Medicine has seen the rapid progress of technology in many areas, affecting both physicians and patients. One of the most revolutionary advances has been the change of patient medical records from paper to digital.
Most physicians agree that electronic medical records (EMRs) offer great promise and many advantages in healthcare.
“Electronic medical records can be used for more than just keeping records,” says Joseph Heyman, M.D., Chief Medical Information Officer of Wellport Health Information Exchange in Newburyport, Mass. “They can provide a data base that can be used to measure quality, perform research, and provide information about the patient population.”
Dr. Heyman, a former president of the Massachusetts Medical Society and a physician who has used EMRs for most of his 40-plus year career as a physician, joins Glenn Tucker, M.D., a practicing primary care physician and Chief of Internal Medicine and Chief Medical Information Officer at Sturdy Memorial Hospital in Attleboro, Mass., on the August edition of Physician Focus to discuss the advantages and disadvantages of electronic medical records to both physicians and patients. Dr. Tucker is chair of the Massachusetts Medical Society’s Committee on Information Technology, and Dr. Heyman is a committee member. Hosting this edition is Dale Magee, M.D., a past president of the Massachusetts Medical Society.
While the physicians agree that EMRs offer advantages, they also say the technology poses significant challenges as well.
The transition from paper to digital, for example, can be daunting for most physicians. Most physicians and their staffs are not trained in information technology or workflow analysis. Issues can arise because the implementation of information technology into a medical office requires a skill set that does not exist in the office prior to the introduction of the technology. Similarly, those installing such systems into medical offices need to understand how physicians think and work. Those two issues – and how wide the gap may be between them – present the challenges and problems.
The efficient use of EMRs is not simply a matter of being familiar with a computer. “The functions that an EMR needs to do,” says Dr. Tucker, “to be helpful to a physician and to benefit the patient – which is the whole point of EMRs – is very different from what most people are used to with computers.”
A number of factors add to the challenges. The EMRs of a medical practice with a single physician can be quite different from those of a large hospital. Also, different EMRs may be unable to ‘talk’ to one another, impeding transfer of patient records. This inability of different EMRs to transmit information between systems - a lack of interoperability – is a major problem with current EMR systems.
Despite the current shortcomings, EMRs offer important advantages. For the physician, records can be retrieved quickly, take up far less space, are almost never lost, are easily backed up, and can be used to measure quality of care.
For the patient, the record is available to share with other physicians, information can be updated and corrected if necessary by a periodic review through a patient portal, and the patient benefits by greater participation in his or her own care.
Patient access to EMRs, however, is underused, says Dr. Tucker. He encourages his patients to ask questions and become familiar with their EMRs. By doing so, they can become an “informed patient.”
And what about patient concerns about lack of physician attention and to chances of compromised privacy and confidentiality?
Both physicians are quick to say that if a patient thinks the physician is paying more attention to the computer than to the patient during an office visit, they should speak up and let the doctor know. As to privacy and confidentiality, Dr. Heyman says the concerns are unwarranted. “A lot of care is taken about privacy and confidentiality,” he says, “and laws are in place to protect the patient.”
Watch the above video for more discussion, including conversation about health information exchanges, how they facilitate patient care between physicians and hospitals, and why patients should become familiar with electronic medical records.