EHR Integration

Why I Talk About the Flint Water Crisis on Go-Live Day

Nearly eight years after the passage of the HITECH Act, it is easy for IT professionals and physicians to be burnt out trying to harness the benefits of integrating software into healthcare. However, a humanizing story of those benefits can remind us all to help remain steadfast in our goal of improving healthcare through technological innovation. This particular story is inspiration to keep promoting EHR integration in practices, to use that data to search for truth, and better the patient outcome.

As of early 2017, the city of Flint, Michigan has been struggling to provide its citizens with clean, safe water for nearly three years. Although the city now admits a problem that has been scientifically supported, their claims to the contrary may have continued far longer if not for the quick thinking of local physicians and the reporting functionalities of the EHR used by the local hospital system.

Flint’s water crisis began almost immediately after the city switched the main source for the city water supply from the Detroit system to the Flint River as a cost saving measure. Residents consuming the water quickly raised concerns, mostly related to rashes after contact with the water, as well as the water’s taste, smell and appearance. At this point, an almost 18-month long battle ensued surrounding public safety as the residents raised a multitude of concerns about the water’s quality. The city admitted early on that there were high bacteria levels in the water but reported permissible levels of lead in the water, even as home tests by residents showed levels as high as 397 parts per billion. State officials and a consulting group brought in by the city stated that water quality met state and federal standards even as EPA experts voiced concerns that testers may be underreporting lead levels.

State findings may never have been disputed if not for the efforts of a group of doctors lead by Dr. Hanna-Attisha of Hurley Medical Center. While at a dinner party, Dr. Hanna-Attisha heard rumors about Flint’s lack of corrosion control on pipes carrying municipal water and sprang into action, driven by concerns of lead exposure to children. The hospital routinely ran lead screening tests on young children and Dr. Hanna-Attisha was able to use this data to compare blood lead levels before and after the city switched water supply sources. That report, run out of the hospital’s EHR system, showed undisputable evidence that lead was leaching into the city’s water supply and into the bodies of children. The presentation of this evidence met significant backlash, but eventually made way for the city to begin taking steps towards providing a safe water supply again. Once the findings were validated by state epidemiologists, the city declared a state of emergency and requested federal funding to replace as many pipes as possible. Progress began slowly to alleviate this crisis.

Without the digital records and the reporting functionalities of the EHR software, Dr. Hanna-Attisha would have faced an insurmountable volume of paper charts to search for blood lead levels. It would have taken resources and time that may have delayed the discovery of the crisis and further endangered the lives of Flint residents. Instead, she was able to easily access and search the data needed, even without the assistance of a software expert. While the crisis continues to this day, it is important to recognize the vital role played by the EHR in identifying the timeline and evidence of the water emergency. To me, this is a story to tell to the physician who is crippled with frustration on go-live day – struggling to understand why he has to document within the confines of a computer instead of scribbling in a chart. It is a reminder that IT professionals are equipping healthcare professionals with the best tools available to us to serve patients and communities.