EHRs at the Olympics: Boon, bane or both?
I am both excited and wary about the news that the health data for the entire 2016 Olympic Games in Rio de Janeiro will be managed electronically.
The International Olympic Committee (IOC) has selected GE Healthcare's Centricity Practice Solution to handle the health services of not only all of the athletes, but also their families, coaches, the officials and even spectators. The fully connected system is being specifically customized for the project, and will be available in both English and Portuguese. It will be used not only to handle the illnesses and injuries of individuals, but also to study population health related to athletes, such as the prevalence of certain injuries in particular sports and possibly ways to reduce or prevent them. The data will additionally provide the IOC with insight for future games planning.
"The Olympic Games is about providing the best possible service to athletes," said Richard Budgett, medical and scientific director for the IOC said in GE's announcement. ... The EMR is going to be a cornerstone for our medical services going forward."
EHRs have been used before at the Olympics for monitoring and patient treatment. Moreover, GE is no stranger to the Olympics; its EHR has been used by the U.S. Olympic Committee for several years, at both the London and the Sochi games. It appears that the IOC was impressed with the Americans' experience with EHRs at the games and opted to follow a similar path for everyone.
Although the announcement doesn't address it, I see tremendous potential in this development. Granted, it will cover a specialized group of people with admittedly unique needs that isn't necessarily representative of the population at large. But it's one of the first, if not the first, foray into a global health system involving almost every nation. Providers from all over the world will be using the same system.
Just think of the possibilities. The World Health Organization could have information from multiple nations at once. Clinical decision support could be globally oriented, not American-centric--and may better anticipate global health issues, like disease outbreaks. Systems could be in multiple languages. Research could be at a completely different scale than what we've seen before. And it's a real opportunity to standardize EHRs on a worldwide basis.
However, GE--and the IOC--need to tread carefully. I can also envision road bumps, big and small with this move.
For instance, if the EHR is in two languages, what happens if a note is inputted in a language that the next provider accessing the record doesn't speak? How does it get translated?
GE also acknowledges that the non-American providers may not be used to the system. What kind of training will be provided? And will those providers suffer through some of the same learning curve problems that providers tend to have on a new system? Some of them may not have ever used an EHR before.
Then, there are patient care issues. How will a patient's records be reconciled with his or her records elsewhere? Will the records include data not related to the games, and if that's to be accomplished by health information exchanges or other interoperability, how will that work?
And perhaps most disconcerting: With all of these people on the system, how will the data be kept secure? Hacking and other cybercrime is at an all-time high. Will GE's system comply with international security and privacy standards? And won't it be particularly susceptible--and enticing--to cyberthieves who might want to steal the data for pecuniary gain, game the games by compromising the records of certain athletes or simply disrupt the games for the fun of it.
Or who want to hijack the data by installing ransomware.
The 2016 Olympics are already struggling: sewage in water venues, construction delays, budget woes and several mosquito-borne viruses, of which Zika is merely the most recent.
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