I recently read an opinion column from Dr. John Halamka, a practicing

physician at a teaching hospital, which discussed the pros and cons of

converting from paper to electronic medical records. I found the article to be very interesting

and happened to agree with most of what was written until the final few

paragraphs. He stated that the hospital

where he practiced was going to give patients the option to choose between

having their records stored electronically and storing as traditional paper records

– their choice. What? How can this possibly be something that a

patient can make an informed decision about, and more importantly, why offer

the option in the first place?

Dr. Halamka’s main reason for giving patients their choice

of record storage method stemmed from the publicity of recent data

breaches. He reasoned that though it was

relatively easy for someone, authorized or not, to walk around a hospital and

swipe a handful of patient records, one electronic data breach can compromise

the integrity of thousands of records.

While he makes a valid point that the total number of patients at risk

for identity theft is higher using electronic storage, you shouldn’t just

transfer such an important matter to a person who probably doesn’t understand

the far reaching implications of their decision. And my guess is, if they are ill enough to be

at the hospital, they probably have more pressing topics on their mind than

what format their medical record is kept.

If you’ve been to the hospital recently, you probably remember how many

papers are placed in front of you to sign – insurance authorization, privacy

rights, acknowledgment of treatment risks, etc.

Please sign beside the
X here, here, here and here.

Yes, whatever you say.

Just let me see the doctor. I’m

sure everyone reads and understands all of the paperwork placed in front of

them, right?

The benefits of converting to an electronic medical record

system are many. Complete records can be

viewed anytime from anywhere, and records can be accessed concurrently by other

hospital staff. Any location with a PC,

proper authorization and access to the hospital network can be used to view an

electronic medical record (EMR). Faster

access from more places means medical staff can make quicker and better informed

healthcare decisions. Greater

coordinated care can be achieved by interfacing the EMR system with hospital

clinical applications, resulting in a more complete care assessment and reduced

critical errors. Improved hospital

workflow efficiencies can result in greater physician productivity and patient

care. Audit logs showing who accessed

which record and when can be maintained by system administrators. The ability to comply with HIPAA and other

government compliancy regulations can be achieved. The list goes on and on.

Likewise, paper records can only be checked out to one

person at a time and must be picked up in person or sent for. This can result in delays in patient care and

potential errors in critical decisions.

Also, many times the paper medical record remains incomplete, even

through follow-up reviews, while it takes time for various labs, x-rays and

tests to make their way into the paper chart.

Access audit logs are often not available.

Besides the above pros and cons, when a person becomes a

patient at a medical facility they grant a certain amount of trust to the

institution to make decisions about how best to provide a safe patient care

environment. In other words, I don’t

need to see everything that goes on behind the big red curtain. There are certain decisions best left to

trained professionals and not second guessed by the average lay man. If the hospital you are seeking care at spent

the money to research and implement an EMR system, you are indirectly opting to

have your medical record stored electronically.

In fact, a decision to install an EMR system is not made as an IT

decision, but requires heavy buy-in from physicians. If your preferred physician practices at a

hospital utilizing EMRs, it is likely that he or she bought in to the benefits

at some point; otherwise, they’d probably be practicing elsewhere.

I’m all for empowering people to make decisions concerning

their own welfare, but certain decisions are best left to trained

professionals. If patient care truly is the

hospital’s number one goal, storing electronic medical records as opposed to

paper records is an easy choice to make.

It pains me to see knee jerk reactions to media reports of data breaches

that could compromise patient care. Hospitals

should make a decision and stick by it.