Updated: Dec. 5, 2017 at 1:00 p.m.
The student health center will move to an electronic record-keeping system next summer, following student criticism of the existing paper system and a lack of communication between health clinicians at the center.
Student health officials said the Colonial Health Center maintains paper copies of student medical records for physical ailments and psychiatric issues, but the former leader of the center said medical staff don’t always check paper records from other units in the center before prescribing medications. Health experts said this is a potentially unsafe practice because mixing some medications can have dangerous health affects.
Paper records are maintained for both physical health services and the psychiatry department, while records for students who see a mental health counselor are kept electronically. The records are not typically shared among the different units of the center, Glenn Egelman, the former associate dean of the CHC, said.
“Within the Colonial Health Center, it is not routine for a physical health care provider to stop what they’re doing, access the separately maintained psychiatric records, review those records prior to prescribing a medication for a student,” he said.
Egelman said the implementation of an electronic records system was a project he’d begun working on this semester and aimed to accomplish by the end of the academic year, saying it would “ensure consistent and safe health care for our students.” The former director unexpectedly resigned from his post in September after just six months in the role.
By not keeping all CHC health records electronically, Egelman said the center was at risk of not sharing information between health providers, which could lead to adverse reactions if a student was prescribed two medications that clash when taken together.
“Without that, there is no good mechanism to ensure quality of care meeting national standards,” he said.
Officials merged physical and mental health services together when the CHC moved into the Marvin Center in 2015 in an effort to centralize health care for students.
University spokeswoman Lindsay Hamilton said the CHC plans to move to an electronic records system by next summer “as part of the work to better integrate systems and serve the student population.”
“The University is always working to ensure care is coordinated and comprehensive,” she said in an email.
She said only medical health professionals in the CHC can prescribe medication, including psychiatrists but not mental health clinicians. Students typically visit mental health clinicians at the CHC for short-term therapy sessions.
Psychiatrists have access to medical records when prescribing medicine. Medical staff can also review psychiatric records and ask students what other medications they are taking, including over-the-counter medications, before filling out prescriptions, she said.
Stephanie Gill, a member of Care for GW, an unofficial student organization that lobbies for lower health insurance costs, said maintaining paper records is both unfriendly to the environment and unsafe for students. Gill will be an inaugural member of the Student Association’s student health advisory council, which will work to support the move to an electronic records system, she said.
When records aren’t easily shared between different CHC units – which would be easier to accomplish if records were kept electronically – doctors may not realize links between physical and mental health issues, Gill said.
“Maybe a student’s broken arms or whatnot are tied to underlying mental health issues, and similarly, maybe a student’s mental health issues are tied to a medical condition that they’ve been diagnosed with, and so not knowing that information can put a student’s life at risk,” she said.
Under D.C. law, it is illegal to disclose mental health information from a patient. But if a student sees a psychiatrist, records and medications from that meeting can be disclosed to a physical healthcare provider if the provider is in the same organization as the psychiatrist.
Noah Wexler, a junior and member of Care for GW, said the CHC was in “disarray” from departures of top officials at the center and the inability to store electronic records was an example of how the health center was failing to function efficiently.
Wexler added that having a culture where two health services share the same space but don’t communicate with one another could have dangerous consequences for students.
“In theory somebody could be prescribed a medication for some sort of mental ailment and then a medication for some sort of physical ailment and those two things could have really adverse side effects,” he said. “We hear about that happening in horror stories.”
Experts said storing patient records physically could not only be burdensome to health centers due to the high volume of records, but could also lead to confusion between healthcare providers as to what treatment or medications a patient had already received.
Carl Kesselman, a professor of industrial and systems engineering at the University of Southern California, said there wasn’t much debate that keeping electronic records is a better practice because those records are often more efficient in a healthcare setting where they can be more easily accessed by many different departments.
“Certainly best practice is to have an electronic medical record system in place, that it be used by all the departments and all the physicians at the point of care, and that patients have consolidated electronic health records to help keep track of what’s going on, to make sure they’re not being prescribed drugs improperly,” he said.
But for an institution that did not have any electronic records currently stored, Kesselman said the process of moving over to such a system could be a significant financial burden potentially costing millions of dollars and would usually require the work of an outside firm.
Greg Hugie, a partner of IMERGE Consulting firm, said simply asking students what other medications they are taking isn’t always enough to ward off the negative impacts of mixing drugs.
“Obviously one doctor shouldn’t prescribe something without obtaining information from the student that says what they’re already taking,” he said. “But that’s certainly not foolproof.”
This post was updated to reflect the following correction:
The Hatchet incorrectly reported that the SA’s student health advisory council has not yet launched. The council has recently begun meeting. We regret this error.
This article appeared in the December 4, 2017 issue of the Hatchet.