There are fewer things in life more important than our health. And yet, most of us have never even peeked at those records. In the five -- make that nearly six decades -- that I've been seeing physicians, I have never once looked at a single page in my medical record. Not one page. Ever.
How bizarre is that? What if there is something in there that's inaccurate? What if there is something in there that I should know but have forgotten? Until recently, it never even occurred to me that I should review these records. It just wasn't on my radar.
My medical records probably are skinnier than most. I have no chronic diseases. Don't take medications on a regular basis. Have had a couple of surgeries. A concussion. A couple of pregnancies. The most significant medical event was a case of shingles on my facial nerve that created a rather thick file for my ophthalmologist. To the best of my knowledge, that file has never been shared with my regular physician. Maybe there is something in there in how I responded to treatment that would be important for future medical episodes.
One of the key criticisms of electronic medical records is that there is no common network, making it impossible for physicians on one electronic medical record system to talk to the electronic medical records from a different vendor. Given there are about 300 EMR vendors and growing, its a veritable Tower of Babel out there.
He likens a network to telephone lines, which tie together various types of phones and communication equipment so information can move around. Until such a network is well developed for health information, demand for electronic medical records will be slow, even with stimulus money, Brailer says.
Proponents of electronic medical records (EMR) say they are essential in emergency rooms. Dr. Reid Conant, a board-certified emergency physician and chief medical information office for Tri-City Emergenecy Medical Group in Oceanside, California, has worked with EMRs for the past six years. In a phone interview, he explained why they are so important in emergency rooms.
"When paramedics are bringing in a stroke victim I can pull up their records as soon as I know their name. I can see if they have had prior strokes, what kind of symptoms they had in the past, and compare that with new symptoms today." Conant says that having access to the medical records can mean the difference between a full recovery and a patient having lasting symptoms from the stroke.
"Time is a major differentiator [in treating strokes] and I need to know immediately if this patient is a candidate for a clot-busting medication," says Conant, "If I don't know their prior history and symptoms it's very difficult to get that medication into them quickly."
Prior to EMRs, it could take hours for physicians in an emergency department to get their hands on a patient's medical file. For stroke victims, that delay could be a life-changer.
The benefit, say EMR enthusiasts, is not just in the emergency room. EMR fans say it's extremely beneficial for managing a patient's prescriptions. One of the trends in EMR is to provide patients with online access to their own records. Some physicians encourage patients to study those records, particularly the listing of their prescription drugs. Dr. Lynn McCallum, a family practice physician in Redding, California, who uses Practice Fusion, a free web-based EMR program with a patient interface, says, "I tell all my patients to check the dosage amounts we have listed in their EMR with the dosage amount that appears on their prescription bottles. "
A new research study indicates that EMRs can save infants' lives. The study, conducted by Amalia Miller of the University of Virginia and Catherine Ticker of MIT’s Sloan School of Business, shows that baby mortality rates drop in hosptals with EMRs.According to the study:
The adoption of EMRs by one additional hospital in a county reduces infant mortality by 13 percent.
The average cost of the HIT used to save that baby is about $450,000.
The reduction of infant mortality is twice as great for African-Americans than non-African-Americans.
Dr. McCallum started using her EMR system a year ago. She believes having the EMR system improves her patient's medical history. "I find my notes are more complete, because I am doing it in front of my patient. I'll type something and then I'll read it back to them so they are aware of what is going into the chart and that I've reflected to them that I have their story right."
Dr. McCallum says charting in real-time is definitely saving her two to three hours a day even though she now does the charting during the patient visit. Depending on the practice, some physicians wait to do their charting until the end of the day or even the weekend. Dr. McCallum says, "How do you remember on Saturday what you're doing with a patient that you've seen on Monday?"
Not only does Dr. McCallum believe electronic charting saves time, she believes her charts are more detailed. "Having EMR has helped my charting tremendously." As far as her patients are concerned, she says they think its cool that she's online. And because she uses a small laptop to do her charting, she doesn't believe the patients find it distracting or less personal than if she took handwritten notes with the file sitting on her lap.
In addition to taking notes during a patient visit, many doctors rely on dictation to complete a patient's chart. One of the major complaints about EMR systems has been the lack of quality voice recogntion software for dictation. As part of my interview with Dr. Conant, he invited me to a GoTo Meeting to demonstrate the effectiveness of Dragon Medical -- which promises 99 percent accuracy. Dr. Conant has a professional relationship with Dragon Medical and regularly provides training to teach physicians how to use this with their EMR systems. Dr. Conant says the training takes just three hours.
While physicians and medical practices continue to debate when they will begin implementing EMR and which vendor they will choose, consumers do have some options to create their own EMR. Both Microsoft's Health Vault and Google Health allow consumers to organize their health information in one place. The concept is similar to the story Dr. Conant told about a stroke victim entering his ER. By having your own personal electronic medical record, you can make sure that in the event you were rushed to an emergency room that did not have your EMR, you could allow physicians to access the records you created for yourself -- and maybe by doing so, help save your own life.
Note: The burgeoning field of digital medical records is rich in acronyms. Depending with whom you talk, you may hear them refer to EHR rather than EMR. Technically, they are two different things. Click here to learn about all the new terms floating around as medical records go digital.
BlogHer Contributing Editor: Business & Career
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