Our world has been radically transformed by digital technology – smartphones, laptops and web-enabled devices have transformed our daily lives and the way we communicate. Medicine is also an information rich enterprise. To provide effective patient care and seamless flow of information within digital care infrastructure, EHRs (Electronic Health Record) are created.
An EHR is a digital version of patient’s paper chart. It is real time, patient centric records that make information available instantly and securely to authorised users. Even though many healthcare systems are moving from paper-based records to electronic medical records (EMR), it can be a huge change when it happens for your healthcare delivery system.
Some technological aspects dealing with EHR are:
• Compliant with various standards like ICD10, DICOM, ASTM and HL7.
• Include functionality for CPOE, laboratory, imaging and medical devices interface
• Could be cloud-based or client server based
• Secured, confidential and accessible to authorised person only
With an objective to introduce a uniform standard-based system for creation and maintenance of electronic health records, the Ministry of health and family welfare has issued the “EHR standarads 2016” for adoption in IT systems by healthcare institutions across the country.
EMRs do not just transmit information they compute it but manipulate the information in a way that make a difference and provides better quality of treatment. It provides automated functionalities that help improving patient care and safety such as
• Drug-drug interaction checks
• Drug-allergy interaction checks
• Automated checks for problems whenever a new medication is prescribed and alerts the clinician to potential conflicts
Information gathered by a primary care provider and recorded in an EHR tells a clinician in the emergency department about a patient’s life-threatening allergy, and emergency staff can adjust care appropriately, even if the patient is unconscious.
Major benefits of EMRs:
I. Efficient, coordinated care: Clinicians access to medical records across department saves time, provides transparency
II. Patient advocacy: Patient access their own medical information online
III. Timely updates: Medical charts are updated in real time
Today a lot of health IT companies is coming out with different EHR software that is customised with innovative techniques. The data generated via EHR are analysed and new strategies are being made specific to the conditions, thus leveraging the data to provide effective patient care.
For example, a new scheme of IHIP (Integrated health information platform) is approved by the government recently to centralize the EHR of patients for better analysis. AIIMS – New Delhi is the first amongst government hospital targeted for the pilot study.
Recently, Max healthcare hospital, Apollo group has implemented EHR and achieved stage 6 level of EMR model. Sankara Nethralaya (SN) and Tata consulting services (TCS) offers EHR and EMR suits to other hospitals also.
• EHR/EMR adoption rates are higher than ever at around 87 percent.
• When asked by Medical Economics which task they wish EHR provided more efficiently, 36 percent of healthcare providers cited documentation issues.
• In a Deloitte survey of physicians, 35 percent of respondents reported lack of user-friendliness as the largest problem with their EHR system.
• Experts think that the greatest improvements in EHR will improve user friendliness, accessibility, regulation and standardization.
• Big changes like AI and the entrance of tech giants into the space are on the horizon for the healthcare industry.
The challenges of communicating such a major effort will require you to manage several issues, including:
Impact on multiple audiences: One needs to keep almost everyone in the loop, from executives who want constant updates, physicians who don’t have time to provide feedback on the EMR, and patients who need to learn a new system.
• EHR can amplify inefficiency, incorrect process and incomplete data input If proper process design and functioning of system is not done.
• It is intensive in capital cost, labour and time.
• It needs absolute top management support for implementation and they need to work together at many different levels.
• Doctors are reluctant to use technologies like these.
• Private hospitals are more reluctant to exchange EMR with EHR because the data remain in same hospital and is referenced that patient will visit again to the same hospital.
• If hospital is using client server based EHR there is risk of security of data.
So EMRs have come a long way, but they still have a long way to go. What does electronic medical records’ future hold? Soon, EMR will be focused on the model of value-based care as the industry switches over from volume-based models.
Humans are going to continue to get sick and need care, so we’re going to need to be taken care of. Here are some electronic medical records trends to keep an eye out for in the coming years.
(Disclaimer: Writer is Neha Lal, Sr General Manager – Operations & HR, GCS Medical College, Hospital & Research Centre, Ahmedabad. Views expressed are a personal opinion.)