As with just about everything these days that goes the route of becoming electronic, so are medical records. Not to be confused with Electronic Health Records (which tends to be a more complete record of a person’s health history), Electronic Medical Records, or EMRs, are typically comprised of health related information that pertains directly to an individual procedure, diagnosis or a specific treatment. The idea behind using EMRs is that a specialist, say a Dermatologist, will not need all of your health related information to treat you for eczema and will be able to use an EMR for that specific disease and treatment.
Once the information has been saved in an Electronic Medical Record, it may also be included in an overall Electronic Health Record if your doctor has compatible software for combining the two, or interoperability as the term is known in the technical community. This would ensure that your complete medical history stays intact from doctor to doctor and procedure to procedure. However, many doctor’s do not choose to use medical record keeping in its electronic form; according to surveys completed in 2006, over 90% of hospitals in the United States and 84% of primary care physicians do not use any form of electronic record keeping. This is unfortunate because implementing this form of record keeping could save roughly 11 Billion dollars annually and in order to promote this form of record keeping, the United States Congress has allowed for an incentive provision in the 2009 Stimulus and Economic Recovery Act.
Even though there is a push for more doctors and hospitals to use Electronic Medical Records, there is still great resistance due to the potential for privacy breaches. The privacy concerns are due to the large number of people who would need to have access to them in order to do their jobs properly. While there are strong security measures in place for wired computer systems, the wireless networks are causing concern and give credence to the privacy factor. Once security is not an issue, and proper confidentiality safeguards are in place for those who have access to the system, the move to Electronic Medical Records should begin to happen across the country.
Feb
20
2010
The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) released documents detailing what physicians and hospitals must do to qualify for (EHR) incentive payments under the HITECH Act. To qualify for incentives, physicians and hospitals must be using “certified EHR technology” in a “meaningful manner.” These documents were released on December 30, 2009, one day before they would officially be considered late.
These documents provide a list of features physicians and hospitals need to have included in their EHR technology and how these features are to used to meet the definition of meaningful use during the 2011 EHR adoption period.
There’s only one minor problem, there are no qualified organizations that can certify that your EMR is up to stuff including CCHIT. That’s supposed to come later this year. Instead of getting all puffed up about this I would say that the standard will have to be slimmed down and/or delayed, stay tuned.
Jun
08
2009
The Office of the National Coordinator for Health Information Technology (ONCHIT) will soon release a description of the “meaningful use” of electronic medical records (EMR). Until HHS releases what it will require for a EHR user to receive the EHR stimulus money, then it’s anybody’s guess just what the heck meaningful use of an EHR actually means, please forgive the pun 
I can think of a number of factors that may or may not be part of this aspect of the standard:
- The number of years the practice has used the system within the practice. Part of the way the money is being passed out is to encourage early adopters, they actual get a bigger incentive to convert to an EMR.
- Does the data on the system get passed to other systems. In other words, is the data transparent and can other systems export and import the demographic and clinical information. A simple example is placing a lab test and recieving the results back into the EMR.
- Does the system improve the quality of care. Well duh, but I bet this is the hardest part to quantify but isn’t this the most important factor.
But as I’ve read the healthcare blogs I’ve seen another thought about meaningful use. The concept evolves around that concept that “meaningful use” should somehow measure if the user(s) is/are move effective in their practive of medicine with the system. From a productivity vantage key to measure this would be great but even more difficult to define.
Mar
31
2009
In today’s ModernHealthcare.com there’s an article on EMR Usablity and CCHIT Evaluation. The main point is simple, make the user friendly aspect of an EMR part of the certification process. I am in total agreement, most EMR may pass the “mechanical” aspects of interoperability but are hard to use.
The stimulus act ignores the brutal fact that traditional EHR systems will NOT solve much of the healthcare industry’s woes if doctors can’t or won’t use them. The incentives assume that “if you fund it they will come” this just isn’t the case. I love this remark in the article “Based on the “success” of EHR systems over the past 10 years, this bet could be akin to AIG’s bets on credit default swaps.”
Here’s the problem with usability, much of this is in the eyes of the beholder. Its not just a matter of how many clicks a task takes. I agree with the sentiment of the author but this is a very subjective issue, classic apples and oranges.