Electronic medical Records - The Pros and Cons

Blue Cross Health Insurance Plans - Electronic medical Records - The Pros and Cons

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In this digital age, more and more bulks of information 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.

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The main proponents of Emrs cite the following advantages:

(1) The use of Ehrs supposedly reduces errors in medical records. There is no doubt that handwritten records are branch to lots of human errors due to misspelling, illegibility, and differing terminologies. With the use of Emrs standardization of sick person condition records may at last come to be acheivable.

(2) Paper records can be categorically 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 information that patients tend to forget with time, i.e. Inoculations, old illnesses and medications.

(3) Emrs make condition care cost-efficient by consolidating all data in one place. Previously, paper-based records are located in different places and getting access to all of them takes a lot of time and money. In a systematic review, Kripalani et al. Evaluated the communication replacement between primary care physicians and hospital-based physicians and found considerable deficits in medical information exchange. The report recommended the use of Emrs to decide these issues and facilitate the continuity of care before, while and after hospitalization. Emrs translates into better rehabilitation for patients. Take the example of one asthma center's taste with Emr: "A major benefit connected with Emr implementation was the increase in the whole of children who were hospitalized with an asthma exacerbation and received an asthma operation plan upon discharge. Prior to the Emr system, [only] 4% received an asthma operation plan upon discharge. After implementation of the Emr system, 58% received an asthma operation plan upon discharge."

(4) Emrs can save lives. VeriChip, developed by VeriChip Corporation is the first one of its kind ever popular ,favorite by the Us Fda. It enables rapid identification of at-risk patients and access to their medical history, thereby enabling rapid determination and rehabilitation especially in crisis situations. Classic examples are citizen with diabetes and/or heart problems who have high risk of collapsing and having attacks. VeriChip is also useful 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. Agreeing to a coroner in Mississippi, VeriChip helped identify 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 medical record, the sick person should control it, decide what should be in it, and who gets access to it. One of the features of the assistance includes records from hospitals and pharmacies that are Google Health-enabled or are registered Google condition partners.

The HealthVault is another online condition information warehouse assistance offered by Microsoft with features similar to Google Health. Keith Toussaint, senior schedule owner with Microsoft HealthVault recently stated " prominent hospitals like Beth Israel Deaconess medical town are categorically integrating their systems with both us and Google -- because some citizen like one or the other. It's a Coke or Pepsi thing."

What are the disadvantages of Emrs? Not surprisingly, privacy possession 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 citizen are comfortable about having their entire medical history recorded and digitized for approximately just any person to see - in other words, incursion into people's privacy. The confidentiality of physician - sick person connection is still sacrosanct. Besides, medical data can be used against a man in some cases - be it for a job application, assurance coverage or a college scholarship. Although it is against the law to discriminate against citizen 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 further adds to people's fear of incursion into their hidden 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 naturally 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 understanding on an private 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 categorically far from being standardized and not as effective as it is purported to be. It often happens that one clinic's Emr principles 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 in general efficiency and healthcare quality, one study showed that nurses in the Netherlands are not wholly 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 protection of their online condition accounts. access to the patient's account is only inherent using log ins and password. In addition, HealthVault assures that "all condition information transmitted between HealthVault servers and schedule providers' systems is encrypted" and that Microsoft does it best to use the "highest standards of protection to safeguard consumer condition information from theft, loss, or damage."

However, there are cases wherein passwords and encryptions do not seem to be adequate as data protection tools. Stories of data hacking, stolen identities and blackmail abound. Even high protection databases such as those run by banks and prestige 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 medical information on Hiv and hepatitis from a Canadian condition group computer. - September 22, 2008, Uk. The National condition assistance (Nhs) reported the loss of 4 Cds in the mail containing information on 17,990 employees. - September 30, 2008, Us. The business Blue Cross and Blue Shield of Louisiana confirmed breach of personal data, including social protection numbers, phone numbers and addresses of about 1,700 brokers. The data was accidentally attached to a general email.

In addition, there is annotation over Google condition not being a "covered entity under the condition assurance Portability and accountability Act of 1996 and the regulations promulgated thereunder (Hipaa)" under its terms and conditions and is therefore not branch 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 regarding this issue.

(5) VeriChip is not for humans. It is to be unbelievable 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 consumer advocacy group Spychip.com. In a position paper, Spychip and many advocacy and consumer awareness groups see Rfid tagging (be it on your man 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 attentiveness camp detainees. Favorite Hollywood films on privacy incursions (e.g. The Net, social Enemy No. 1) increased further 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 information accounts are enabling patients to take control of their medical records. The main issues that need to be overcome are data security, protection of privacy and gaining the reliance of the patients. It doesn't seem clear that the use of Rfid and similar tagging chips will come to be thorough or Favorite anytime soon. However, we live in a digital world and we cannot hold back progress indefinitely. With improved technology and data protection tools, let us hope the Emr issue will be resolved soon.

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