Flint, Michigan: Kudos to the EHR
The news coming out of Flint, Michigan, that the city's decision to switch to a cheaper water source caused a lead poisoning crisis, is tragic. But there appears to be a slight glimmer of good news, and it's coming from a rather stodgy, unlikely hero: the electronic health record of the local hospital.
Flint's Hurley Medical Center is crediting its EHR system for helping it detect the increase of unsafe lead levels in area children after the city changed its water supply. Pediatrician Mona Hanna-Attisha decided to review the medical records of the children whose blood had been tested at the hospital after hearing reports this past fall that Flint's water contained more lead after it began pulling its water from the Flint River.
Hanna-Attisha compared blood test results for the 736 Flint children under 5 years old whose tests were performed at Hurley from January through September 2013 with test results for 737 children tested in the same time period in 2015. She found the percentage of children with elevated lead levels in their blood increased from 2.4 percent to 4.9 percent; in parts of the city with the highest lead levels, the percentage increased from 4 percent to 10.6 percent.
This is a great example of how EHRs can provide real practical benefit. Sure, we know that the systems crunch numbers for research and can help flag patient issues--and Hurley will use its EHR to issue alerts in the affected children's records and monitor their health.
But here, a relatively modest review of patient data in the system revealed, in no uncertain terms, that Flint had a medical crisis on its hands. And it sounds like it was easier and quicker than combing through paper records for any elevated lead levels.
Consider the implications of this news: This quick study of one hospital's own records may have stemmed the crisis and prevented the lead poisoning of hundreds more children. Talk about making the best out of a bad situation.
Also worth consideration are the implications on population health. This kind of review may be expanded to other cities, other medical problems. This will be truly wonderful when data sharing really takes off.
Of course, EHRs are not perfect. Some of their problems originate from reactive design not necessarily geared to unanticipated medical crises or pandemics; we learned that from the Ebola outbreak. But we certainly now can anticipate that a change in water supply could affect lead levels. And we've been alerted to the Zika virus pandemic.
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