EMR Systems

Healthcare, along with construction, education, and retail are ranked as being the
slowest adopters of Information Technology (IT), according to EMR Experts.
Computerised information systems have not achieved the same degree of
penetration in healthcare as that seen in other sectors such as finance, transport
and the manufacturing and retail industries.

An electronic medical record (EMR) is usually a computerized legal medical record created in
an organization that delivers care, such as a hospital and doctor's surgery. Electronic
medical records tend to be a part of a local stand-alone health information system that
allows storage, retrieval and manipulation of records.

In the US, one-quarter of office-based physicians reported using fully or partially electronic
medical record systems (EMR) in 2005. However, less than 10 percent of these physicians
actually have a "complete EMR system", with all four basic functions deemed minimally
necessary for a full EMR: computerized orders for prescriptions, computerized orders for
tests, reporting of test results, and physician notes.

If medical records were electronic, prescriptions would be more legible and could be filled
more accurately. Public health officials could spot disease outbreaks quickly and track their
spread. Doctors could speedily check a patient's record, helping to avoid wasteful repetition
of tests and minimize harmful drug interactions and other errors, which kill an estimated
98,000 people a year in the US.

Not only can EMR systems make it easier to treat patients, they can protect patient
confidentiality as they show "audit trails", showing who has looked at the files, the LA Times
reported back in 2006.

Yet, a major concern is adequate confidentiality of the individual records being managed
electronically. According to the LA Times report, roughly 150 people (from doctors and
nurses to technicians and billing clerks) have access to at least part of a patient's records
during a hospitalization, and 600,000 payers, providers and other entities that handle
providers' billing data have some access.

When President Obama designated $19.5 billion to expand the use of electronic medical
records, former House speaker Newt Gingrich (R-Ga.) said it was one of only "two good
things" in February's stimulus package. Under the stimulus program, hospitals and
physicians can claim millions of dollars for IT purchases, and will be penalized if they do not
go digital by 2015. Obama has said the changes will save billions and will minimize
medication errors.

Despite Obama wanting to expand the use of EMR's, there has been problems reported by
the use of them. According to the Washington Post, more than one in five hospital
medication errors reported last year - 27,969 out of 133,662 - were caused at least partly
by computers, according to data submitted by 379 hospitals to Quantros Inc., a healthcare
information company. Paper-based errors caused 10,954 errors, the data showed.

As well as that, some have reported that productivity has gone down.

"It's been a complete nightmare," said Steve Chabala, an emergency room physician at St.
Mary Mercy Hospital in Livonia, Mich., which switched to electronic records three years ago.
"I can't see my patients because I'm at a screen entering data."
Last year, his department found that physicians spent nearly five of every 10 hours on a
computer, he said. "I sit down and log on to a computer 60 times every shift. Physician
productivity and satisfaction have fallen off a cliff."

The future

In the US, the development of standards for EMR interoperability is at the forefront of the
national healthcare agenda. EMRs, while an important factor in interoperability, are not a
critical first step to sharing data between practicing physicians, pharmacies and hospitals.
Many physicians currently have computerized practice management systems that can be
used in conjunction with health information exchange (HIE), allowing for first steps in
sharing patient information (lab results, public health reporting) which are necessary for
timely, patient-centred and portable care.

The argument for EMR's seems like it's going to be another issue to plague the healthcare
reform.