The Use of Smart Card Technology in Health Care

Background

At present, the lack of a wholly integrated health information system leads to redundancy for the patient and a struggle for providers to coordinate care and control costs. Patients become frustrated to repeat complex sets of information and health history to multiple providers, such as emergency personnel, hospital admission staff, and primary care doctors, often within one episode of care. Patients and providers may lose faith in the medical system. Information that patients convey may not be properly captured. Providers should document the data correctly once and share among providers to assist in patient compliance with prescribed care, while better managing costs of care. Several agencies advocate for health IT to help health care workers communicate more effectively in care coordination for patient safety, better efficiency, and cost reduction in the U.S. and the world (National Quality Forum, 2011; IOM, 2011).

Health IT also extends geographic access to low- and middle-income countries around the world where there are critical shortages of health care providers (Lewis et al., 2012). To control costs while maintaining quality, healthcare has adapted systems improvement initiatives, such as PDCA (Plan, Do, Check, Act) cycles, TQM (Total Quality Management) methods, and Six Sigma and Lean Systems. Breakthrough technological advances such as Electronic Health Records (EHR) and Electronic Medical Records (EMR) are increasingly used to boost the capacity and assure sustainability of healthcare systems particularly with regards to the vast amount of patient data needed to manage care and control costs.

In the U.S., the increase in EHR adoptions arose from pressure exerted by the Obama Administration who offered $2.5 billion in incentives to increase the use of these systems (U.S. Department of Health & Human Services, 2010). As a result, the number of office-based physicians applying for EHR certification through the Office of the National Coordinator (ONC) for Health Information Technology grew to over 100,000 nationwide (ONC, 2012). A National Ambulatory Medical Care Survey (NAMCS) of physicians found that 57% nationally use some type of EHR/EMR system (Hsiao et al., 2011). Hence, the expanding use of EHR and EMR systems may still not completely satisfy patient and provider needs.

While EHR is supposedly capable of interoperability between organizations, EMR does not communicate with other EHRs or EMRs (Garrett & Seidman, 2011). In 2012, EHR and EMR adoptions markedly increase redundant manual data entry needs. The inability to consistently share accurate data remains a substantial barrier to realization of return on investment for EMR and EHR adopters. Some systems may deliver unmodified content to the patient, who may not understand the terminology. Instead, smart card technology, cloud-based Internet access, self-service kiosks and data readers would provide the patient a human-factors approach to explaining technical information in layman’s terms. Patient-identified ‘inaccuracies’ can be systematically shared with providers to correct real or perceived gaps in data and improve patient compliance with effective therapies, providing a natural bridge to shared decision making (Heisler et al., 2009; Stacey et al., 2011).