by Rick Lehtinen
December 29th, 2011
ChiroCode Hot Topics, January 2012
Watching Out For Electronic Records
By Rick Lehtinen
The digitization of medical records is one of the most exciting, and yet the most challenging, fronts in health care today. There is a lot of misinformation, and a lot of important information. There are things that you should know that are not well explained. Electronic medical record keeping is being billed as the last great tool to conserve healthcare dollars by cutting out the waste and delays caused by paper records. But there may be more than meets the eye.
To start, electronic medical records include lots of abbreviations and new terms, some of which overlap. Here are three biggies:
Personal Health Record (PHR). This is a term for medical records kept by the consumer in electronic form. In theory, this is a great idea. It allows the consumer to carry their own records from doctor to doctor. A good PHR would likely contain the following:
- Your name, birth date, blood type and emergency contact
- Date of last physical / treatment
- Dates and results of tests and screenings
- Copies of X-rays and diagnostic images
- Major illnesses and surgeries, with dates
- A list of your medicines, dosages and how long you’ve taken them
- Any allergies
- Any chronic diseases
- Any history of illness in your family
Of course, it’s easier to imagine a good PHR than it is to create one. For instance, many practitioners regard their x-rays of you as their intellectual property, not the patients’. Who owns it really? And how is the information going to get included in the PHR? Google and Microsoft both offer solutions that make it easy to upload information from your doctor or from your own computer. But not all offices have digital x-rays or scanners with which to digitize films. Still, imagine the convenience of reading a patient’s prior records from a secure web browser or from a memory stick, and never having to depend on the patient’s memory or understanding of what was performed previously. Look at the convenience for the patient. Storing, or keeping, the electronic data is much handier than dragging around a suitcase full of old records.
Electronic Medical Record (EMR). The office version of PHR is the Electronic Medical Record. All of the case notes, test results, x-rays, treatment plans, and billing and insurance correspondence for each patient are stored in the office in secure electronic form. The advantage is speed of access and completeness of records. Also, requests for outside services and giving and receiving information from consulting physicians can be accomplished instantly by e-mail rather than scribbling and mailing or faxing hand-written notes. This greatly increases accuracy.
EMR is a national goal, and there is the potential of earning a $44,000 bonus for converting to it—if the information is used meaningfully, a term left undefined. Don’t expect to buy a scanner and connect it to your computer and then ask for a check. Expect to revamp your entire workflow process and demonstrate that you can cut costs and reduce errors. It will be hard work, and the criteria are not clearly set.
Electronic Health Records (EHR). So who made EMR a national priority? It grew out of a need to knock down “data silos,” which are isolated clusters of data, and create an Electronic Health Record (EHR) that is interoperable with the systems of others. Let’s say that you have finally got your office buzzing around its computers like a top. Wouldn’t it be nice if all of the groups with which you file claims and accept payments (and that would include insurance providers and CMS), could profit from your automation and efficiency as well? Then the savings which you earned (and presumably were paid a bonus for) could contribute towards making the health care system more efficient and less expensive throughout. There are too many incompatible files and programs and procedures to facilitate easy data transfer.
When unified data exchange does finally come to pass however, then the promise of EHR can finally come to pass. After suitably scrubbing the data so that there is no way to trace records back to individuals (supposedly), the data can be used for statistical studies, and eventually to provide a shot in the arm to evidence-based medicine.