The Future of Electronic Health Records
President Barack Obama has made universal adoption of electronic health records, or EHRs, a goal of his administration's health care policy as a way to improve the quality of care, minimize medical errors, and increase efficiencies. Patients with chronic diseases, such as diabetes, have the most frequent contact with the health care system and, as a result, potentially the most to gain.
As I begrudgingly have to admit, I have been a physician long enough to have witnessed technology's major effects on health care delivery. For one thing, thankfully, my colleagues no longer must struggle to decipher my poor penmanship. Nor does the transfer of health records now require the help of the U.S. Postal Service or even "next-day delivery." Yet, as with most technology, the true benefits do not always meet the hype. The integration of clinical and research platforms has been a focus of my new position at the University of South Florida. This has highlighted for me the limitations of our current systems.
For EHRs to live up to their potential, they must be accessible to every health care provider in the country and, ideally, the world. This means that all the systems must be able to "talk" to one another. A doctor, nurse, or therapist you see for an illness while vacationing in Europe should be able to access your records entered at a doctor's office or hospital here in the United States. Plus, all of the information entered by your provider should be quickly available through searches.
Currently, most of the information that is entered electronically is stored as whole documents (think of photographs). It is not possible to jump directly to specific information to track changes such as your response to treatment. Nor can one easily look at the response of a large group of patients to the same therapy. Instead, anyone seeking that information must read through each note entered by health care providers. This dramatically limits the EHR's utility.
Hospital systems and doctors in private practices have historically been slow to adopt EHRs. But the 2009 economic stimulus package and the 2010 health care reform law include incentives to adopt electronic health records. That has stimulated EHR developers to create systems and interested providers in adopting them.
The challenge now is to do it right, carefully considering how EHR systems will be used and what we'd like them to accomplish. Hastily adopting substandard systems would limit their ultimate utility, at a great loss to us all. As educated consumers, we must encourage both our health care providers and elected officials to ensure that the nation's investment in electronic health records is a sound one. The systems we adopt must meet our expectations and realize their potential to improve the lives of people with diabetes and the health of our nation.