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Paper or electronic?

Electronic health records becoming the clear choice

Created date

July 26th, 2011

No more paper-cluttered desks. No more giant repositories of charts stored in hospital basements. When it comes to health care delivery, the electronic health record (EHR) is the wave of the future. Some doctor s offices and hospitals have had EHRs in place for several years most of them using the information only within their medical practice or facility. But in 2004, the U.S. Government created the Office of the National Coordinator for Health Information Technology (ONC) to make it possible for health care providers to better manage patient care by sharing health information. And many states are getting on board Maryland in particular. In 2008, Chesapeake Regional Information Systems for our Patients (CRISP) was formed as a not-for-profit collaborative by Erickson Living, Johns Hopkins Medicine, MedStar Health, and the University of Maryland. CRISP will facilitate the exchange of data among all health care providers in Maryland. All 46 of Maryland s acute care hospitals plan to participate, and some are already exchanging information electronically. At a June press conference held at Erickson Living s Charlestown community in Catonsville, Md., Maryland Lt. Governor Anthony G. Brown announced that over 1,000 primary care physicians have agreed to implement EHRs.

Many benefits for you

EHRs mean more efficient care. Less of your time may be spent in emergency rooms or health care facilities that have your records on file. If your doctor uses EHRs, it can mean less time sitting in the waiting room. If you ve been to an emergency room or a hospital, you know that one of the first questions asked is about your medications. Under the best of circumstances, an emergency room visit or hospital stay can be disorienting, says Matt Narrett, M.D., chief medical officer for Erickson Living. You may not have your medication list with you or be able to remember everything. If providers have instant access to your records, that crucial information is immediately available. As a doctor, I ve witnessed firsthand the power of an electronic health record, Narrett says. When Vioxx was recalled in 2004, physicians at Erickson Living communities were able to immediately identify and contact all residents who were taking the drug.

Access by providers

Health information exchange (HIE) is the capability of communicating health information among your health care providers. Along with emergency rooms and hospitals, HIE can facilitate information exchange among participating doctors offices, labs, radiology centers, and other specialists. It s a waste of your time and money if you ve had to have a lab test repeated simply because a facility or specialist couldn t get your records. HIE makes it possible for a provider to quickly make the right decision by having the right information about the right patient at the right time, Narrett says.

Building confidence in the system

If people lack trust in the electronic exchange of information, it may affect their willingness to disclose necessary health facts, which could result in serious health consequences. ONC is working to ensure that electronic health information exchange is private and secure. Participants using and exchanging EHRs must follow all state and federal laws to protect your information. EHRs have processes and controls in place that allow access only by people who need that information, says Scott Byers, president and CEO of Diversified Information Technologies in Scranton, Pa. Passwords, encryption, and other safeguards all contribute to ensuring proper authorization of users. Breaches can occur, but the safest systems are regularly tested and certified by third parties. With a paper chart, you have little control over who has access, he adds. It may be sitting on a desk in a hospital where anyone could pick it up. As added privacy protection, a federal rule has been proposed that will allow you to view a list of everyone who has accessed your EHR. As opposed to paper charts, EHRs provide a trail of who has seen your records, Byers says. What about computer viruses and system crashes? If for whatever reason EHRs are wiped out on one system, they are typically backed up on another secure system so that information is not lost, Byers explains.

Opting out

You can choose not to participate in HIE. Doctors and nurses will not be able to search for your health information through the HIE to use while treating you. But your doctor or other providers can still access your EHR for lab results, radiology reports, or other data that was previously sent to them via fax, mail, or other means. In addition, public health information (such as the reporting of infectious diseases required by law) will also occur through the HIE after you ve opted out. What if you don t want your records to be electronic at all? People may not choose whether they want their records to be paper or electronic, says Michael A. Cassidy, health care law attorney at Tucker Arensberg, P.C., in Pittsburgh and author of MedLaw Blog (medlawblog.com). You d have to choose another doctor or provider. In addition, the Medicare program that offers financial incentives to doctors who adopt electronic records does not provide you with a right to opt out. You have rights under the Health Insurance Portability and Accountability Act, he adds, such as the right to obtain a copy of your records, to amend certain information, and to decide who is allowed access to your information. You can find a list of your rights on the Federal Office of Civil Rights website [www.hhs.gov/ocr/privacy]. lisa.davila@erickson.com

What those acronyms mean

EHR: electronic health record EMR: electronic medical record HIE: health information exchange HIT: health information technology HIPAA: Health Insurance Portability and Accountability Act

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