New data reveals that 28% of Americans have gotten sick or injured while on vacation. Getting sick and injured are among the worst travel scenarios because, in addition to ruining our plans, we’re away from our medical team and possibly from the comfort of family, friends, or colleagues who might be able to help. If the illness occurs during international travel, it can be even more complicated and dangerous due to different health systems and language barriers.
Even worse, what happens if the passenger is unconscious and unable to communicate what happened, how they feel, and their medical history, assuming someone else is there to help find medical help? This scenario could result in a death that could have been prevented if only more information was available. For example, people with diabetes can die if they pass out and are not given insulin in time, which is simply a remedy for a life-threatening situation. The same can happen if someone who has had thyroid cancer faints and needs hormone replacement therapy.
A travel health record can help improve care
A travel health record can help improve our health safety and treatment outcomes if we become ill or injured while travelling. Like a passport that provides instant identification, it would provide the basic health information that medical professionals need to provide appropriate care. The travel health record can be displayed by pressing a few buttons on a smartphone, without requiring login credentials, or by scanning a QR code.
Most patients do not understand the clinical details of past illnesses or injuries, or how the doctor has helped them. Clinical details are often very complex and difficult to communicate. A glance at the Unified Medical Language System (UMLS) Metathesaurus would reveal the complexity of clinical terminology. Even doctors 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 provide appropriate 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 tetralogy of Fallot repair with a transannular patch as a child, chances are they won’t be able to explain it. This operation requires a detailed explanation of exactly what was touched so that it is not touched again, because retouching can be fatal. There are many ways to perform a tetralogy of Fallot repair and knowing exactly what is done and why is essential to ensure proper care. Patients with congenital heart disease are likely to pass out at some point and will need a method of communicating details of their condition and procedures. So the travel health record should not only list current and previous medical conditions, but also the procedures applied to those conditions.
Current status of travel health records
Although comprehensive travel health records are not available today for those using US healthcare systems, advances in technology and the legal environment are opening the necessary doors.
Ideally, a common ID such as a driver’s license or passport would be sufficient to retrieve a travel health record. The ID number will be entered into an electronic health record (EHR), which will find the complete medical record for the care team. This applies to countries that have nationalized healthcare, indicating that there are no longer any technical restrictions on providing a travel health record.
Because the United States does not have a nationalized health care system, patient medical data is typically shared among multiple insurance providers and health care systems. However, legislation such as the final rule to block patient information and access under the 21st Century Cures Act; data format and application programming interface (API) standards, such as Fast Healthcare Interoperability Resources (FHIR); and incentive programs like Meaningful Use make it easier for patients to access their health records and for providers to integrate their systems. This will help achieve the combination of medical records from multiple sources into one easy-to-understand resource to provide effective medical care.
Solutions with access to at least partial health information are available in the United States and around the world. Apple Health can include health records, medications, labs, activity and sleep, and allow the 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 over which information is shared with whom and enable automatic sharing with certain individuals or groups. There will be more participants and more detailed information as demand for travel health records increases and more integrations emerge.
Overall, with the above legislation, technical standards and emerging applications, we are moving in the right direction to achieve access to a comprehensive travel health record that will help us provide informed, quality care wherever we choose to travel.