Veterans Health Administration has been using its computerized patient record system (CPRS) system for the past decade, and its doctors report that it has greatly improved the care of some eight million veterans. Physician’s prescriptions, laboratory tests, studies, consultation records, reports and progress notes from all visits by patients to any Veterans Affairs hospital are stored in each patient’s electronic record of their software application known as VISTA which is also an open source application.
With privacy constraints in place to prevent unauthorized access to electronic health records, a requirement of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 came into being. Patients can now get electronic copies of their own medical records and have them sent directly to a doctor, hospital or other designated recipient. The issue is that these different hospitals and care providers use different healthcare applications or health information systems and cannot exchange electronic information amongst each other easily. Hence, a need to integrate all the systems across the country arose so that information can be exchanged (transmitted, received and well interpreted) without any barriers, with no compromise on the privacy and confidentiality of health information.
A digital account of one’s medical records can do far more than relieve doctors’ dependence on unreliable memories. The numerous other benefits are:
• Avoid duplication of diagnostic tests. If a patient has been prescribed and tested by a physician, the test results can be can be accessed electronically by another doctor. This can sometimes be life-saving in a crisis situation. If a test has a built-in hazard, not having to repeat it enhances patient safety. Or if a test must be repeated, the doctor can see immediately whether an important change has occurred since the last test.
•Reduce medical errors. An electronic system could reduce pharmacy errors often known as prescription errors that result from misinterpretation of a doctor’s prescription, misplaced decimal points, not being aware of or warned about drug allergies and potential drug interactions in individual patients. If a drug is recalled, with an electronic record every patient on the drug can be alerted quickly.
•Make surgery safer. Automated pre-operation and post operation checklists and alerts come handy like lab tests, blood clot checks, antibiotics, bed arrangements, surgical instrument and swab count, nursing instructions. The checklists are very extensive and cannot be remembered. Once automated with reminders, these are helpful in making surgeries safer for the patients and preventive for the physicians in terms of medico legal aspects.
•Encourage better self-care. By giving patients, access to critical parts of their own health records, especially their test results, they may be “more likely to engage in healthy behaviour and more likely to bring symptoms to the attention of their doctors as the more informed the patients are, the easier care giving gets. More are the success rates and more productive are the medical visits
• Improve care of chronic illnesses. Most patients with chronic illness do not take prescribed medications or get the periodic checkups done as recommended by their doctors. An electronic system can alert the physician to noncompliance and when it is time for another office visit. Electronic reminders and prompts can help patients get better preventive care. Electronic records may also help to reduce waste in the system by identifying the most effective treatment regimens for common conditions.
•Identify the right drug and dose. Electronic records will enable doctors to choose the most effective medication and dose for each patient based on evidence based medicine practices.