Medical Records EMR PHR

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	Medical Records EMR PHR

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Plans For Change

Since 2005 President George W. Bush, many politicians and healthcare providers have decided to follow other countries' examples, such as the United Kingdom, Canada, Denmark and Australia and are collaborating on plans where within the next ten years all people under the care of a physician in the USA will have an electronic patient record.

A Call for Expansion of Electronic Medical Records

We are witnessing the approach of a new era! Although health care computing, IT solutions in disease management, and medical informatics is nothing new, the United States of America's health care system is still largely based on paper and ink.

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The Plan

In his January 2004 State of the Union address, President George W. Bush set the goal of ensuring most Americans had an EHR by 2014. The Markle Foundation's Connecting for Health Initiative defined the personal health record as follows: (Source: Wikipedia PHR Definition - Clinfowiki)

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"The Personal Health Record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it. PHRs offer an integrated and comprehensive view of health information, including information people generate themselves such as symptoms and medication use, information from doctors such as diagnoses and test results, and information from their pharmacies and insurance companies. Individuals access their PHRs via the Internet, using state-of-the-art security and privacy controls, at any time and from any location."

PHR and EMR

Patient-owned PHRs differ from electronic medical records (EMRs). EMRs are created and controlled largely by health care providers and their staff. Healthcare providers, such as a family practitioner, allergist, pulmonologist, etc. compiles a separate medical record for each patient. These multiple medical records can lead to an incomplete health history which can easily lead to "the right hand not knowing what the left hand is doing" situation in the medical office. It is beneficial to patients to keep their own complete, updated, and easily accessible health record. This allows them to play a more active role in their healthcare.

AHLTA, the military's electronic health record (EHR), marks a significant new era in healthcare for the Military Health System (MHS) and the nation. The Department of Defense is leading this effort by completing the implementation of AHLTA, the interoperable, globally-accessible, protected, and always available EHR for Uniformed Services members, retirees and their families by 2011. AHLTA gives healthcare providers access to data about beneficiaries' conditions, prescriptions, diagnostic tests and additional information essential to providing quality care. With real-time access to beneficiaries' information "on demand," healthcare providers are able to deliver safer and more efficient care around the globe.

Read: AHLTA – Electronic Health Records

Purpose

Connecting patients and providers electronically is going to be one of the key issues, along with managing electronic patient documents within HIPAA compliance rules, developing new mechanisms and regulations which enable patients to control access to their PHI, while securing web enabled electronic medical records and e-transactions, achieving patient satisfaction and resolving efficiency and disaster recovery issues.

What Does This Mean to the Medical Office Manager?

Inevitably, this means many working in the various settings of the health care delivering industry will have to prepare and adjust for changes to come! To implement EMR for their practice and become electronic record and practice management experts, health care providers and their staff will have to:

become aware of new laws

be ready for new ideas and solutions

carefully plan implementation and financing

learn new industry specific terminology

know future health care IT approaches

learn concepts of securely linking hospitals and physicians over the Internet

learn how to maintain and authenticate electronic signatures

improve strategies in cost effectiveness and ROI

cope with HIPAA and security issues

negotiate EMR contracts and deal with vendors

meet the challenges of developing and maintaining a physician, or group practice web site

build a network of industry collaboration and support

Privacy (Source: Wikipedia CCSR:Electronic Patient Records)

A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, 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 also.[6] Multiple access points over an open network like the internet increases possible patient data interception. In the United States, this class of information is referred to as Personal Healthcare Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws.

In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care. The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported. Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.

Medical Office Staff

Medical office staff of all specialties, which includes physicians, clinicians, nurse practitioners, physician assistants, nurses, medical office, health system and benefit managers, HIPAA and claims processing professionals, which includes the medical coders and billers, as well as clinical and administrative medical assistants and many other professionals will have to learn how to integrate new skills, vocabulary and software into their daily office routine to improve workflow and reimbursement procedures, as well as to put coding from paper to EMR into action.

Pricing

Pricing for EMR systems is highly dependent on each practice's unique needs. Because every medical practice has distinct requirements, systems usually need to be custom tailored. This is due to the majority of EMR systems being based on templates that are initially general in scope. In many cases, these templates can then be customized in co-operation with the vendor/developer to better fit a medical specialty, environment or other specified needs. There are also EMR systems available that do not use templates and therefore can be easily personalized by each individual user, for example those based on Concept Processing technology.

Read: Medicare Modernization Act (2003, MMA)