Electronic medical records were meant to empower patients, making it easier to change doctors, coordinate care among providers, and better understand their treatments. But for several years, they were little more than another frustrating technology that never seemed to work.
That’s until Seema Verma came along, championing interoperability for medical records.
It’s not often that a federal bureaucrat has both the opportunity and the understanding to make changes that affect people in real-time. As the administrator of the Centers for Medicare & Medicaid Services, Verma was able to implement meaningful procedures and practices that have helped millions of Americans take control of their personal medical histories.
Verma’s push for progress came about thanks to a rare combination of professional expertise and personal experience.
Living a Tragedy
When Verma talks about how EMRs can save lives and affect health care choices at critical moments for American families, she speaks from firsthand experience. In 2017, her husband, Sanjay Mishra, collapsed while away from his hometown hospital and primary care provider. In the whirlwind of emergency treatment that followed, Verma saw — in stark detail — how EMRs worked in practice. Or, more accurately, how they didn’t work.
Not only did the team tending to her husband lack the ability to pull up any information about his medications, past conditions, and treatments, but the family also left the hospital with virtually no more information about his health. After days full of tests and treatments, the records they took home amounted to little more than a bill of service.
Recounting the story in an opinion piece in The Philadelphia Inquirer, Verma explained that she had requested her husband’s medical records shortly before he was discharged. “We would soon be returning to our doctor in Indiana, and I knew that every element of his treatment — test results, information from hospital equipment, drugs administered — could be used to inform his treatment going forward,” she wrote. “They handed me five sheets of paper and a CD-ROM containing information about just one of the procedures he underwent. I was floored. Where was all the information they had been collecting?”
What had been promised to all Americans — an easy system of moving their medical records between their preferred health care providers — still felt far in the future to Verma in the summer of 2017.
During her husband’s hospital stay, Verma’s whole family searched through their phones and pulled up countless internet sites on the hunt for their EMRs, but they encountered a slew of problems. Specifically, one issue kept coming up again and again, what health care professionals call “interoperability,” or the ability of different systems to share readable information.
The problem with interoperability is a lot like working with the same software on a Mac and a PC. Sometimes, it works fine. Other times, you need an expert just to open the file. If you’ve ever been sent a picture by a family member that you couldn’t open or seen a box instead of an emoji in a text message, you’ve experienced an interoperability problem.
Interoperability may be annoying in text messages — but it can be deadly for hospitals. Many times, doctors and patients simply can’t access files from other health care providers. In those cases, EMRs are close to useless.
Seema Verma’s Case for Change
After a scary few days at the hospital, Verma resolved to change the system to help families like hers. By the time she was serving as administrator of the Centers for Medicare & Medicaid Services, the experience of nearly losing her husband had colored her approach to oversight.
To make sure she wasn’t alone, Verma toured the country on a listening tour. Talking with Medicare and Medicaid patients across the nation, she heard many stories that echoed her experience.
In 2020, she penned an op-ed in USA Today in which she acknowledged: “For many Americans, collecting and navigating their own health care records is a frustrating, time-consuming burden that leads to lower quality and higher costs.”
Luckily, Verma had a plan to fix it.
The Solution
While there’s never a one-size-fits-all approach to health care, medical records are a different story. In her capacity at CMS, Verma implemented transformative efforts that reformed how American providers and patients interacted with EMRs.
Under her watch, all health plans that did business with Medicare and Medicaid were required to create EMRs that were more accessible to patients. This meant allowing patients to use cutting-edge internet technology or download simple apps to their smartphones that could securely collect and contain their health care histories.
Verma wanted to do away with the electronic excuses that kept families frustrated and unable to easily access their EMRs. Instead, health care would operate the way that the biggest technology companies did — everything would be available to everyone, no matter their phone or operating system.
“In a crisis, access to one’s own medical record can literally be the difference between life and death,” Seema Verma wrote in USA Today. “No American should struggle to access and share their own health information in life’s most vulnerable and uncertain moments.”
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