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New data shows that 28% of Americans have gotten sick or injured while on vacation. Illness and injury are some of the worst things that can happen while traveling, as they not only ruin our plans, but also seek comfort from our medical team and possibly family, friends or colleagues who can help. If an illness occurs during international travel, it can be more complicated and dangerous due to different health systems and language barriers.
Worse, if a passenger is unconscious and unable to communicate anything about what happened, their feelings, or their medical history, what happens if someone else can help them get medical help? This situation may have resulted in deaths that could have been prevented if more information had been available. For example, people with diabetes can die if they pass out and are not given insulin in time, a simple solution to a life-threatening condition. The same thing can happen if someone with thyroid cancer goes through it and needs hormone replacement therapy.
A travel health record helps improve care
If we are hurt or injured while traveling, a travel health record can help improve our health and medical outcomes. Like a passport that provides instant identification, it provides essential health information that medical professionals need to ensure proper care. Travel health records can be viewed on a smartphone by pressing a pair of buttons or scanning a QR code without requiring login credentials.
Most patients do not understand the clinical details of past illnesses or injuries or how they helped a doctor. Clinical details are often very complex and difficult to communicate. A glance at the Unified Medical Language System (UMLS) Metathesaurus shows the complexity of clinical terminology. Even physicians may not understand terms or procedures outside of their specialty, but the travel health record provides the information that general practitioners and specialists need to provide appropriate care.
It is very complicated when patients undergo a complex surgery that medical professionals need to know. For example, for a heart patient who had tetralogy of Fallot as a child with a transannular patch in childhood, you may not be able to explain it. That operation requires a detailed explanation of exactly what was touched so as not to touch it again because touching it again can be fatal. There are many ways to treat Tetralogy of Fallot and knowing exactly what is done and why is important to ensure proper care. Patients with congenital heart disease will probably go through a period of time and need a way to communicate details about their condition and procedures. Therefore, a 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
While comprehensive travel health records are not currently available for all users of the United States health care system, advances in technology and the legal environment are opening important doors.
Ideally, common identification such as a driver’s license or passport is sufficient to obtain a travel health record. The ID is recorded in the electronic health record (EHR), which provides the care team with access to a complete medical record. This is true for countries that have nationalized health care, indicating that there are no technical limitations to providing a travel health record.
Because the United States does not have national health care, patient medical information is often distributed among different insurance providers and health systems. But under the 21st Century Cures Act, rules like the Data Blocking and Patient Access Final Rule; Data formats and Application Programming Interface (API) standards such as Fast Healthcare Interoperability Resources (FHIR); And incentive programs like Meaningful Use are making it easier for patients to access their health records and for providers to integrate their systems. This helps to access medical records from multiple sources in one easy-to-understand source to help ensure effective medical care.
In the United States and internationally, at least some health information access solutions are available. Apple Health can include health records, medications, labs, activity and sleep, and enables the creation of an emergency medical ID card available 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 automatic sharing with selected individuals or groups. As demand for travel health records increases and more integration occurs, more revenue and more detailed information will become available.
Overall, with the aforementioned laws, technical standards, and new applications, we are moving in the right direction toward a comprehensive travel health record that will help provide quality, data-driven care wherever we choose to travel.
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