What are the concerns of practitioners and patients on Electronic Medical Records?

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Information Technology in a Global Society

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What are the concerns of practitioners and patients on Electronic Medical Records?

(Health)

November, 2009

Tran Thai Bao Khanh

The British International School

Vietnam

News Item:

Technology News, 2009, Building a Better Health Data Network

[April, 2009]

Presentation of the issue

In the United States of America, many medical centers have begun to have electronic records for the patients. The almost immediate access gives the doctors the advantage in saving time and the undoubtedly understanding of the patients’ medical histories.

According to Dr. James E. Sanders from the article “Building a Better Health Data Network” I just read recently on TechNewsWorld, the electronic medical records system helps him to flawlessly treat any patients who from different regions in different states, however, when the patients are not in the system, hours, or even days, are spent on searching for crucial information. Medical practitioners all around the country are encouraged to have the EMR (Electronic Medical Records) systems installed as they help save a huge amount of time, decrease errors yet reduce the cost. Developers at different regions need to corporate to agree on how the information is presented uniformly in all the systems throughout the nation and once the system is completely built, a patient who travels all around the US or changes places to live can still get the best care at any clinic or hospital without filling medical forms again and again.

However, there is a concern on the security of the access and the exchange of the private information, as well as the loss of data. Apparently, new threats of the EMRs’ security are a concern. Anyone can access to the data system with relevant passwords. Even people can hack into any accounts as long as the system is connected to the internet. Paper records can be copied, scanned or faxed but the occasions rarely happened. Besides that, the security also means the loss of data due to technical problems or losing hard drives.

The IT Background of the issue

The rapid developments of technology like fast processors, large hard drives, and even the widespread of the internet have allowed the installment of the EMR systems more feasible.

As soon as the patients or the practitioners logs in into their own accounts, they can see all the medical histories. EMR is the abbreviation of Electronic Medical Record, an electronic system of recording patients’ data and storing medical information. An EMR can store almost every piece of information like X-rays, treatment histories, test results, prescription records, medical lab or progress reports, etc., ...

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The IT Background of the issue

The rapid developments of technology like fast processors, large hard drives, and even the widespread of the internet have allowed the installment of the EMR systems more feasible.

As soon as the patients or the practitioners logs in into their own accounts, they can see all the medical histories. EMR is the abbreviation of Electronic Medical Record, an electronic system of recording patients’ data and storing medical information. An EMR can store almost every piece of information like X-rays, treatment histories, test results, prescription records, medical lab or progress reports, etc., requiring different technical standards. The space of a hard drive for EMR data storing is usually very big. These pictures below are a few examples of the many forms within an EMR system:

There are certain technical standards needed in order to build a complete EMR like the CDR – a real-time transaction-processing database that stores the patients’ information. The picture below is an example. The form is displayed on the screen; this is the very first step when the technicians or nurses follow the format using the keyboard to type in the patient’s information. For further identity and recognition, a webcam is used to take picture of the patient’s face. The information is then saved into the system, for later examination, practitioners can search for the patients’ names alphabetically.

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Additionally, for hospitals or large group practice, a link for the network is required so that all the computers can access to the EMR. Therefore, XML – a set of codes that can format the documents electronically, is used to integrate between networks of the patients’ record on the internet. Moreover, DICOM (the picture below is an example of how the whole medical system works)– Digital Imaging and Communications in Medicines, which is a basic program in the EMR system, includes a file format definition and a network communications protocol being responsible for transmitting medical information and images. A DICOM file can be interchanged between the two systems that are able to receive the medical data in DICOM format.

Those are some of the most essential applications needed in order for an EMR to work, when the symptoms are diagnosed, prescriptions and tests of a patient carried out by a doctor are saved within an EMR system and usually exchanged and stored by the applications mentioned above, and other doctors can view it easily by the access to the network locally or nationally by the internet access.

The impact of the issue

Having an electronic records system benefits the doctors and patients in many ways. The internet storage would be huge and therefore has the ability to store as much information as more than ten times on papers. The immediate access to the medical histories saves a lot of time and gives the doctors the chance to improve the quality and take a good care of their patients; even though they just meet each other for the first time. There is no need to spend time on finding or organizing the patient’s document of medical information, since we just need to type out the name of the patient and the system will automatically search for it and the screen soon displays all the histories that it saves. Besides that, as far as what I have been researching on the internet, almost all of the websites, which are related to EMR, stated clearly that the electronic medical records help the U.S. to save a large sum of money, the level of spending from the National health Accounts reduced. Around $31 billion is saved for private buyers while the Medicare would have the potential savings of about $23 billion per year. Others savings also come from the errors of treatment that can lead to other expenses. (Wapedia, 2009)

However, the disadvantage may come along. Security is a big problem with EMRs as they being developed nationally leads to the problems of many more people can view the records. Patients have been concerned about their personal data being read, stolen, changed, etc. by hackers or any strangers who intend to do something appalling to the patients, the negative consequences like are inevitable. There is also the confidential issue of the patients who are afraid of listing out their sensitive symptoms for the public to see, causing the doctors and patients’ work uncompromised. (Computerworld Security, 2009)

A Solution to a problem arising from the issue

Many patients are worried about the security of the data and privacy of their information. To answer this question, there have been legislations restricting the access of specifics to the personal data; only doctors, nurses and billing clerks can have the access to system. However, there are certain levels of access and rules, in which only doctors can have the ultimate access to all the documents not nurses, and billing clerks can only have the access to the contact information and other personal expenses not the medical histories. Institutions and providers have made it strict for the EMR network authentication, privacy and safety requirements. Additionally, the EMR systems always have back-ups; hence, there is hardly any loss or damage of one’s data.

Word Count: 1000 words

Bibliography

Twiddy, David, 10/04/09, “Building a Better Health Data Network”

Mick, Michael & Conners, Susan, “Ethical Issues of Medical Records on the Internet”
MAFP, 09/22-23/2006, “Making an EMR Work”
Mertz, Jon, 11/10/2006, “EMR, HER, CCR … How Do They Work?
Mehlman, Maxwell, October 1999, “Emerging Issues: The Privacy of Medical Records”
Mertz, Jon, 16/10/2006, “The Road to EMR Interoperability“
Mendoza, Elaine, October 2003, “Health Care Industry”
Aware, 2008, “Standard-Compliant Streaming of Images in Electronic Health Records”
Nanji, Feisal, 19/02/2009, “Security Challenges of Electronic Medical Records”
Securosis, 19/05/2009, “Security Requirements for Electronic Medical Records”
Wikipedia, 09/11/2009, “Electronic medical record”
Silk Information Systems, 2008, “Our Approach to EMR”
Advanced Medical Billing, “Software Screenshots”
Alibaba.com, “DICOM 3.0”
DICOMNetOffice, “DICOMNetOffice”