Now, with that being said, he added, we have to recall that the patient’s medical records belong to the patient, not to us, and the clinical interpretation is something that we, as health care professionals, provide for our patients. Sometimes these electronic communications are a little less personal.
Explore This IssueJanuary 2007
He offered a classic example of communicating a bad outcome-a new cancer diagnosis-to a patient via this medium. One might ask, is it appropriate to release a biopsy result of a malignant melanoma to a patient via a confidential electronic means without having appropriate counseling in place? Although Dr. Marple would agree that no physician would think that it is appropriate, if you’re not very careful in how you set up your systems, there can be automatic release of information that is unintentional. And if for some reason?I’m at the AMA meeting, for instance?and that information becomes prematurely released to a patient, that could be quite a catastrophic blow emotionally.?
Decisions on what kind of system to implement involve a choice of interface, acquiring certification of confidentiality, cost, and addressing the specific needs of the practice.
Dr. Marple’s general observation has been that the more complex the medical system, the more complex the EMR interfaces with other electronic information systems. Integrated patient billing, procedural coding, automated prescriptions, and radiology are only a few of the systems that can be integrated into an EMR. Interfacing is a key consideration for the growth of EMR, he said. To answer that need, the American Health Information Community (AHIC) is a certification organization, endorsed by the US Department of Health and Human Services, which certifies EMRs based on their ability to interface with other information systems.
Because this technology is in its infancy, many systems don’t communicate with each other, said Dr. Marple, and if you are a small single-specialty clinic, say maybe a private practice with just one or maybe three practitioners, your requirements for EMR are going to be different than they would be if you are a large campus with several thousand physicians. The flexibility, versatility, and all the bells and whistles vary based upon the product.
For instance, he said, his practice is completely electronic with regard to the storage of radiographic information. If I get a CT scan of a patient’s paranasal sinuses, we don’t have hard films anymore; we look that up on the computer. And each time you have something separate or you have another hospital or clinic involved, there needs to be another interface to efficiently link all that information.