EPRs should ‘include location data’

A patient’s location history should be a key piece of data going into new electronic health records, a geographic health expert has said.

Speaking at Wired Health, part of EHI’s Digital Health Festival, Bill Davenhall, from geographic information system software supplier ESRI, said the geographical data can allow medical practitioners to easily view and account for environmental factors when considering a patient’s potential health risks.

During his presentation on the issue of geomedicine – combining geographic information with clinical databases- he said said geography is an increasingly important factor in healthcare, with 20 to 30 per cent of a person’s health future “locked up” in environmental exposures in the places they have lived.

“Each one of these places has their own environmental history: we have such things as sick buildings that have their own complex data points.”

Davenhall said healthcare professionals need to “connect all the dots” and become better at gathering and analysing data about a patient’s environment to ensure they are aware of all possible influences on their health.

“There’s no randomness to disease or treatments for disease. With the environments that we live in, if we presume everything is the same, we’re missing a huge part of the data.

“We’ve not used geographic information as the least common denominator to put the data together and help you with your health.”

ESRI has released a mobile app for the United States, My Place History, which maps data from the US Environmental Protection Agency’s toxic releases database to allow users to assess their level of potential exposure to toxins based on where they have lived.

Davenhall also mentioned the recently released Environment and Health Atlas for England and Wales  as an example of how data can be used to map environmental factors.

He said this type of work cannot prove a link between a person’s environment and their illness, but is a starting point for further discussion on the issue.

“I’m not saying there’s causality, I’m just saying there’s proximity, but proximity is on the way to association, and association is on the way to causality.”

Davenhall said electronic patient records should include location information for a patient so it can be easily accessed by GPs and clinicians and allow them to consider potential environmental exposures when forming a diagnosis.

“While we spend all this money on e-health records, we should stick your place history in it and it can serve you your entire lifetime.

“What if you lived on a toxic waste dump 30 years and you don’t know it? But if it’s discovered later, then [with the data in the records] we can tell you about it.”

However, Davenhall said practitioners need to be transparent about why geographic data was collected and how it could help patients to ensure the public understand its benefits.

“If you don’t build trust in the data and an understanding of the data, no-one will trust it.”