Even More About Electronic Health Records (EHRs)

The subject of EHRs must be a really “hot” topic these days since in almost any medical journal or newspaper I pick up there is something about EHRs.  For example, yesterday’s New York Times (Saturday, April 18, 2009) had an article in the “Patient Money” section entitled “Some caveats about keeping your own electronic health records,” written by Walecia Konrad.  The article was a well written general discussion about  patient-controlled EHRs (these are often called personal EHRs).  It was clear from the article that just as U.S. hospitals are a long way from wide-spread use of EHRs, the same is true for personal EHRs.  In fact, the article contained an interview with Dr. Ashish Jha, who was the lead author of the New England Journal of Medicine article I wrote about yesterday.  That study surveyed U.S. acute care hospitals and found that fewer than 10% were using EHRs in any meaningful way and fewer than 2% that switched over entirely to EHRs.  In the newspaper article, there was even a photo of Dr. Jha (it’s always nice to put a face with a name), as well as a quote: “we’ve got a long way to go before we get there,” referring to universal use of patient-controlled online health records that can be shared with physicians.

Anyway, I am yet to be convinced that patients should bother just yet with trying to put together a detailed EHR.  It would be much easier if we had a real health care system and in that system every patient had a primary care provider (physician or nurse practitioner or whomever) who had a comprehensive EHR on every patient in the practice.  Of course that EHR would need to have data from specialists the patient might have seen, results of all laboratory tests performed, and so forth.  In this way, all the patient would need is easy access to his or her EHR, which eliminates the need for the patient to do much of anything to have a personal EHR.  I believe that in the long run, that’s how EMRs will work.  In the short run, everything is up in the air, largely blown about by the $17 billion the U.S. Congress just budgeted to stimulate the development of EHRs.

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