Electronic medical records are a central element in the transformation of the healthcare system. Replacing paper with electronic records reduces errors, increases information sharing and is expected to make the medicine more efficient.
Look at the web and you will see that the issue of electronic medical records is described as largely a technology problem. Wikipedia’s entry reads like a software compatibility discussion. http://en.wikipedia.org/wiki/Electronic_medical_records While the technical challenges of electronic records are daunting, technology alone will not realize the value and benefits attributed to moving information from paper to disk.
Our family doctor has used electronic medical records since we started going to him more than five years ago. It has been interesting to see how the presence of electronic information has changed the way they practice medicine and how they handle patients. Their experience offers an example of how electronic medical record technology has evolved and how one practice is applying this technology to change patient service.
When we switched doctors back in 2004, we immediately noticed the lack of paper. You signed in at the front desk, made your co-payment and were then taken to an examination room. There were more exam rooms than normal and no central office space consumed with racks of records. The office space layout was clear
In 2004, the practice used wireless devices as the primary input device for electronic medical records. At the start the medical staff and doctors used handheld devices to input information. Through a combination of handwriting recognition and stylus based data entry, the doctor captured our medical record.
While the technology was interesting, the impact on patient care was not immediately evident. However, over time the impact of electronic medical records started to become evident. The impact came not from having electronic records, but rather incorporating information into the way the doctor’s office worked and the physician’s delivered care.
First was the scheduling accuracy of future appointments. The office had a keen understanding of the available appointment slots as well as the doctor’s progress through the day. I cannot recall having to wait for more than 10 minutes before seeing a doctor.
At the same time, there was no redundant data entry. Your identifying information of name and birth date gave the office access to all of your information. Insurance claim filing was electronic and handled by the office. When we needed to see a specialist, information was transmitted electronically without the need to redefine ourselves to the other doctor.
Increased office efficiency can be expected from turning paper-based information into electronic files. This office did more than capture information they integrated information into their office processes from records management to scheduling to billing.
Second, electronic records have changed the way the doctor interacted with us as patients. Electronic records enabled the doctor to keep track of our vital signs over time. He sees the data in control chart form and can readily comment about the overall trends. This gives him the ability to offer preventative advice based on my personal condition rather than generalities.
The electronic record enable him to ask about myself, recent activities and even ask about my family. The records do not violate their privacy. He used the record to know what college the kids were at and how they were doing. The doctor used this information to make the visit personal, memorable and more encouragement to follow the course of recommended treatment.
Effective medical care requires more than automating medical records or transforming paper files into networked information. Medical processes, procedures and structures will need to move beyond their current manufacturing based models to serve individual patents as the t group outcomes they represent.