Of all the individual ideas for healthcare reform proposed by President Obama, the notion of transitioning to a fully electronic process for the maintenance of medical records would seem to be the most obvious. It also seems like one of the easier things to accomplish, given the other, more ambitious reforms on the agenda. After all, its clear that the technology for such complex electronic record keeping already exists and is currently in use by other industries. Yet nearly two decades after the beginning of the information revolution, while the technology has grown exponentially there has been little will to apply it to medical record keeping.
President Obama was not the first inhabitant of the White House to suggest that enormous savings could be captured through the application of information science and Internet technology to replace old, paper based data management. Maximizing efficiency is one, legitimate way the insurance industry could keep the climbing costs of healthcare down without cutting service levels. Presidents G.W. Bush and Bill Clinton also supported moving in this direction. So what are the obstacles?
Among the roadblocks to adoption of widespread Electronic Medical Records or EMRs in the US are such issues as:
Interoperability – the ability (or inability) of disparate computer systems to “speak” with one another. Doctors’ offices, hospitals, labs, insurers, public health institutions, etc.
Privacy – developing protocols for transfer of data among the numerous providers in a way that protects personal information (partially addressed in HIPAA)
Legacy Data Capture – the logistics involved in scanning and entering existing patients’ medical histories into the system to avoid discarding valuable, historical, medical perspective
Change Management – the process of fostering adoption of new technologies and practices across entire enterprise level industries is challenging
Other obstacles to adoption include: cost of implementation, unclear standards across all programs, problematic legal issues (digital signatures and data preservation procedures etc.).
Everyone seems to agree that implementing EMRs in the US is a worthy goal. Yet, as with so many goals worth achieving, this one is easier said than done.
One Response to “File Under: Easier Said Than Done”
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I agree that electron medical records would be the best way to go, but definitely not the easiest thing to do. I think that interoperability is a great thing that is going to be a positive benefit for everyone. If you as a patient are being seen by several different physicians, this would save everyone a lot of paperwork. Anyone that works with the patients would have access their health information. Privacy has always been an issue that we have to be very careful of, and I feel that it is always going to be a big issue. Something will have to be developed to help secure patients records to help protect their information. With more than one person being able to access their information at one time, we need to have a safe, secure program so patients are as happy with this as we are. Obviously since this is the way to go this also entails a lot of work. All of the patients records will have to be scanned into the computer system, and after that long task is completed the office staff will have to have a safe and secure site to store all of the paper files. Some business keep files on site, and others deal with off site locations. This is something that would be very costly for a hospital or a physicians office to do with training the staff, scanning the files, and also finding a storage site for all of the files. In the end it would benefit the business.