Recently, I wrote an article
about the cost benefits (or lack thereof) of Electronic Health Records (EHR) during the past few years in the US. While it is clear now that the promised savings for healthcare providers, patients, and the administration are fuzzy at best, the savings from EHR on medical research and drug testing are much clearer.
The UK has taken a leadership role in this area. Recently,
they opened four eHealth Centers focusing on conditions such as cancer, diabetes,
obesity, and cardiovascular disease. The centers share anonymized patient information with research firms and drug companies, saving millions in costs and years in time in medical trials, and helping identify potential treatment problems because of incompatible drugs.
Drug incompatibility is one of the areas where EHR has proven to be extremely helpful. It is impossible for a pharmaceutical company to identify potential side effects of combining a particular drug with the millions of other medications on the market. They usually test their products with other drugs prescribed to patients with the same condition, but they can't trust all drugs used to treat unrelated conditions, and some combinations can be dangerous taken together. Even without dangerous side effects, some drug interactions cancel the positive effect of one or both drugs.
With access to the records of thousands of patients taking different drug combinations, researchers can identify some side effects, such as rising blood-sugar levels, in some patients and check if there is a correlation with those patients taking another medication. The same can be applied to the effect of a particular drug in groups of patients of certain race or age.
"That's a remarkably rare opportunity to look at a
population that has many other health issues going on," said Elizabeth A. McGlynn, director of the Kaiser Permanente Center for Effectiveness and Safety Research. "The sheer volume and the richness of the data will enable us to have insights that are beyond anything we could have had any other way."
There are some obstacles though. Electronic records need to be "de-indentified" before they can be used for research. But also researchers, in order to make the best use of the information in databases, need to be able to tell when they are looking at the same patient, which in the case of the US, may be stored in several databases.
We can't just dump large amounts of "anonymized" raw data in the hands of drug companies and insurers. Precisely because there are now so many different public datasets to cross-reference, anyone making an effort has a good chance of matching identifiable individuals. This information can be a gold mine for insurance companies, but not in the best interest of patients. New HIPAA rules also allow patients paying cash for some treatments to stop healthcare providers from sharing information with their insurers. That's why some countries are creating specialized government datacenters to collect and process all EHR before they can be shared.
These problems can be overcome. I believe healthcare industry CIOs, from drug companies to hospitals and insurers, need to start looking for ways to tap into this new source of savings for research, especially in light of other difficulties in making EHR cost effective. Biotech companies could speed up bringing new drugs and treatments. Then EHR can be really profitable.