What You Need to Know About Your Electronic Health Record

Laura Shin

electronic health recordsIf you’ve ever switched doctors, then you’ve probably endured the brain-racking process of trying to remember the names and dates of your last vaccinations, illnesses, medications and medical procedures.

You might have even wondered whether a record of your medical history should exist so past and future doctors would be able to quickly see pertinent facts about your health.

Well, electronic health records (EHRs) could be a solution to this problem.

EHRs are still relatively new in doctors’ offices: According to a December report by the Centers for Disease Control, more than a quarter of doctors are still using paper, and most doctors who are using EHRs are relatively new at it—two years ago, only a third of doctors used EHRs. And adopting them is different from really taking advantage of them: Only one in six doctors is using them to a significant extent, even though doing so makes a physician eligible for a $44,000 bonus (spread out over five years) from the federal government.

Whether or not your doctors are currently using them, you should know more about how best to use them for your own personal health, because they are likely to be adopted by more physicians. By 2015, doctors not using EHRs will be subject to penalties.

Before you get excited about the day when you won’t have to remember your health history, we have to warn you that many EHRs don’t yet communicate with each other, so, at the moment, we’re still stuck with having to inform new doctors of our medical histories.

We’ll give you the rundown on the potential benefits of EHRs, how they work right now and what you should do in the meantime to organize your personal health record.

The Push to Create Electronic Health Records

While EHRs could make it unnecessary for you to remember all the important information in your medical history, they also promise a whole host of other benefits—many of them that could improve your treatment and, by extension, your health. They could:

  • Make it easier for different health care providers to coordinate care, thereby increasing the continuity of your care no matter which doctor or facility you are visiting and improving physician decision-making—especially in emergency situations
  • Help prevent medical errors and the duplication of treatments and procedures
  • Cut administrative costs and clerical errors
  • Help collect standardized data that could be used in research for medical techniques, technologies and drugs
  • Give patients and their families more complete information that can help inform their health decisions
  • Warn doctors and patients of potentially dangerous drug interactions
  • Ensure that pharmacists provide the proper dosage of a drug that was prescribed

Indeed, studies of some health care providers that have adopted EHRs already show not only these benefits but also cost savings. For instance, researchers at the Center for IT Leadership found that the Department of Veterans Affairs, which was an early adopter of EHRs, found that the savings just from preventing adverse drug reactions totaled $4.64 billion.

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  • dn27

    I wish this story addressed some of the reasons why having fluid personal health history is controversial. Who has access to your health records? Can insurance companies use that info for determining premiums? How secure is a national health care database?

  • serious concern

    For now, I would just urge people to look very closely at the information in your medical records and verify accuracy. Then read the forms they slide in front of you that gives them permission to share this information. And think it through. Think about what is at stake

    Who enters your information? Often someone with limited training and understanding of the language, diagnoses, etc.

    What do they enter? How accurate is it? Seriously, does your doctor listen to you? What does he write down? Is it true, complete, and accurate? Who translates his handwritting and enters it into the computer? Who verifies that the entry is complete and accurate? Do you even know what is being written about you? Permanently recorded?Has it occurred to you that your busy physician may not be listening very well or that their notes are often written with their own agendas in mind (ie medical coding, billing, CYA, etc).
    And while your medical record information may be borderline worthless if not outright bogus as far as you are concerned, do you realize that the information really does belong to you ( although you may run up against significat resistance and barriers if you try to get access to it)

    Does everything in your medical history even need to be shared? Have you considered who it may be shared with?

    I will tell you what I have experienced: diagnoses that don’t exist, information that is plain wrong. Or worse. I have had hospitals share incorrect with those who had no business with access to the information.
    Consider this example: you are a passenger in your friends car when another car runs into you. You go to the hospital to rule out any broken ribs. Now your hospital sends not only the bill but every diagnosis ever entered on your chart to the auto insurance provider. Does the auto insurance company have a right to know that you had cancer, used to smoke, perhaps suffered depression after the loss of a child…..you get the picture.

    HIPPA sounds great, but do you read those documents they make you sign allowing them to share your information with others? It seems the one with the least knowledge of what is your private information is most often :YOU.

    Maybe your life is an open book, but I believe people should have a right choose the information they want to share.
    From what I can see, it seems to me that while those who are in the money end of things will be better served, the patient is likely to benefit the least from electronic health records system.
    But then again, I’ve long given up the notion that our healthcare system exists for the benefit of patients anyway. It seems to have taken on a self perpetuating life of its own, and the focus is on dollars not humans. But that is another conversation.

    • msk

      It sounds like your negative experience and fear of sharing confidential medical information spur from your hospital’s organizational decisions, not their electronic medical system. Paper or electronic, those past diagnoses could have been shared with the insurance company.

      I strongly disagree with your notion that electronic medical records have little concern for the patient. The purpose for patient portals like MyChart are to empower patients to take ownership of their health as well as their medical records. In addition to displaying medical history, allergies, medications, lab results, etc, these online patient records have the ability for patients to interact with their records. A diabetic, for example, could enter their blood sugar readings daily. Any deviations from the norm will alert their PCP, and the patient can recieve swift and efficient care.

      Another incredible benefit of EHR’s is the opportunity for research. Recently, a newborn baby born with AIDS was cured. Whether or not this was an impossibly rare case or a cure for AIDS still requires extensive research. In the US, only 200 babies a year are born with aids. Electronic Medical Records and database warehouses may hold the secret to allowing researchers to gain enough of a patient base to better understand these cases. Identifying patient information is always stripped of the patient record before researches get their hands on it.

      I hope this helps shed a new light on EHR’s. Although there are undoubtedly hurdles along the way, the benefits far outweigh the risks.

    • You’re right, Serious Concern

      You’re right, Serious Concern. Even if you have nothing to hide, that doesn’t mean you want to grant access to all your medical records, to every entity that’s remotely qualified to access them, for the rest of your life … and that’s even if the records are accurate (which is indeed a long shot). You can be sure your history “can and will be used against you” in pricing for health insurance and life insurance premiums, in determinations of creditworthiness, and in background checks for employment.

  • Wilhelmina

    Like anything else, digitized records is a double-edged sword, and those concerned have good reason to be. Having worked in the industry for five years now I can’t imagine enduring a hospital stay without a detailed run down of what they charged me for and why.

    Regardless, electronic medical records are a reality. This is happening. And there will be breaches of confidentiality. Employees will foolishly leave laptops with your information in their car. Doctors will leave their sessions open and others will view their patients. Patients will use insecure passwords like password1 to secure their data online, and they will be accessed by others.

    The silver lining is that we are all still riding this wave – it hasn’t yet crested and solidified. There is a vibrant and passionate community setting up standards and workshopping solutions that address patients, providers, and the infrastructure that houses us both. Like with anything else it is much easier to find the holes in what others are trying to build then help raise the barn.