New data reveals 28% of Americans have gotten sick or injured on vacation. Illness and injury are among the worst-case scenarios while traveling, because beyond ruining our plans, we’re away from our medical team, and possibly also from the comfort of family, friends or colleagues who could help. If illness happens while traveling internationally, it can be even more complicated and dangerous due to different health systems and language barriers.
Even worse, what happens if a traveler is unconscious and unable to communicate anything about what happened, how they’re feeling and their medical history, assuming anyone else is even there to help find medical assistance? This scenario can result in a death that could have been prevented if only there were more information available. For example, people with diabetes can die if they pass out and aren’t given insulin in time, which is a simple remedy for a life-threatening situation. The same can happen if someone who had thyroid cancer passes out and needs hormone replacement therapy.
A travel health record can help improve care
A travel health record could help improve our health safety and treatment outcomes if we become ill or are injured while traveling. Like a passport that provides immediate identification, it would provide the essential health information that medical professionals need to ensure proper care. The travel health record could be displayed by pressing a couple buttons on a smartphone without requiring login credentials, or by scanning a QR code.
Most patients don’t understand the clinical details of past illnesses or injuries, or how a physician helped. Clinical details often are very complicated and difficult to communicate. One look at the Unified Medical Language System (UMLS) Metathesaurus would reveal the complexity of clinical terminology. Even physicians may not understand terms or procedures outside their specialty, but a travel health record would provide the information that general practitioners and specialists need to deliver proper care.
It’s even more complicated when patients have complex surgeries that medical professionals need to know. For example, for a congenital heart patient who had a tetralogy of Fallot repair with transannular patch as a child, chances are they can’t explain it. That surgery requires a detailed explanation of exactly what was touched, so that it’s not touched again, because touching it again could be fatal. There are many ways to perform a tetralogy of Fallot repair and knowing what exactly was done and why is essential to ensure proper care. Patients with a congenital heart condition probably will pass out at some point and will need a method to communicate the details of their condition and procedures. So, a travel health record not only should list current and former medical conditions, but also the procedures applied to those conditions.
Current status of travel health records
While comprehensive travel health records for those using U.S. health systems are not available today, advances in technology and the legal environment are opening the necessary doors.
Ideally, a common ID such as a driver license or passport would suffice to retrieve a travel health record. The ID would be typed into an electronic health record (EHR), which would find the complete medical record for the care team. This is true for countries that have nationalized healthcare, which illustrates there already are no technical limitations to providing a travel health record.
Since the United States does not have nationalized healthcare, patient medical data usually is distributed across multiple insurance providers and health systems. However, legislation such as the Information Blocking and Patient Access Final Rule under the 21st Century Cures Act; data format and application programming interface (API) standards such as the Fast Healthcare Interoperability Resources (FHIR); and incentive programs such as Meaningful Use are making it easier for patients to access their health records and for service providers to integrate their systems. This will help achieve having combined medical records from multiple sources in one easy-to-understand resource to help ensure effective medical care.
In the United States and globally, solutions with access to at least partial health information are available. Apple Health can include health records, medication, labs, activity and sleep, and enable creation of an emergency medical ID card accessible from the lock screen with no login credentials required. OneRecord claims to have the largest FHIR network including 365 health systems and 100 health plans, connections to EHRs such as Epic and Cerner, and is available on iOS, Android and the web. Such applications allow control of which information will be shared with whom and allow automatic sharing with designated individuals or groups. There will be more entrants and more detailed information available as desire for travel health records increases and more integrations occur.
Overall, with the above legislation, technical standards and emerging applications, we’re heading in the right direction to achieve access to a comprehensive travel health record, which will help provide informed, quality care wherever we choose to roam.