Mining Electronic Records for Revealing Health Data

Description: Over the past decade, nudged by new federal regulations, hospitals and medical offices around the country have been converting scribbled doctors’ notes to electronic records. Although the chief goal has been to improve efficiency and cut costs, a disappointing report published last week by the RAND Corp. found that electronic health records actually may be raising the nation’s medical bills.

Source: www.nytimes.com

Date: Jan 14, 2013

Electronic-Medical-Records-Software

“Medical discoveries have always been based on hunches,” said Dr. Russ B. Altman, a physician and professor of bioengineering and genetics at Stanford. “Unfortunately, we have been missing discoveries all along because we didn’t have the ability to see if a hunch has statistical merit. This infrastructure makes it possible to follow up those hunches.”

The use of electronic records also may help scientists avoid sidestep the rising costs of medical research. “In the past, you had to set up incredibly expensive and time-consuming clinical trials to test a hypothesis,” said Nicholas Tatonetti, assistant professor of biomedical informatics at Columbia. “Now we can look at data already collected in electronic medical records and begin to tease out information.”

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 Questions for discussion:

1. What are the benefits of digitizing medical records as a country?

2.  Who should own the data and have access to the data contained in these records?

3.  This medical information has a value, who should get the monetary value that this data contains?

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23 thoughts on “Mining Electronic Records for Revealing Health Data

  1. Richelle Merrick

    This article highlights many benefits of digital health records. The most obvious would be that it makes medical research much more accessible. It also reduces the cost of medical research and provides concrete evidence from real people in an uncontrolled setting.
    As the artice states this really is a gold mine for medical research. By adding every patients medical records to an electronic record it could potentially save a life. Generally if a patient has a health concern there is a medication to help, these medications are supposed to promote good health. Some medications however can have serious side affects especially if mixed with the wrong things. With this database they are able to reduce that risk and see exactly what those risks are and how to avoid them. That alone is reason enough for me to put my medical records out there. Some people will argue that it goes against patient privacy. Steps have been taken to protect individuals privacy which in my oppinion should be optional. I am glad some academic medical centers and health organizations are de-identifying patient records. I would be glad to sign a waiver releasing my medical records to the medical database if it helps solve seriouse health concerns.
    Not only does it make data mining more efficient but it reduces costs of medical research. Instead spending large amounts of money testing out hunches, it is possible to find statistical merit and then proceed. It reduces risk or pointless research. It is as if there is a file of data ready for them to test versus starting from scratch.
    Although I promote this idea and believe it has enormous value I think data this significant should be used appropriately. Data this personal should not be sold to research companies trying to make a buck. If I were to give me consent to use my data I do not want it being sold off to the highest bidder. This data should only be accessible to research teams that are trying to use it to benefit the population as a whole. Such as the population that is not tested in controlled clinical trials because of risk.

    Reply
  2. Jarett French

    There are huge advantages to digitizing the medical data of the country. First of all is the fact that massive amounts of research could be done on the potential information contained in a digital health records. Once the health records are de-identified the privacy of the individual is kept safe and the information can then be used for the common good. Next there are huge advantages available for doctors and patients. For example, if you were out of your home town and had a medical issue that needed attention, the clinic you went to could open your digital file and have your complete medical records available to aid in there diagnosis of your issue. This makes the doctor’s job more accurate in his efforts to help you, and in turn you receive better treatment.
    The data should be owned by the person for whom they are a record for. The system would be managed and operated under the government since the government operates the health care system currently. Your information would be private on this national database, and would be released to clinics in which a patient is receiving medical care upon the patients consent. The person would also need to give consent before medical records were released for research purposes.
    The monetary value of the data would go to the government to help fund the upkeep and security of the system.

    Reply
  3. Lauren Gallimore

    There are many advantages to a uniform country wide database of digital medical records. For example, the ability to access a person’s medical record at any clinic or hospital in the country would be useful if a person moves or travels. This allows doctors quick access to their information in the case of sickness or injury. Although a paperless medical system will be expensive to set up, it would cut down on paper waste and make it easier to locate a person’s file. Having online records also allows for faster communication between doctors to coordinate patient treatments and access test results faster.

