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 offerthe option in the first place?
Dr. Halamkas 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 shouldnt just
transfer such an important matter to a person who probably doesnt 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 youve 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. Im
sure everyone reads and understands all of the paperwork placed in front ofthem, 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 othergovernment 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 dont
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 benefitsat some point; otherwise, theyd probably be practicing elsewhere.
Im 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
hospitals 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. Hospitalsshould make a decision and stick by it.