Balancing the Risk and Reward of E-Health Record Systems

Lora Bentley

Even though both government and industry organizations have pushed for health care organizations to move to electronic records systems, doctors are still hesitant to do so, according to U.S. News & World Report.


A study headed by Catherine M. DesRoches at Massachusetts General Hospital's Institute for Health Policy found that only 17 percent of U.S. physicians use electronic records systems. Such a system encompasses patients' medical records, prescription lists, problems, and notes from past visits. It allows doctors to order prescriptions and tests, and review results from those tests. An electronic records system also allows patients to easily access and transmit their own medical records when necessary.


The roadblocks to broader adoption of electronic health record systems include concerns about implementation costs and return on investment, and about system downtime preventing doctors from seeing patients. Finally, the study indicated that particpants were also concerned that their systems would not be scalable or flexible enough to meet future technology needs.


Despite those concerns, however, physicians who do have electronic health records systems in place are "very satisfied with them," U.S. News & World Report says.


What doesn't come out in this particular piece, however, is that many physicians are also concerned about the security risks that e-health records systems present. And then there are the privacy issues raised by such initiatives as Google Health.


If these systems are going to work well and still protect patient information, strict requirements regarding how and by whom they are accessed will have to be in place, and those requirements will have to be enforced. What's more, because humans will still be involved in the process and humans screw up sometimes, patients will have to be willing to risk the privacy of their information in exchange for the convenience that such systems provide.

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Jun 23, 2008 1:10 AM Scott Smith Scott Smith  says:
I read with great interest your blog about electronic medical records. (MMR) is an advanced patient health record and an Integrated Service Provider on Google Health.Using MMR, complete patient records can be easily faxed, voiced, or uploaded into a password-secured, web-based account. An emergency log-in feature also allows access to your critical medical information in the event of an emergency, and it has a drug interaction database for prescriptions, as well as many other features.Perhaps you and your readers would like to test drive MMR by signing up for 30 days free using the promotion code TRYMMR.Scott SmithMyMedicalRecords.comssmith2@mmrmail.com10100 Santa Monica Blvd #430Los Angeles CA 90069888-808-4667 ext. 123 Reply
Jun 26, 2008 1:24 AM Frank J Kiernan Frank J Kiernan  says:
There is currently a large group working on addressing the above mentioned issues and concerns. The Healthcare Technology Information Standards Panel, HITSP, has been working very hard on all of the above and some that have not been mentioned, like Patient Indentification, and data transfer from home or office technologies. I am a member of HITSP and I am glad to see the concerns the group has, are the same as those working in the field. Reply
Jun 27, 2008 1:00 AM Gary M. Zeiss, Esq. Gary M. Zeiss, Esq.  says:
In my experience, there are three primary reasons that e-Health record systems have not met with wide acceptance within the medical community.First, physicians think that these systems primarily benefit health insurers and hospitals - but physicians are being asked to foot the bill for those benefits. While there are public benefits for these systems, physicians see few private benefits for their investment.Second, physicians fear that the systems can be used to monitor their services - and depending on who is doing that monitoring - that could prove troublesome. Under the current system, an audit of a physician's records is a time consuming, manual task which, by its nature, reduces the likelihood of it occurring. Automated record keeping, however, would allow for automating those tasks and would make monitoring far more efficient. In the physician community, fear of big brother - be the health plan, the insurer, the malpractice plaintiff's attorney or the regulatory body - is a real and legitimate fear.Third, the current generation of physicians are not, for the most part, "do it yourself-ers." They have staffs that handle these issues, and they don't have the time or interest in learning a new system that will not, in reality, change much for them.A few years ago, I was involved in a pilot e-prescribing project. It was an utter failure - even though the hardware and installation was being given away, the SaaS services were made very cheap, and incentives were created to encourage participation. Ultimately, we discovered that it was difficult to justify using a PDA and a wireless network - which required training, could break, could go down, or could have other difficulties - to replace a free prescription pad (provided by a pharmaceutical company) and a free pen (provided by a different pharmaceutical company) and a zero-length learning curve.These issues have to be addressed openly and honestly before e-Health records become ubiquitous. I do expect, however, that recently-minted physicians are more likely to welcome this technology - but it will be a bit of time before these physicians rise to prominence. Reply
Jun 28, 2008 1:09 AM DeniseH DeniseH  says:
There are also roadblocks with these systems interfacing with other systems to exchange data. Billing systes have to transmit data in multiple formats for different funders. Medical Records exchanges have to also occur through an interface. Many organizations have their own personalizations in their systems which require different interfaces to facilitate these exchanges with providers and funders.Until there is more uniformity throughout the entire Medical community, digital medical records that are freely and securly available to providers, consumers and funders will continue to struggle into existance. Reply

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