As a doctor, I have a confession to make.
During a typical patient-physician encounter, we discuss the patient's health concerns, provide some clinical guidance, stress the importance of staying the course, and then send them off. But the truth is, the intention was noble, but the execution was weak.
The next time we see the same patient, we often don’t know exactly how healthy they are or whether they followed our recommendations to take medications, monitor blood pressure, increase activity, etc.
That's because, as physicians, we rely almost entirely on whatever information appears in a patient's electronic health record (EHR), and a limited view simply isn't enough to fully understand a patient's health.
Electronic medical records often document clinical experiences but miss information that reflects a patient's entire health, limiting their efficacy in tracking health progress and measuring success.
It's like reading a dictionary that only has words starting with “A” through “M” – it's incomplete. To get a complete picture of a patient's health, physicians must incorporate other data sources into their decisions, such as wearables, claims, patient communication data, and admission, discharge, and transfer information.
More diverse data, more comprehensive care: Expanding beyond the clinical realm, enabling physicians to move from reactive to proactive care, supported by a more complete understanding of each patient. Here are some ways additional non-EHR data can enhance this mission:
Wearable device data: Everyday devices like smartwatches and fitness trackers generate a continuous stream of information about activity levels, heart rate, sleep, and more. Doctors who can see trends in these data can detect early signs of depression, intervene when patients are not meeting activity goals, and monitor recovery after discharge. Clinicians can initiate preventive interventions in a timely manner rather than waiting months to assess progress.
claims data: Claims provide a comprehensive record of where patients received care, the prescriptions they took, and the procedures they underwent—often beyond the scope of their primary care physician's EHR. This data can reveal critical gaps, such as medications not being dispensed or tests being repeated, and help avoid unnecessary costs and risks. For example, knowing that a patient recently had a CT scan in another state can prevent unnecessary repeat imaging, thereby avoiding harm and expense.
communication data: Most medical care is delivered outside the exam room via phone calls, secure messages and staff notes. These interactions often include important contextual information, such as patients revealing that they cannot afford medications or are struggling with side effects. When captured and analyzed, communication data can provide early warning of clinical problems, highlight barriers to adherence, and reveal social determinants of health that may have been overlooked.
Admission, discharge and transfer (ADT) data: Unlike claims, which may lag months, ADT feeds provide real-time updates as patients are admitted, discharged, or transferred between care facilities. Timely awareness of these events allows clinicians to follow up quickly after a hospitalization—a critical window to prevent readmissions and ensure a smooth transition of care.
Taken together, these additional data streams create a more complete patient story, enabling physicians to practice proactive, personalized and precise medicine.
Not more technology, but better technology
Ironically, while technology is supposed to make healthcare more efficient, it often has the opposite effect. Physicians are already overwhelmed with excessive documentation, inbox management, and disjointed data systems.
For example, one study found that primary care physicians require 26.7 hours per day to provide all guideline-recommended preventive, chronic, and acute care, as well as the documentation and inbox management required by patient panels. Another revealed that one in five emergency room patients arrive with medical records exceeding Moby Dick. On average, physicians spend more than 16 minutes per visit browsing the EHR instead of directly connecting with patients.
The way forward is not simply to embrace more technology, but to introduce tools that work with doctors rather than against them. Artificial intelligence (AI) and large language models (LLM) hold special promise for distilling large amounts of information into clear, actionable insights.
Instead of sifting through countless data points from electronic medical records, claims, and wearables, doctors can be provided with prioritized summaries, such as patients who recently missed refills, experienced decreased activity levels, and visited the emergency department in the last week. These technologies can display the most relevant information at the right moment, allowing physicians to intervene earlier, focus on patient interactions and reduce cognitive overload.
Smarter, more proactive healthcare
Healthcare today requires more than the partial snapshots provided by traditional technologies. By integrating disparate data sources such as wearables, claims, communications and ADT sources, clinicians can gain a comprehensive, real-time view of a patient's health.
When combined with AI-driven tools that can filter and put this information into context, the result is more effective not only for doctors, but also for patients. Moving forward is not about adding complexity. This is about enabling smarter, more proactive, and more patient-centered care.
Photo: elenabs, Getty Images
Dr Mahadevan
is the co-founder and chief medical officer of Fold Health
Professor of Emergency Medicine (Emeritus) at Stanford University.
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