We're hearing more and more these days about the importance of electronic medical records (EMRs) as a vital component of healthcare reform. With $19 billion of the stimulus plan allotted to health information technology, many see EMRs as the key to dramatically improving the quality, efficiency and cost of healthcare in the U.S.
If you’re a Seinfeld fan, you might remember the episode where Elaine, alone in the exam room, just happens to take a peek at her medical file while waiting for the doctor and sees, to her horror, a notation that she is a “difficult patient.” Chances are Elaine, like the rest of us, saw more than one doctor and had paper medical files with different and overlapping information in several offices and facilities. In Elaine’s case, the “difficult patient” label followed her from doctor to doctor.
In the real world of paper-based medical files, we seldom if ever have an opportunity to see our files. And our medical information, as our care, is fragmented and uncoordinated.
A digitalized, comprehensive and secure patient record—one that collects information, displays test results, allows providers to enter medical orders and prescriptions, and provides access to state-of-the-art databases that support treatment decisions—offers many benefits:
- Information is accurate and easy to retrieve which means less possibility for medical errors and greater possibility for improved patient care and safety
- EMRs greatly reduce or eliminate multiple files, records, and tests
- Doctors can access information at any time or place even when a person moves or needs medical care while traveling
- From the patient’s perspective, the most compelling reason to have an EMR is for your doctor to be able to quickly access information during an emergency
- There is also less stress and wear and tear on patients. With EMRs you will no longer have to arrange for X-rays and other films to be sent from one doctor’s office to another, or wait for lost films to be found, or have tests redone because films could not be found
- Having access to your medical information will make you more knowledgeable about your health, better prepared to ask questions and discuss your health with your doctor
- In some models, you may also be able to add information, e.g., record symptoms, follow a self-care plan, upload blood pressure and glucose meter readings, etc., as well as track progress for healthy behavior goals
Currently, less than 10 percent of doctors use a fully operational system of EMRs. Major obstacles to adoption have been lack of interoperability among systems and cost of software, system maintenance, and training office personnel.
But that’s about to change, as physicians and medical centers are incentivized to meet the Obama administration’s goal of computerizing all medical records within the next five years.
As adoption of EMRs is accelerated, there are very real concerns about privacy. People are worried about who will have access to their health record and the potential for employers to use information to limit job opportunities.
In a recent survey, IT security professionals who work at major hospitals and large medical groups expressed concern that the push to adopt EMRs was putting patient privacy at risk. Respondents said the new HIPAA rules, while not a perfect solution, are a good start in improving the protection of EMRs.
According to the Associated Press, federal recommendations for controlling how information is shared are expected to be issued in mid-2010. Interoperability is still an issue, however, and David Blumenthal, President Obama’s director of health information technology, acknowledges that a national record-sharing system is a long way off.
How to Create Your Own Personal Health Record
There’s really no need for you to wait until then. The one thing that most experts agree on is that electronic medical records help empower patients to be more involved in and knowledgeable about their care.
Creating a Personal Health Record (PHR) for yourself and your family can be as easy and uncomplicated as making a list that includes:
- Major illnesses and surgeries
- Medications and dosages
- Allergies
- Types and dates of vaccinations
- Names and contact info for doctors
- Insurance information
You can take it a step further by scanning documents or compiling the list on your computer and adding:
- Results of physical exams
- Laboratory tests
- Eye and dental exams
- Living will
- Information about organ donation and any other information you feel is relevant to your health and wellness
As a first step, you may want to ask your doctor what his or her plans are for an EMR and if the system includes a portal for patient input so that you and your doctor can create an integrated medical record, which is the ideal.
If your physician isn’t wired yet, share with him or her what your plans are for a PHR. If you will be tracking a care plan for a chronic illness, ask your doctor to check your PHR periodically to see how you are doing.
If you sense any reluctance, tell him it is important to you and don’t worry about being labeled a “difficult patient.” You’ll be doing him a favor…it may be just the push he needs to propel him into the 21st Century.
References
New Study Reveals Push to Electronic Medical Records Puts Patient Privacy at Risk. Press release, October 20, 2009, Loglogic. Accessed October 2009 at http://loglogic.com/news/news-releases/2009/10/electronic-medical-records-put-patient-privacy-at-risk/
AP Explores Interoperability Obstacles to EHR Adoption. Robert Wood Johnson Foundation News Digest (Twiddy AP/Washington Post, 9/30/09). Accessed October 2009 at http://www.rwjf.org/qualityequality/digest.jsp?id=23205
Peters K, Niebling M, Green T, et al. Usability Guidance for Improving the User Interface and Adoption of Online Personal Health Records. UserCentric, Inc. February 2009. Accessed October 2009 at http://www.usercentric.com/publications/2009/02/02/google-health-vs-microsoft-healthvault-consumers-compare-online-personal-hea
