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Emergency Back-up Plan for Slow EHR Implementation: Us
| April 5, 2010
We can be excused for thinking that our doctors have a computer program that allows them to track our health history and forward relevant record to a specialist to whom they are referring us. After all, when I walk in to my provider's office, the receptionist is sitting in front of a computer; plus my doctor makes use of other computerized devices for measuring my temperature, blood pressure, weight and heart rhythms.
For years my credit card company has tracked me down to make sure that I and my card are still together when I charge the first espresso of my foreign vacation, and Amazon and NetFlix have both long generated new offerings based on their intimate knowledge of my book-buying and movie-ordering history. So how hard could it be to keep my medical record organized electronically in a form that could help my doctor remember our interactions and allow her to forward relevant information to another doctor?
Well, it's harder than we think, apparently.
According to 2009 preliminary results from CDC's National Ambulatory Medical Care Survey , about 20.5% of U.S. physicians reported having basic EHR systems, and 6.3% reported having a fully functional system. Other studies show that only 1.5% of hospitals have a comprehensive EHR system in place.
It is interesting that so many physicians seem to be strongly resisting the effort by the Obama Administration to set standards and provide incentives for physicians to implement electronic health records that are useful, transferrable and secure. For example, over 80 physician organizations representing most of the major professional organizations and state medical societies signed on to a 35-page letter describing how the many barriers physicians will encounter while implementing electronic health records will prevent them from accepting Medicare and Medicaid assignment
Now I am agnostic about the validity of those claims. But I am certain about what the lack of widely available interoperable electronic health records means for me and other patients.
If we are going to avoid the current risks of medical errors and lack of care coordination among different delivery sites and different providers that results from inaccurate or absent information, we can't afford to wait until our physicians sort this out: we patients and caregivers must become the keepers and conveyers of our own medical records.
Is it possible to ask every physician who does not make use of an electronic medical records system to explain to us that because of the barriers he or she faces in implementing one, our best chance of making sure our medical records are available is for us to maintain our own records and hand-carry them to each appointment?
And would it also be possible for our providers to make it easy for us to do this by making test results, vaccination records and key notes available so that we can, on our laptop or in a shoebox, make sure that our records are accurate, current, portable and can be present when they are needed?
We may not readily assume responsibility for our own medical records'but at least we should have the opportunity to protect ourselves.
More Blog Posts by Jessie Gruman
Jessie C. Gruman, PhD is president and founder of the Center for Advancing Health. Her experiences as a patient — having been diagnosed with five life-threatening illnesses — inform her perspective as an author, advocate and lead contributor to the Prepared Patient Blog. Her book AfterShock helps patients navigate their way through the health care system following a serious or life-threatening diagnosis. You can follow her on Twitter @JessieGruman. | More about Jessie Gruman
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April 5, 2010 at 3:52 PM
My daughter has MRSA, and while I could go into the offhand, creepy treatment she has gotten in the ER (only the initial visit was kind and helpful), she wanted to follow the PA that cut into her wound to his emergency room assignment at another hosp over the weekend, but was told they would not have any of her records. She could, of course, have been seen there, but would have been starting over except for that PA. I am mixed on having one big record that the feds can see, but nothing seems to be compatible between institutions...which in this case was a nuisance. I guess dealing with the medical establishment is now a pain and will be getting worse.
|Connie Davis says|
April 6, 2010 at 8:30 AM
One freely available way of carrying some of your own health records is www.howsyourhealth.org. (HYH) You can answer a health questionnaire and record your own medical history. You can print it or save it to your computer or a jump drive to carry with you. If your physician/NP/PA participates in HYH you will get a code that matches up your data (anonymously) to your MD/NP/PA so they get feedback on how they are doing providing care and can get an understanding of the needs of the patients they serve. If you choose to, you can email your results to your MD/NP/PA. This method has been widely used by many throughout the US and we are now piloting it in BC.
April 9, 2010 at 10:36 AM
I have written about this, too--but I wonder if I took a memory stick into one of our podunky ERs, if they would do anything with it. Do you have a take on this? It takes 6 hrs for a doctor to come in as it is.
April 9, 2010 at 10:38 AM
PS I ask this because once when I requested a record of an ER visit from a hospital they gave me a disk with the history on it. My doctor's office looked at it blankly and handed it back.
April 9, 2010 at 11:18 AM
We are talking about this at the New York Times.
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