Electronic medical records have been widespread for more than a decade. Hospitals and clinics nationally have put effort, investment and training into getting such computerized records up and running.
They were supposed to improve patient care and make prescribing safer. Patients should have their electronic records with them wherever they need care. This portability was supposed to improve efficiency, lower costs and reduce medical errors. For example, if a patient has a scan in hospital X but undergoes surgery in hospital Y, the scan along with the prior medical records should be available to the surgeon.
Are Electronic Medical Records a Giant Disappointment?
Billions of dollars have been spent converting paper records to digital formats. How well has the new system worked? Not as well as we might hope.
According a new report based on data from the American Hospital Association, less than a third of the hospitals surveyed were able to exchange electronic medical records with other institutions. Even fewer hospitals (almost one in five) actually used data from another institution in planning and providing patient care.
As a result, patients and their families needed to access records and carry them from one medical facility to another. The bottom line seems to be that hospitals are not sharing information in a usable fashion. The public may need to exert pressure on these institutions before they make the effort to truly utilize electronic medical records as originally intended.
How Patients Use Medical Records:
A five-year-old study shows that patients who have access to their medical records do better. The study, called OpenNotes, was carried out in three large health care systems in Boston, Seattle and Danville, PA. Over 100 primary care physicians and more than 13,000 of their patients participated.
Patients were offered the opportunity to review their medical records including the clinic notes their doctors wrote after every visit. Clinic notes are detailed descriptions of the encounter, including diagnosis and treatment plan.
How Patients Reacted:
Some doctors worried initially that the notes would frighten or offend patients, but very few patients reported that they were confused or upset. More than three-fourths of the participating patients said that reviewing the notes made them feel they had better control over their own health care and were more conscientious about taking their medicines. Some patients spotted mistakes in their medical records and asked to have them corrected.
Although very few patients in this country have access to their complete medical records, this study published in the Annals of Internal Medicine shows that the OpenNotes system improves patient safety. (Delbanco et al, Annals of Internal Medicine, Oct. 2, 2012)