Health & Fitness
Electronic health records
Electronic health records are revolutionizing health care information management. What is the balance between quality care and patient confidentiality?
Patch-electronic health records
Slowly but surely the evolution of medical records from paper to electronic is progressing. Spurred on by the improved quality of such systems, the potential benefits of tracking results and trends electronically, and changes in the health care market, adoption of electronic health records (EHRs) is taking place in virtually every hospital in the United States. In addition, it is estimated that over one-half of the nation’s office based practices are now using some form of EHR.
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Initially focused more on billing issues, the current generation of EHRs has been created with patient care in mind. For example, in a paper based system, your primary care physician had no way of tracking the health maintenance status of his/her patients. If a patient was due for a mammogram, a colonoscopy or a cholesterol test, it was virtually impossible to screen paper charts, proactively reach out and remind every patient that a test was due, and track compliance. A modern EHR, however, can be programmed to print out on a daily basis which patients in the practice have now hit the date a procedure is due, and can alert the office to reach out to the patient (or can even generate an email for patients who desire electronic communications).
For patients with chronic conditions, the EHR can facilitate the primary care provider in assuring optimal care. For example, patient with diabetes may need a whole panel of evaluations, including quarterly blood tests, annual eye and foot examinations, influenza vaccinations, etc. The EHR allows the physician to create a registry of his/her patients with diabetes, and to manage with proactive reminders, calls and appointments.
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On a broader level, we are witnessing the creation of Regional Health Information Organizations (RHIOs), which are regional or statewide initiatives to allow the transfer of healthcare information across organizations. The ultimate objective is to improve the safety, quality and efficiency across a region. So, for example, if you consent to have your personal information accessible within a RHIO (and such personal consent is an ABSOLUTE requirement), if you are brought to an emergency room anywhere in the RHIO’s area, the physicians will have access to prior tests, medications and conditions that would allow them to provide better and more comprehensive care. Recently the New York City and Long Island RHIOs combined to form NYCLIX-check out the website at www.nyclix.org.
Polls have shown that patients are ambivalent about EHRs. 68% of patients say they believe their care will be improved and 60% believe medical costs will be reduced because of the EHRs ability to minimize redundant care. On the other hand, 63% of patients are concerned about the security of their personal health information.
In the near future it is likely that you will be asked by your physician about whether you would like your information available to health providers in the New York region. From a clinical point of view, this would almost certainly offer the potential of better, quicker and safer care from a provider who would be fully conversant with your medical issues. However, many will be concerned about privacy. I suggest you think this over carefully, talk with your family, and get the perspective of your primary care provider.