    Although having a central database of information can provide useful information to researchers, it cannot take the place of detailed clinical trials and lab research. The information within the database could act as a supplement and highlight unusual patterns for researchers to study. The data sold to researchers would then offer the healthcare system funds to be reinvested into research grants.

    As long as the identities of the patients are not released to researchers buying the information and there are adequate safeguards to protect against hackers, a digital healthcare system could offer many benefits and opportunities for medical research.

    Reply
  4. Sheri Durina

    There are many benefits to digitizing medical records. First, the physical benefits of eliminating the enormous inventory of paper files would result in cost and environmental benefits. Archiving procedures for this type of information can be a very costly and time-consuming process. Transferring this information to an electronic record would eliminate or at least reduce this issue. Electronic records can be set up for automatic archiving which may be much more efficient.

    This article mentions one of the downfalls of electronic records in regards to “de-identification” of records. This can lead to input of medical information into multiple databases for one individual. This can be an issue; however, this can also be an issue for paper files. Often when paper files are kept, an individual may have multiple paper files located in multiple locations. If these files get filed into a file bay there may be no actual record that this information even exists. If this information is input into an electronic database the information is less difficult to locate than if it is filed away in a dusty old file bay.

    The ease in which the electronic information can be accessed in regards to research would be especially beneficial. As there would be fewer clinical trials costs would be decreased, which would allow for more time for the actual research to take place. The elimination or decrease of clinical trials and face-to-face research may also have its downfalls. Obtaining information purely through an electronic database may not offer researchers the entire picture. There may be other factors affecting the outcomes. Planned clinical trials are carefully monitored. If there are outside factors affecting the outcomes the researchers will be well aware of these factors. By obtaining the information electronically these outside factors would likely not be known to the researcher and may and may not offer accurate data.

    Reply
  5. Callie Matz

    I think the benefits of digitizing medical records as a country are that it allows doctors to access a patients complete medical history so they can find patterns in their history that may lead to different conclusions for diagnosis. Since all the previous records for a patient are kept it could allow for other doctors to look at the history and offer a second opinion. Allowing records to follow a patient wherever they go means that as a patient moves around the country they won’t be lost in the system. It could also allow for better communication to the patient. When a patient is tested at a lab, as soon as the results are determined a letter could be instantly mailed to the patient and the doctor. This way patients will know that forms haven’t been lost and they can be certain of the results instead of just assuming that everything is “okay” if the doctor doesn’t contact you.
    I believe that only the patient or guardian of the patient should have access to the information. It should be their responsibility to decide if they want the information to be used in research or if they want a doctor reading up on their last visit. It is their history and their information and they should be solely responsible for its distribution.
    I think that the research companies that patients are authorizing to use their records should be making a profit on this information. I think in the end as a society we will all benefit from greater information on diagnosing and prescribing medication. If the researchers can find solutions for less money, hopefully that will mean they will reduce the price of prescription drugs and in the end save money for consumers and patients.

    Reply
  6. Jacqueline Wegener

    There are huge benefits of digitizing medical records as a country and I think these include the ability to achieve great advancements in the medical field, having patients files stored in an database that can be stored in many different locations so if the files at a primary location were lost they would be able to retrieve them from an offsite location. Patient diagnosis would also potentially increase with the digitizing of medical records and what combinations of drugs may cause certain side effects and therefore reduce the chance of a patient experiencing side effects from prescription drugs. There would have to be a great deal of communication to decrease the amount of redundancy so that when researchers are going through unidentified files they will not have duplicate files. I think that they data should be owned by the government (provincial and federal). Access should then be granted to authorized research firms who would be using the records for legitimate purposes and would only be allowed to have files that have no patient identification. Any monetary value that these records contain should go directly back to the federal or provincial government who would then reinvest the money into the medical field. This money could be put towards new technologies in the hospital.

