EHR and EMR Technology
Electronic Health Records - EHR and Electronic Medical Records - EMR
Over the last ten years there have been significant efforts made toward building a Healthcare Information Technology - HealthIT / HIT Infrastructure in the United States that allows for Secure and Reliable Exchange of Patient Information between Healthcare Providers, Medical Professionals, individual Patients, and their families.
The success of these HealthIT systems have tremendous implications for the overall health and well-being of Public Health and Population Health, allowing Healthcare providers and Patients to have a more complete understanding of their particular needs. While individual Patients are the centerpiece of these efforts, it is important to also acknowledge the impact that effective Electronic Health Record - EHR and Electronic Medical Record - EHR interoperability would have on the over all U.S. Healthcare Policy by providing Population-Level Data for National Decision Making.
Despite the seemingly obvious benefits associated with HealthIT interoperability, numerous barriers still stand in the way of its successful implementation. The complexity of standardization, cultural challenges, physician burdens and burnout, privacy and security concerns, and high costs associated with EHR, EMR and HealthIT / HIT adoption are all challenges that remain to be addressed.
In 2009, President Obama signed the American Recovery and Reinvestment Act, which sought to improve the U.S. National Healthcare Delivery System by Digitizing all Patient Records. The Health Information Technology for Economic and Clinical Health - HITECH Act was a part of this initiative that invested $35 Billion in an effort to incentivize the adoption of EHRs and EMRs by Hospitals and other Healthcare and Medical Providers, in addition to achieving Interoperability through all levels of the Healthcare System. HITECH evaluates “Meaningful Use” of EHR information based on:
- Data Capture and Sharing
- Advance Clinical Processes
- Improved Outcomes
The Health Information Technology for Economic and Clinical Health - HITECH Act has succeeded in its mission to increase utilization of EHRs and EMRs, with 96% of Hospitals and 80% of Office-Based Physicians in the U.S. having adopted a certified EHR and EMR programs, the overall effectiveness of these systems is less conclusive. Only 12% of Physicians were able to meet stage 2 of the Meaningful Use criteria and only 6% were able to share patient data with other EHR and EMR systems in 2015. In a survey of 5,000 Anesthesiologists, 49% reported unanticipated need for ongoing IT support and 61% reported difficult integration of Anesthesia Information Management Systems - AIMS with an existing EHR and EMR as major problems associated with adopting such a system. Since the passing of HITECH, the Office of the National Coordinator for Health Information Technology - ONC has outlined a 10-year vision for achieving an interoperable health IT infrastructure by 2024.
Among their list of guiding principles are customization, ease of use and access, value of care, and security of patient information.They plan to establish core technical standards and functions for Terminology, Vocabulary, Content and Format, Transport, and Security while utilizing the ONC HealthIT Certification Program to Test HealthIT products and services. “Building Block #5” in their plan also addresses their responsibility to help establish a governance mechanism for a U.S. National Health Information Network. Additionally, the document describes continued monitoring of Digital Health Information Exchange Systems to identify and address weaknesses and gaps in security.
As a Healthcare Professional in your own practice, you may already have encountered the challenges and benefits associated with EHR and EMR adoption and Regulatory Compliance. Moving forward, it will be important for you to continue to weigh the short and long term costs and benefits associated with investing in EHR and EMR interoperability, considering what is necessary and meaningful for your practice’s bottom-line while also considering the bigger picture in terms of contributing to a national U.S. National Vision for improved Patient Care through improved information access and exchange. As a Healthcare Provider and leader in your field, it is important to advocate for and empower your patients to utilize the EHR and EMR information that is available to them.