How a doctor handles a wife’s cancer diagnosis

At his blog “Life as a Healthcare CIO,” Harvard Medical School chief information officer John Halamka has started writing a series on an unfamiliar health care challenge he now faces: His wife Kathy’s recent breast cancer diagnosis.

“One in 8 women will develop breast cancer in their lifetime,” Halamka wrote last month. “We never thought we’d be the one.”

After spending much of his career advocating for electronic medical records, many of the posts deal with how electronic coordination affects care for a complex disease:

All of her providers share data among themselves and with Kathy. Here’s a view of Kathy’s electronic profile, showing her problem list, medication list, allergies, appointments, labs, and social history (yes, we’ve been together 33 years from age 17 to age 50). She’s given full consent to share this data publicly as it illustrates the importance of an electronic health record for care coordination.

She can view the same data via her personal health record. The only difference is a few delayed staging results to ensure patients and doctors speak about cancer diagnoses before the data appears on the web.

All of Kathy’s chemotherapy orders were written electronically via the BIDMC Oncology Management System. Humans do not dose chemotherapy, computers calculate everything based on protocols that humans maintain based on clinical trial evidence. In Kathy’s case, the oncologists designed and made the clinical decision to place her on the “Breast Oncology - CA - Dose Dense” care path.

The computer wrote these orders for her based on her height, weight, age, kidney function, and allergies.

Electronic medical records aren’t actually the norm in medicine right now. A 2011 study in the American Journal of Managed Care found that just 15 percent of hospitals have implemented a basic electronic medical record.