    Reply
  7. Josh Bodnaruk

    The biggest benefit to digitizing data in my opinion is the pure raw computing data you have for running statistical tests. With every patient in the country in a database, doctors could instantly run analysis on statistically significant variables, such as the health effects of living within the radius of X company’s factory. This makes isolating causes much easier for group illness, as well as being able to pinpoint affected area. Another potential benefit is the ability to receive treatment from a doctor when you are across the country, he simply needs to pull of your file and he has all relevant information he needs.
    While the benefits are enormous, so is the potential invasion of privacy. Medical records contain nearly unlimited amounts of information on individual persons, such as allergies, mental illnesses, and previous physical issues. That being said, I think that if such a system were developed, it would almost certainly need to be run by some sort of collection of doctor practices. This way, the only people with access to the relevant information are the people who need it, not insurance companies or crime databases.
    If the information is given anonymously, the information should go to the highest bidder. As long as the identities of the persons aren’t compromised, private companies and governments alike should use the information to further better themselves, whether it’s a great new medical breakthrough, or government policy on a certain epidemic.

    Reply
  8. Josh N

    Since taking this class, I have already begun seeing the numerous and diverse applications of information systems, and how expansive this technology is. The collection and compilation of digitized medical information is an application of information technology that I had never before thought about, but it seems to make great sense. The compiling of these records could, as the article states, lead to great advancements in the health-care field, but vast coordination and inter-communication is required to make the process of research and retrieval an efficient and effective one. This seems to be the largest obstacle for the various information collecting agencies and bodies to overcome.

    As the article’s introduction has stated, the process being undergone as initiated by government legislation (or force) has had the effect of increasing medical costs rather than lowering them. Although there are many important factors to consider, such as privacy and distribution, I would argue that the immense task of such coordination and system development must be carried out by private and innovative firms willing to apply logistical expertise and work under the motivation of profit. Just from my own experience and observations, private firms such as FedEx or Amazon, working with a profit motive, are the best suited to take on and solve tough problems such as this – much more so than government bureaucracies. Competition, as coupled with cooperation, has the potential to bring about amazing things – I believe the field of medical research and development is no different.

    Reply
  9. yuxuan.hou

    Based on all of the information I have get from this interesting article, I know the importance of the information system for every country. There is no doubt that the information system plays an important role in the modern society. It could accelerate the development of our society through helps increase the productivity of the other trades. For example, in the digitalizing medical trade, information system could provide lots of information to the digitalizing medical trade. So the digitalizing medical can record much databases. There are two kinds of important advantages for digitalizing medical with the help of information system. The first one is digitalizing medical with lots of databases can reduce its time and resources cost. The digitalizing medical workers can research their customers’ information quickly and easily. They can get a good communication with their customers. It is good for their work. The other advantage is there are lots of information be saved in the certain place, digitalizing medical workers can use these clearly records. It is possible for digitalizing medical workers get a huge breakthrough in medical technology trade with the help of these records information. However, each coin has its two sides, privacy and cost are important issues for information system.

    Reply
  10. Tanner Speager

    The benefits of digitizing medical records are quite obvious. It would greatly enhance medical research, patient diagnosis, and scientific research. Pharmaceutical research facilities would be able to see reactions of different combinations of drugs, which would allow them to have an idea of how different chemicals would react when testing new drugs. Patient diagnosis would vastly increase as well. If a patient were to take Paxil and Pravastatin, but also had diabetes, with access to a database such as the one described in the article, the medical practitioner would know that the combination raises blood sugar, or at least have a way to find it out very quickly. It would be necessary to de-identify the records, which could produce some redundancy problems; however, the vast majority of statistical information would most likely be accurate. The initial data, because this article is based in the United States, would belong to the hospital or clinic. Once the data is de-identified, the hospital could sell it research facilities, universities, statisticians, or anyone who has interest in obtaining it. In Canada, however, since the hospitals are owned provincially, the data would become property of the government. This would mean that any initial monetary profits would go to American hospitals or the provincial government. This would create a secondary positive impact, because those medical institutions would have higher funding for equipment or medical professionals. Overall, humanity only benefits from sharing any scientific knowledge.

