Smart cards take on language barriers in healthcare

The Queens Health Network (QHN) in New York serves one of the most ethnically diverse neighborhoods in the United States, if not the world. Its centerpiece facility, the 513-bed Elmhurst Hospital, just underwent a US$250-million modernization and now operates 16 clinics.

But technology and not renovations will help overcome the communications difficulties serving a patient population that speaks 127 different languages. The problem is daunting and the consequences are potentially disastrous.

That’s why QHN next month will launch a pilot smart card program to help ensure that proper treatments in life-threatening or even mundane situations are administered at the correct moment.

“With multi-ethnic and linguistic patients, the problem is getting immediate information about medications and procedures in emergency situations,” explains Peter Velez, QHN senior vice president and executive directive of Elmhurst (Velez was the recent recipient of Modern Healthcare magazine’s CEO IT achievement award.

The way it works is simple. The ID card contains a computer chip bearing basic medical information about the patient, such as medications, allergies, and recent lab results. When the card is swiped through a $20 reader, up comes the precise information on a computer screen. The advantages of smart cards versus a patient struggling to communicate their medical status go beyond the obvious.

“This empowers patients to have their own medical record. Historically, medical facilities have protected that information. The patient should be able to determine how it is going to be used and managed. It no longer belongs to us,” Velez explains.

The hope is that the first 7,000-10,000 users in the pilot program will embrace this notion and carry the card with the realization that information on it could one day save their life. “We are hoping to educate our patients so they understand what they are carrying is their medical record. It is valuable information that pertains to them,” Velez says.

QHN will pick up the initial $6.50 cost per card but will charge a nominal fee if it is lost, adds Velez, who says that he knows of no other hospitals and healthcare systems in the United States that have embraced smart card technology in a similar fashion. However, he adds, the technology is popular in Europe.

Supplying the cards is Gemplus. The software provider is Data Industries, according to QHN CIO Al Marino. Data are pushed to the card when a change or modification is made in the patient record in QHN’s clinical information system (from Per-Se Technologies Inc., which last week sold its Patient1 product line system to Misys Healthcare Systems).

“One of the keys to do this is that we have pretty extensive clinical information system in place. Without the structure, we would not be able to push the data to the card,” Marino says.

The smart card project is part of a larger technology initiative at New York Health and Hospitals (NYHHC), of which QHN and the 169-year-old Elmhurst Hospital are a part. NYHHC serves a patient population of 1.3 million, half of whom do not have health insurance. No one is turned away because they can’t pay.

“If we are going to really have an impact on communities to health outcomes, the use of technology and data is going to be dramatic. We are very good at practicing one to one. Now we have to transform how we view our responsibility,” Velez says.

For instance, providers are now looking at patient cohorts and how to better serve them with technology. “If we have 4,000 diabetics, we are looking as a group of chronic disease patients. If the patient deviates from the protocol of standard treatment, an electronic system will show which ones are deviating or not complying,” he says.