The Clipboard

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In recent years the ability to network healthcare information has been advancing, which has made interconnectivity a possibility.   Clinical systems, and financial systems are more capable of exchanging information.   Medical research is advanced through the aggregation of clinical data.   In light of these advances it is interesting to step back and look at the input sources for these data. We will look at how data is interpreted and transformed into information and utilized in future articles.

Health Information can be viewed from a variety of prospective:

  • Capture – collection of data in a format that is usable
  • Data Interpretation – understanding of structured, semi-structured and unstructured data.
  • Information Life Cycle – distribute, utilize, store, reuse, destroy

We will focus first on Capture. Where does healthcare data come from? The patient is always a good place to start. Patients provide:

  • Personal information
  • Medical historynurse
  • Payer information
  • Referring physician information
  • Pharmacy information
  • Legal / Privacy consent
  • Patient / customer feedback

The patient is asked to provide much of these data at the time of admission or first visit. Sometimes updates are necessary and in the worst case patients are asked for the same information every visit.   Up until recently a patient would most likely be given “the clipboard”. On the clipboard there would be forms: demographics, insurance information, patient medical self-assessment, current medications, and legal documentation (release/ consent forms.) Once complete these documents were very possibly scanned and electronic files established. Most likely forms would be retained in paper format as well.

The burden of “the clipboard was placed squarely on the patients shoulders and was not a patient friendly activity. “The clipboard” had inherent problems as well. Handwriting was not always legible and accuracy of machine interpretation of these forms could be low.   Here are possible paths to a solution:

  1. Hand the patient a tablet, then all information will be in an electronic format. While some patients would prefer this method many would not. Some would not be able to successfully navigate the tablet. Information would have to be typed on a “soft” keyboard (QWERTY?), which can be difficult. The tablets are also difficult to secure in the office. Although advances will be made and demographics will shift, there has not been widespread success with collecting information on tablets in the physician’s offices and in admissions.
  1. Automate the information capture process. Information on sources like driver’s licenses, government medical cards and insurance cards can be scanned and automatically extracted.   The information Drivers Licensecontained on cards that patients carry can provide a wealth of data. The patient is not burdened with transferring information to a paper form, accuracy improves and properly integrated, the information accessed can extend beyond what is written on the card itself.   This could help with demographic and payer information.   To collect effective medical history look to a form design that will be easily readable.
  1. The best solution is to not have to ask for the patient to fill out “the clipboard” at all.     In this scenario “the clipboard” information already exists. When a patient presents themselves they could be asked to produce a driver’s license/ government ID and government medical / insurance card. This would provide identification and the “key” to integrated medical information that was acquired in previous visits. Integrated pharmacy records could be retrieved assessing doctor’s orders against pharmacy dispensation records to assess compliance. Release, consent and privacy forms could be reviewed. If the patient is utilizing mobile health / fitness apps, they could share those data and incorporate them into their EMR. I was in a radiology office recently where no additional patient information was requested.

Although path #3 would be the ultimate goal, currently path #2 is the most actionable. This provides a system that takes some of the burden away from the patient and relies on capture technology to relieve the pain. If you are a healthcare IT professional or system integrator this technology exists. Capture vendors and imaging VARs have the tools to improve both the patient and staff experience, while providing a cost effective means of yielding more accurate data in the process.

Mike Spang  – Vice President, Research, HSA, Inc.

About HSA, Inc.

Since 1989, HSA, Inc. based in New York (US tel: 1+ 631.368.8393) has been specializing in electronic information (image based and electronic transaction) capture technologies. Our services include Market Analysis, Technology Planning Assistance, Product Positioning, Product Management, Client Sponsored Research and Strategic Planning Services. These products include high-speed document scanning hardware, image acquisition software, character recognition software (OCR, ICR), optical mark recognition, barcode recognition and other pattern recognition and classification tools.


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