    Reply
  11. Ryan Orr

    As a country moves towards digitizing medical records it presents a massive opportunity for researchers to sort the data in search of links or similarities. As it is said in the article “Medical discoveries have always been based on hunches”, having this mass of data will allow these hunches to be pursued quickly and effectively. I believe the data should be accessible to anyone who desires it; however the data would have to be de-identified first. The monetary side of the data base should be shared between the initial input companies, right on through to the researchers who will be solving medical cases.

    Reply
  12. Kristian Rochon

    The benefits that come from digitizing medical records may in the long run, far outweigh the cost. More to this point, by digitalizing medical records this will allow hospitals not only domestically, but internationally pull up records that may be crucial and lifesaving for a foreign patient. With rapid globalization, and the emergence of countries such as India, Brazil, and China, doctors know in Canada and the US have the opportunity to work/collaborate with the best minds in the field. As quoted in the article “Medical discoveries have always been based on hunches”, by providing digital records of doctor’s notes, even if they are just ‘scribbles’, collaboration and extensive databases between MD’s can initiate major medical breakthroughs. With rare cases, doctors and hospitals databases may not have the reach nor the money to conduct plausible alternatives or tests for the patient, with a electronic database this will allow for hospitals to perhaps communicate with hospitals across the globe to find the safest, most cost efficient, effective alternative for the patient. As far as who owns the data, doctors will still have to adhere to client/patient confidentiality. If agreed to release, the ownership should then fall on the doctor or doctors that published the material. All in all, with an ever increasing IS sector, in all lines of business it would make fiscal and monetary sense in the long run for hospitals to digitalize.

    Reply
  13. Crystal Smallface

    I think the benefits would far outweigh the costs in the long-run. Being able to retrieve and send data at the click of a button will give patients better service. This can be extremely important especially in those circumstances when time is critical and the patient may be in a life or death situation. It will also give those in the medical profession greater flexibility to do their jobs and to help advance medical techniques along with the increasing innovation of technology. These records should contain everything that is already in the patients file but would have to be guarded well to prevent hackers from obtaining confidential information. The medical records should be owned by the government but give the hospitals, clinics, or medical professionals, who the records originated with, free access. This will give the country a digitized medical system that will benefit everyone. Any monetary gains should revert back to the patients through some kind of concession, since the profits came from their pockets. Maybe a reduction in fees, better service delivery, increase in health programs, etc. . In the short-run expenses will be high because of the task to put the records in a database, but once the program starts operating efficiently and everyone participates the expenses should decrease. Overall a digitized medical record system will help everyone involved in some way or another.

    Reply
  14. Colin

    There are several benefits to digitizing medical records as a country. As human beings begin to live longer with advances in medicine this creates a great strain on the health care system. In Canada for example which is a public health care system any uses of technology that can reduce costs while at the same time maximizing efficiency, would benefit the entire population. Doctors can instantly call up the medical history of any given patient where as before paper copies would have to be sorted through for the same information. Saving time in this manner can ease the wait times for patients. Also with such a large amount of information from several patients cross referencing data on specific diseases may lead to new discoveries and treatments. Information is power and the more access doctors have to pertinent information, the faster medical advances will be achieved. While there are questions of ethics about who has access to this information, and who might potentially profit from this information; the reality is that the possible benefits of digitized medical records far out weigh the draw backs. If it leads to better health care, and less costly health care technology should be considered truly beneficial to the population as a whole.

