Medical data management has come a long way from simply storing files on a shelf or hard drive. Large-scale data repositories are now being leveraged in many different healthcare specialties to gain insights into disease management, patient outcomes and quality of care.
Health Catalyst calls healthcare in the United States "too expensive and inefficient, with undesirable variation in quality," but points to data as a solution. Measuring, managing and monetizing data from electronic health records (EHR) can yield information not only about patient health, but also about the health of a medical practice.
Fertility and Sterility stresses the importance of collecting consistent data across patients. By collecting the same data on each patient, and noting things like missed appointments or noncompliance with medications, infertility clinics may be able to leverage their own data to see reasons for differences in their patients' outcomes. Additionally, by sharing data with organizations like the Society of Assisted Reproductive Technology, practices contribute to a larger mission of improving fertility treatments for all patients.
Avoiding Mismatching in IVF: EHRs and Tissue Tracking
In IVF clinics, accurate data management is crucial. Cases of gamete or embryo mismatching are heartbreaking for IVF patients and subject physicians to wide public scrutiny. While clinics are checking identity and double-witnessing procedures at crucial points in the IVF process, mistakes are still possible.
Implementing an EHR can help improve data management and reduce the frequency of mismatching errors. A report published in InVitro Fertilization estimates that only about 50 percent of IVF clinics are using an EHR; the remainder would do well to adopt a system that can hold clinical protocols, store data forms and link to secure cloud storage.
Tracing failures are also being addressed with tracking methods that ensure proper handling and processing of biologic tissues. At least two methods of tracing tissues are emerging that go beyond simply labeling containers and noting placement on shelves.
RFID (radio-frequency identification) technology uses radio frequencies and sensing devices to physically track tagged objects. For instance, in a laboratory, the RFID sensor would sound an alarm if samples from two different patients were introduced to a work area at the same time. Barcode tagging involves tagging the samples themselves with polysilicon barcodes that are read under a microscope. While both methods improve tracking, neither removes the need for human double-witnessing. Additionally, it is not yet known whether RFID and barcoding introduce any kind of risks to gametes and embryos.
Any tracking system requires sufficient storage and backup to safeguard data once it is collected. These systems need to be secure and private, as well as long-lived; a handful of babies have been born from embryos that had been frozen for nearly 20 years.
Patient Satisfaction with Tracking Systems
Because of high-profile mismatching cases, patients seeking IVF may worry about their tissues being swapped with those from another patient. One study published in the Journal of Assisted Reproduction and Genetics evaluated the use of an electronic witness system (EWS) in 408 patients. Patients were interviewed at different points along the study to measure their concern about mismatches and their satisfaction with the EWS. Halfway through the study, there was a high-profile embryo mix-up. The study found that while patient concerns rose during this incident's publicity, their satisfaction with the EWS rose more than their concerns.
IVF is far from a perfect process, but when it's performed, clinicians should make every effort to ensure that medical data management mistakes are avoided. Reproductive clinicians should make the most of their ability to track and harness patient data to improve outcomes and reduce missteps during IVF.
