Considering my experience in EMR, I think a good place to
start is talking EMR.
An EMR, for those who don’t know, is an electronic medical
record. An electronic medical record virtually replaces all paper patient
charts in a medical practice or hospital. Another term frequently used is an EHR
or electronic health record. EMR and EHR are technically two different things
but in common usage the terms have become synonymous. For the purpose of this
blog, I will call it an EMR and assume that an EMR and EHR are the same.
We’ll start with a simple introduction to EMR. In general electronic medical records all have
the same basic features such as places to enter/store patient demographic
profile, patient medical history, documentation for each patient visit, scheduler
or calendar, and so on. An EMR program and all the patient data contained
within can either be stored on a server (computer) in your office or it can be
web-based. A web-based EMR holds the same type of information, but the data is
stored on the software company’s servers and you access it over the internet.
There are pros and cons for both. For example, if your EMR
is stored onsite at your office, you need to take precautions against disasters
that would cause you to lose information – like flood. Web-based EMRs generally
have these precautions figured out. Web-based EMR companies use a facility
called a data center to house their servers (and all of your information). EMR
companies have multiple copies of all the information called back ups and some
EMR companies have multiple data centers which means that if one data center
has a problem – the other data center can take over and continue servicing the
customers. On the other hand, web-based isn’t perfect either. If your internet
goes down, you cannot access the patient records.
EMR became a huge topic of conversation back in 2005 when
Hurricane Katrina destroyed parts of the south. Millions of medical records
were lost in that disaster and many realized that EMR, particularly web-based,
would have prevented the loss of that information. In 2009, President Obama
signed the American Recovery and Reinvestment Act (ARRA 2009) in to law. Within
ARRA, the HITECH act dedicated billions of dollars to health care IT such as
EMR.
The manifestation of ARRA’s HITECH act is known as
Meaningful Use. In a nutshell, doctors and hospitals can be paid incentive
dollars by the government for implementing and using an EMR. If
they refused to use an EMR, government insurances like Medicare will begin cutting
their payments within 5 years. This is why so many people are talking EMR these
days.
Still, there is more to it. It is not just the fear of
natural disaster that prompted the EMR madness – it is patient wellbeing and
ever-rising healthcare costs. EMR has features that help doctors and reduce
mistakes. For example, most EMRs have features that help doctors write
prescriptions and send those prescriptions to the patient’s preferred pharmacy.
Writing a prescription on an EMR helps protect patients and keep costs down in
two big ways.
First, doctor handwriting is messy (I think they learn how
to scribble in 3rd year med school). That messy writing can result
in mistakes – either when the pharmacist fills the wrong medication or the
patient takes it incorrectly…just because no one could read it. Secondly, EMR
prescription writing software has built in warnings that will let the doctor
know if s/he is prescribing something that the patient is allergic to or if
s/he prescribes something that will have a negative interaction with the
patient’s other medications. This is a huge help to doctors.
Today, we have so
many medications on the market , no doctor can remember everything. So EMR
helps to prevent medical mistakes and thereby reduces the cost of healthcare. EMRs
are good in other ways too. They keep all of the patient’s information in one
place and it is always properly filed. This too helps to prevent medical
mistakes from missed information such as family history of certain conditions that
can be a warning sign for things to come for the patient.
So, that was a good start to what’s what with EMR. In the
next post, we will get in to some more meaty stuff and I will talk about ways
to successfully implement an EMR in a medical practice (it may sound like a no-brainer…
but it’s more challenging that most realize).