    Reply
  15. Yionna Wesley

    Digitizing medical records would be quite beneficial for the medical research industry as a whole. It would be less costly and less time consuming for the researcher to access readily information on medical patient files. Another benefit is when a patient comes into the hospital unconscious and the triage team cannot communicate with the patient but knows their identification. The medical staff would be able to bring up their recorded history; find out allergies, current pharmaceutical prescription, and other life threatening problems the current unconscious patient cannot tell them. Finally, being a person that travels from province to province, it would be beneficial for me as a patient for my medical examiners to have access to my whole history with one touch of a button, instead of wasting my doctor’s time trying to explain my medical history to them. The problem I see with this country, Canada, is our health care system is administered provincially with different health care practices. Working for the Ministry of Health in Quebec, the records are in French; users have to be able to read French. Ownership of the medical records from a nationwide view, I would have to say belong to the patients. The medical industry should only hold those records in a central location, until needed. Moving forward from hard copies to e-records. Access to patient e-files for a medical research projects should be approval from the patient. They should sign a release form and give permission for the health care system to allow researchers to use their medical data to help promote the health industry. There should be national access administrator, who granted different levels of access through a medical archivist board. The medical archivist board would include chapters like: rules and regulation, ethical standards of practice, annual user fees for access, a national list of licensed users (doctors, nurses, social workers, medical archivist, etc), and a grievance chapter. Setting up an administrative body to up-hold these national standards does cost a lot and even more to maintain the files. Also, there are security issues and keep up-dated software and hardware is expensive. There should be a standard access fee to generate research data for the knowledge seekers and those fees should go towards the administrative body.

    Reply
  16. Mohadese

    At first doctors and health researches need to establish specific goals for electronic health records. The electronic health records may be raising the nation’s medical bills, but simultaneously reduces the cost of research.
    I think installing any new installing system has advantages and disadvantages. Also, some people would agree with new system and some criticize it. I think for any new system we need to consider its goal. Regarding the articles the electronic health records has many advantages for ongoing clinical trial. If we think the advantages are good enough, then we can think of disadvantages and how we can improve them. For instance, if the electronic health records are databases for both doctors and researchers then they need to use the same language to prevent any confusion and to have more accurate data for research. They need to set up a same language for research and medical record. Moreover, there are clients’ privacy issues that can be omit by de-identifiable them. So, by using the same dictionary for medical bills and data that use for the research and de-identifiable clients, we have more efficient database. Moreover, we need to consider the increasing cost for medical bills and the health research simultaneously to calculate that the new electronic health records may reduce the total cost of both.

    Reply
  17. Abraham Sarthak

    For a nation, Information Technology plays a important role in its advancement as it makes the a tedious work much simple and easier .It also has a major role to play in the medical field .Making the medical data of a patient digital has both advantages as well as disadvantages.Medical records of a patient can help a doctor in deciding the treatment he should be giving the patient , not only this he would have access to information like the number of surgeries the patient has gone through ,the drugs to which he is allergic etc .This information can also be used by researchers to identify a lot of problems such as side-effects of a drug , predominant cause for a particular disease and many more .But this also has some serious drawbacks related to it .First problem with this is the privacy of the patient , he can be suffering from a disease about which he does not want anyone to know,the information entered in the database might have some errors, which can prove fatal, also the biggest question , who has the authority to view these records ?
    According to me , these all problems can be solved easily by building a monitoring authority which maintains the Database and also has a proper DBMS which can handle this kind of information in a right manner. The monitoring authority should have full control over it and should solely decide about who can view this records.
    Well in my opinion use of Information Systems in medical field can save a patients life and can solve many medical problems that are present in the society .So even if it takes more money away ,i would say its a sensible step.

    Reply
  18. Brogan Mueller

    There are many benefits to digitalizing medical records as a country. The first, I see, is that doctors handwriting is rarely even close to legible. A pharmacists reading the prescription may have to call the clinic/hospital back, i.e, wasting time and money. Another, benefit to having all digital medical records, is computers could catch errors. If a doctor was to prescribe a new drug to a patient, but was not aware that the patient may be allergic to the drug, or have adverse side effects, the computer could catch this error (potentially). While there are valid arguments against this system, I think the benefits outweigh the negatives and medical records should be digitalized.

    Reply
  19. Ollie Sherwood

    Based on all the information that is been given within this article, there are defiantly befits to this new systems. Even with the increase in cost at the moment, within the next 5 years or so these costs will decrease as the system become more efficient. Research teams will have a dramatic amount of information at their disposal, increasing the success rate of these studies. This could enable the development of new and exciting drug sooner than would have been possible without the increase in technology. Personally i feel that every profession should develop with the time and the days of doctors notes should have been past but this is not the case right now.

