What is EHR• The electronic health record (EHR) is an ever- evolving concept defined as a “systematic collection of electronic health information about individual patients and or populations” 1• The EHR record many include but is not limited to demographics, medical history, medication and allergies, laboratory reports, radiology reports, personal statistics, and billing information
Value of EHR• Electronic health records offer – the potential for quicker access to relevant information – regular updating of information – storage of data in multimedia format – increased efficiency in the provision of health care as well as managerial and clinical decision-making
EHR Benefit to Providers• Some providers and hospitals exchange information through networks or system wide connectionsExampleA Breast Care Navigator can review the chart of a patienthaving unique difficulties with treatment and determinewhat medication or services might assist that patient. It isno longer necessary for physicians to fax referrals andpatient notes to exchange information.
EHR Benefit to PatientsInformation is crucial for increasing the patientsempowerment and autonomy in relevant decision-makingprocesses, especially in malignant diseases.Example:When a patient living with a chronic disease relocates toanother state or country, he or she needs to be able tohave access to a portable medical record or one that canbe easily transferred to the new physician.
Physician Opinion on EMR• According to study results, 69% to 81% of PCPs who participated in the program• Data also showed that 71% to 77% of participating physicians vs. 29% to 58% of nonparticipating physicians thought patient satisfaction would improve patient safety 8”.• “More than half of participating physicians and most nonparticipating physicians thought that access to their notes would increase patients’ worry about their health.
Patient Opinion on EMR• A French study, published online in 2011in Cancer, a journal of the American Cancer Society, tested the idea of allowing some patient access to an organized (OMR) 6. “The study looked at the effects of each on cancer patients anxiety, quality of life and satisfaction 6”.“Of the people given access to OMR, 70.4% said theysaid with hindsight they would still choose to see it and74.8% said they did not regret having it available 6”.
Patient Opinion on EMR “Patients were globally satisfied with the OMR, which helped them to improve their understanding of the disease and eased communication with physicians and family members 13”. OMR not only allowed patients to understand their disease more thoroughly (71.1%) but also helped them discuss it with their relatives (59.2%), their general practitioner (56.3%), and their oncologist (62.3%)
The Consensus on EHR The consensus found in current research is that patient access to medical record is beneficial to both the patient and physician. As our society becomes more global and medical technology more fluid, OMR will become the standard and not the exception.
References• References• 1 Gunter T.D., Terry N.P. (2005). "The Emergence of National Electronic Health Record Architectures in the United States and Australia: Models, Costs, and Questions". J Med Internet Res 7: 1. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1550638.• 2 Warren J. Winkelman, Kevin J. Leonard, Peter G. Rossos, Patient-Perceived Usefulness of Online Electronic Medical Records: Employing Grounded Theory in the Development of Information and Communication Technologies for Use by Patients Living with Chronic Illness, Journal of the American Medical Informatics Association, Volume 12, Issue 3, May–June 2005, Pages 306- 314, ISSN 1067-5027, 10.1197/jamia.M1712. (http://www.sciencedirect.com/science/article/pii/S1067502705000241•• 3 Tayla Holman, Demand Media. iPhone Apps to Track Personal Medical Information. Retrieved on December 3, 2012.hhttp://techtips.salon.com/iphone-apps-track-personal-medical-information-5004.html.• 4 Francis H. Roger France, Control and use of health information: a doctors perspective, International Journal of Bio-Medical Computing, Volume 43, Issues 1–2, October 1996, Pages 19-25, ISSN 0020-7101, 10.1016/S0020-7101(96)01222-6. http://www.sciencedirect.com/science/article/pii/S0020710196012226)•• 5Groll RJ, Leonard KJ, Eakin J, Warde P, Bender J, Jewett MAS. Electronic surveillance of testicular cancer: understanding patient perspectives on access to electronic medical records. Journal of oncology practice / American Society of Clinical Oncology. 2009;5:177-181.••• 6 Rostom AY, Gershuny AR. Access to patient records. Lancet. 1991;338:1337-1338.••• 7 Physicians, patients disagree about shared access to medical records. Orthopedics Today. 2012;32(2):37-38. http://search.proquest.com/docview/931447853?accountid=10639.•
References• 8GravisG, Viens P, Protière C, et al. Full access to medical records does not modify anxiety in cancer patients. Cancer. 2011;117:4796-4804.•• 9Access to personal medical records increases satisfaction among new cancer patients. MD Week. 2011:843.•• 10 Chris Lancelot. Allowing patients to access their medical records is risky. GP. 2012:18.• Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care : Workshop Summary. National Academies Press; 2010.• 11 Fisher B, Britten N. Patient access to records: expectations of hospital doctors and experiences of cancer patients. The British journal of general practice : the journal of the Royal College of General Practitioners. 1993;43:52-56• 12 Milliat-Guittard L, Colin C, Charlois A, et al. Shared medical information: expectations of breast cancer patients. Gynecologic oncology. 2007;107:474-481.•• 13Francis H. Roger France, Control and use of health information: a doctors perspective, International Journal of Bio- Medical Computing, Volume 43, Issues 1–2, October 1996, Pages 19-25, ISSN 0020-7101, 10.1016/S0020- 7101(96)01222-6. http://www.sciencedirect.com/science/article/pii/S0020710196012226)•• 14 Ley P, Whitworth MA, Skilbeck CE, et al. Improving doctor-patient communication in general practice. J R Col GenPract. 1976;26:720-724.•The references list includes references included in the EHR Final Project Whitepaper.