After more than a decade since the introduction of the technology, electronic medical records (EMR) systems, sometimes called electronic health records (EHR) systems, have not gained wide acceptance. Neither medical providers nor patients have fully embraced the idea of medical records vaults in cyberspace, though adoption of EMR is slowly gaining ground. In house, or homegrown, systems have given way to integrated hardware/software products at all levels of healthcare practice. In use today at hospitals, clinics, laboratories, and practitioners’ offices, these systems have grown substantially in recent years.
SHADOWS OF DOUBT
Nonetheless, both medical providers and their patients have reservations about EMR. Physicians are reluctant to have their charts, notes, and prognoses in full view of anyone who has privileges to view that data – namely, other medical practitioners and patients. Patients fear any database containing confidential personal medical information may be subject to abuse or corruption. The very real possibility that erroneous information may enter the system, and the virtual certainty that any system can be cracked by hackers, is of no little concern to patients. Physicians are concerned that patients with full access to records may go on exploratory missions to find evidence of malpractice.
ADVANTAGES OF EMR SYSTEMS
Some proponents of EMR envision every public hospital in the U.S. participating in electronic medical record systems by 2015; As their popularity grows, increasingly these information technology systems are being viewed as a necessity. This application of IT certainly has some advantages for both medical providers and patients.
Advantages for Medical Providers
• EMR will reduce medical records costs in the long term: The installation and startup costs for an EMS system are high, but the total cost of the system over time is less than operating any manual system of records keeping.
• Comprehensive medical records can eliminate the need for repetitive and unnecessary testing: EMR systems collect test results from all sources, thus avoiding the need for tests that have already been performed.
• Accurate medical information is instantly available: Information stored in EMS systems is less prone to human error and it can be retrieved quickly and easily. Data search and retrieval time using manual filing systems cannot compare.
• EMS systems make medical records available anywhere, anytime: Physicians and emergency medical personnel can access patient medical records from anywhere using smart handheld devices. This access to patient records enables treatment no matter where the patient or medical provider may be.
• Collective data may be sorted, filtered, and analyzed: EMR data is stored such that it may be accessed by certain search criteria for comparative analysis, trending, and other statistical computation. EMR systems also allow physicians to order diagnostic tests and view the results on-line.
Advantages for Patients
• Interaction with EMS helps to reduce costs: When patients are more knowledgeable participants in their own care, there is a good chance their health costs will go down. When they become involved in their own care they tend to engage in preventive strategies to reduce the complications of chronic disabilities.
• EMR promotes improved diagnosis and treatment: Patients’ interaction with EMR systems gets faster decision making responses from medical professionals.
• Remote access to EMR can save a patient’s life: When doctors and other medical providers are able to access complete patient records from any location, decisions regarding emergency care are made with better data, there is less guesswork, and chances of misdiagnosis are greatly reduced.
Medical Practice Advantages of EMR Systems
For healthcare providers and practitioners there are numerous other advantages of implementing electronic medical records systems:
• Instant transfer of patient data from department to department or provider to provider
• Digital records require no vast storage space as manual patient records vaults do
• Medical providers can serve a greater numbers of patients per day because of increased productivity
• Operational costs are reduced as the need for transcription services and overtime is eliminated
• Electronic medical records can grow with the practice without increased space requirements
• Systems can be linked with electronic prescription systems (eRx)
• The bottom line of a healthcare provider is enhanced by more accuracy and efficient patient billing
PHYSICIANS STILL HAVE RESERVATIONS
The Federal Government has established incentive programs to encourage the use of EMR which requires adherence to a comprehensive set of criteria for improving patient care and access to personal health records. The criteria are called Meaningful Use. Implementation of the Meaningful Use parameters is costly and time consuming, even though the costs are covered by incentives.
The Healthcare Information and Management Systems Society (HIMSS) has observed that EMR adoption rates have been “slower than expected in the United States” when compared to adoption in other developed countries. A key reason they cited in 2009 was a lack of efficiency and usability of EMR systems [in use then]. Improvements in the past couple of years has improved the perception of EMR systems.
Physicians are vigorously embracing mobile technologies such as smartphones and tablets, according to a 2012 survey by Physicians Practice. Fully 62 percent of respondents said they use mobile devices in the performance of their jobs. The advantages of instant access to patient records at any time and any place are clear, but there are still concerns about the security of this information.
Physicians and medical practitioners view access to data in the EMS system much differently than patients. In a survey of providers by Accenture in 2012, only a third (31 percent) of doctors thought patients should have full access to their medical records, 65 percent felt patients should only have limited access, and four percent believe patients should not have any access to on-line records at all.
EMR SYSTEMS CONTINUE TO MAKE STRIDES
Full participation in any interactive global medical recordkeeping system is still an unfulfilled vision, but it is gradually evolving. Implementation of the CMS Meaningful Use requirements is a forceful nudge in this direction. To date, less than 20 percent of patients access the portals to EMS. Many patients exhibit a prevailing fear of “Big Brother” visibility of highly confidential and personal information, and with good reason. Since 2009, the U.S. Department of Health and Human Services (HHS) reports the health records of more than 18 million American citizens have been breached. EMR systems must improve on this track record if there is to be full acceptance of this technology by patients. Medical professionals stand to benefit the most from use of EMR systems and they will certainly endorse the methodology more with time.