COVID-19 Will Be The Ultimate Stress Test For Electronic Health Record Systems

Eric D. Perakslis and Erich Huang | STAT | March 12, 2020

As the novel coronavirus that causes Covid-19 continues its march around the world and through the United States, it is spawning another kind of infection: Covid-19 cyber threats aimed at individuals and health systems. We aren't crying wolf here. Disaster planning experts know all too well that preexisting weaknesses become worse during crises. The WannaCry cyber attack that devastated the United Kingdom's National Health Service is a good example. Outdated infrastructure containing components with long-understood vulnerabilities are a hacker's paradise...The undeniable fact that electronic health record systems are designed to track and bill procedures rather than provide optimal patient care is likely to be on full display as the health system becomes increasingly saturated with Covid-19 patients.

Eric D. PerakslisBecause of the way most modern electronic health record systems are built, it can take a clinician a long time to get a clear picture of the patient in front of him or her. That's because a patient's electronic health record is split into many tabs. Some information is under the problem list, some under medications, some under imaging, and so on. The essential timeline of health data is lost. This may mask underlying vulnerabilities because it is difficult to reassemble a patient's data into a cohesive narrative, causing an incorrect view of the patient's risk for Covid-19.

This offers an opportunity to consider two issues. One is the lack of a cohesive data model for patients in most electronic health records - an intuitively patient-centric construct that allows clinicians to start with a patient and trace back to their signs, symptoms, and diagnostic tests. The other is whether tightly focused health apps represent an opportunity to streamline patient evaluation, triage, and other essential functions that may be too burdensome within current EHR workflows. Fit-for-purpose health apps may also assist with interoperability, another well-known weakness within our health information technology infrastructure...