In this digital age, more and more bulks of data which used to be paper-based, from library catalogs to telephone books, are digitized and stored in a central location for easy access. The idea of Emrs started about 40 years ago.
The main proponents of Emrs cite the following advantages:
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(1) The use of Ehrs supposedly reduces errors in healing records. There is no doubt that handwritten records are field to lots of human errors due to misspelling, illegibility, and differing terminologies. With the use of Emrs standardization of outpatient condition records may at last become acheivable.
(2) Paper records can be nothing else but lost. We have heard how fires, floods and other natural catastrophes destroy corporal records of many years, data which are lost forever. Digital records can be stored virtually forever and can be kept long after the corporal records are gone. Emrs also help keep records of condition data that patients tend to forget with time, i.e. Inoculations, former illnesses and medications.
(3) Emrs make condition care cost-efficient by consolidating all data in one place. Previously, paper-based records are settled in separate places and getting access to all of them takes a lot of time and money. In a systematic review, Kripalani et al. Evaluated the transportation replacement in the middle of customary care physicians and hospital-based physicians and found necessary deficits in healing data exchange. The tell recommended the use of Emrs to rule these issues and facilitate the continuity of care before, while and after hospitalization. Emrs translates into great medicine for patients. Take the example of one asthma center's contact with Emr: "A major benefit associated with Emr implementation was the increase in the whole of children who were hospitalized with an asthma exacerbation and received an asthma performance plan upon discharge. Prior to the Emr system, [only] 4% received an asthma performance plan upon discharge. After implementation of the Emr system, 58% received an asthma performance plan upon discharge."
(4) Emrs can save lives. VeriChip, advanced by VeriChip Corporation is the first one of its kind ever stylish by the Us Fda. It enables rapid identification of at-risk patients and access to their healing history, thereby enabling rapid diagnosis and medicine especially in urgency situations. Superior examples are habitancy with diabetes and/or heart problems who have high risk of collapsing and having attacks. VeriChip is also beneficial in vehicular accidents and other trauma incidents where the victims aren't capable of answering questions. In cases of large-scale catastrophes, VeriChip facilitates tracking and identification of victims. According to a coroner in Mississippi, VeriChip helped recognize victims while the Hurricane Katrina incident.
Earlier this year, Google condition was launched, an online personalized condition records service. Google condition is based on the principle that since it's the patient's healing record, the outpatient should control it, rule what should be in it, and who gets access to it. One of the features of the aid includes records from hospitals and pharmacies that are Google Health-enabled or are registered Google condition partners.
The HealthVault is another online condition data warehouse aid offered by Microsoft with features similar to Google Health. Keith Toussaint, senior agenda manager with Microsoft HealthVault recently stated " foremost hospitals like Beth Israel Deaconess healing center are nothing else but integrating their systems with both us and Google -- because some habitancy like one or the other. It's a Coke or Pepsi thing."
What are the disadvantages of Emrs? Not surprisingly, privacy proprietary advocacy groups are the main opponent of Emrs. Here is what they have to say:
(1) Emrs threaten our privacy. In this day and age when people's mantra is "I need my privacy", not many habitancy are comfortable about having their whole healing history recorded and digitized for roughly just any person to see - in other words, incursion into people's privacy. The confidentiality of doctor - outpatient connection is still sacrosanct. Besides, healing data can be used against a person in some cases - be it for a job application, assurance coverage or a college scholarship. Although it is against the law to discriminate against habitancy with illnesses and disabilities, it is a fact of life that the fitter you are, the more contentious you are in the job market. The planned incorporation of genetic data in Emrs additional adds to people's fear of incursion into their inexpressive sphere.
(2) Emrs can lead to loss of the human touch in condition care. In the process of digitalization, the interpersonal aspect in condition care may be lost. In handwritten hospital charts, doctors and other condition care practitioners may write what they think and they feel based on their personal observations in their very own words. Emr is plainly about ticking off boxes and crossing out things in electronic forms. The doctors are forced to think in categories and can seldom express a personal belief on an individual case. Because of the lack of flexibility of many electronic reporting systems, cases of misclassification of patients and their conditions have been reported.
(3) Emrs are not that efficient. Despite efforts in digitalization and standardization, Emrs are nothing else but far from being standardized and not as efficient as it is purported to be. It often happens that one clinic's Emr system is not compatible with that of a general practitioner or another clinic's system, thus belying the claim of added efficiency. In addition, not all users of Emrs are satisfied with the current state of the art. Although the objective is generally efficiency and healthcare quality, one study showed that nurses in the Netherlands are not completely satisfied with their Emr implemented in 2006-2007.
(4) Emrs are not safe and secure. Google condition and HealthVault are quick in assuring patients of the safety of their online condition accounts. access to the patient's catalogue is only potential using log ins and password. In addition, HealthVault assures that "all condition data transmitted in the middle of HealthVault servers and agenda providers' systems is encrypted" and that Microsoft does it best to use the "highest standards of security to safeguard buyer condition data from theft, loss, or damage."
However, there are cases wherein passwords and encryptions do not seem to be sufficient as data safety tools. Stories of data hacking, stolen identities and blackmail abound. Even high security databases such as those run by banks and credit institutions are often compromised. This impression was aggravated by the many well-publicized incidences of data loss or breach. A few examples are listed below:
November 26, 2007, Canada. Hackers accessed healing data on Hiv and hepatitis from a Canadian condition division computer. - September 22, 2008, Uk. The National condition aid (Nhs) reported the loss of 4 Cds in the mail containing data on 17,990 employees. - September 30, 2008, Us. The enterprise Blue Cross and Blue Shield of Louisiana confirmed breach of personal data, together with communal Security numbers, phone numbers and addresses of about 1,700 brokers. The data was accidentally attached to a general email.
In addition, there is commentary over Google condition not being a "covered entity under the condition assurance Portability and responsibility Act of 1996 and the regulations promulgated thereunder (Hipaa)" under its terms and conditions and is therefore not field to Hipaa privacy of individually identifiable condition information. The HealthVault terms and conditions do not mention Hipaa privacy laws so it is not clear what its status is about this issue.
(5) VeriChip is not for humans. It is to be staggering that although many of us are amenable to the use of Rfid chips in pets, the idea of implanting similar chips in human beings is bound to raise hackles in humans, no matter what the Us Fda says. A big opponent of the VeriChip and similar chips of its kind is the buyer advocacy group Spychip.com. In a position paper, Spychip and many advocacy and buyer awareness groups see Rfid tagging (be it on your person or on the items you buy) as a major threat to privacy and civil liberties. They see the tagging as some kind of "Big Brother" operation. another group, the No VeriChip Inside Movement, likens VeriChip as "cataloguing" humans similar to the way the Nazis have tattooed numbers on the skin of attention camp detainees. Beloved Hollywood films on privacy incursions (e.g. The Net, communal Enemy No. 1) increased additional people's paranoia about personal data.
Where do we go from here? Without doubt, we have the technology to make Emrs standardized and efficient. Google Health, Microsoft HealthVault and similar online personalized condition data accounts are enabling patients to take control of their healing records. The main issues that need to be overcome are data security, safety of privacy and gaining the trust of the patients. It doesn't seem obvious that the use of Rfid and similar tagging chips will become suitable or Beloved anytime soon. However, we live in a digital world and we cannot hold back advance indefinitely. With improved technology and data safety tools, let us hope the Emr issue will be resolved soon.
Electronic medical Records - The Pros and Cons SECURITY
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