create a place where this function, and innumerable other possibilities can exist, while also being mindful that “endless possibilities” include some scary ones that we need to guard against.