    I think that the biggest issue with this new technology is who owns the rights to the data and who should be able to access the information. I feel that this type of information should only be accessed by people who need access to the information like doctors and research teams. The key issue is the security of this information. Hopefully the data base which this is held within is not only efficient but secure at the same time because if this information is leaked, it could get into the wrong hands. In terms of the monetary value of this information, that is an issue that will make or break this system due to the value of this info.

    Reply
  20. Katie Guccione

    There are several benefits to digitalizing medical records, some that may outweigh the cons of digital medical records. One benefit is that the information and data is collected and stored in one easy to find and use location, it makes it easy to look for data. By having everything together it helps other doctors who may have a similar case to find the relative data, it eliminates the use of test groups. By using these records instead of having to formulate a test group, it saves money and time that the patient may not have to cure their ailment. Although there are several negative factors that counter act these arguments, such as one doctor could use a slightly different vocabulary than the next, it still is a mutual area where data can be gathered. When doctors use these databases they should be sure to not be using these databases for a diagnosis, but instead as a reference that can help to aim them in the right direction. It still needs to be noted that everyone is different and their bodies could react differently to each disease but this database is a great starting point to help doctors get aimed in the right direction for a diagnosis.

    Reply
  21. Navreet Dhillon

    Digitalizing medical records into large databases can provide a lot of benefits only if the Database Management System (DBMS) is efficient and accurate. Data mining essentially deals with creating important relationships between itemsets in large databases. If the medical information of the patient is stored efficiently into a database, then it can contribute a great deal in creating an important statistic that might result in a medical breakthrough. This vast heap of information can be a researcher’s goldmine and facilitate their respective research by conserving time to find the necessary information. It makes sense for the doctor, researchers and other medical officials to have access to this data but privacy and confidentiality needs to be maintained. By combining the medical information of many patients, comes responsibility to keep it safe and private. Access should only be given to researchers and doctors who directly influence or benefit from the data provided. Although it does seem reasonable to keep these records anonymous so that even if they get into the wrong hands, they cannot be misused. The patients can be referred by a unique identification number which can act as primary key to the database. Monetary value associated with updating and protecting the data should be funded by the government as it facilities and encourages research, and new discoveries in the field of medicine.

    Reply
  22. ibrahim.akinola

    Based on what I’ve read from the article, it shows that information technology has it’s advantages as well as disadvantages; but in my own opinion I feel that I.T offers more advantages than disadvantages.
    The use of I.T has allowed numerous records of individuals to be stored for a very long time and these data can be retrieved by doctors or researchers to work with when carrying on medical trials, this has helped to reduce costs and has offered researchers far more data to work with and has allowed them to be able to compare their medical trials with the patients in the database, although this might lead to concerns about privacy issues. We need to look at it from a positive light and see how this will benefit the society as a whole. for example, A doctor might be on the verge of making an important drug or vaccine and without him being able to access peoples record from the database suffering from the disease he is trying to cure, how will he be able to verify his medical hunch. Although not all members of the population are found in the medical database, at least the number of records kept will be sufficient to carry out a hypothesis testing. in addition to this, I feel that I.T will be a great implementation into our society and people should give it a chance instead of turning a blind eye towards it.

    Reply
  23. Dallon Martin

    well there are definite benefits of digitizing medical records as a country, maybe we will not see those benefits right away or even in the next 5 years but i think that it will help lead to a huge breakthrough in medical technology. Researchers will have so much data that they will be able to use, and although it might be a bit expensive right now to get it started, it will save tons in the future because researchers will not have to spend extra wasted time on carrying out long studies. just waiting for information so they can do there research.

    The biggest question lies in who should own the data and have access to the data contained in these records. First of all they need to find good efficient way to make sure names are not on this data but at the same time being able to identify a person if they have been treated twice. The data also needs to be secure, i would think that the hospital it self should be in-charge of their own data and then researchers need permission to be able to use it but at the same time this way is not very efficient.

    Reply

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