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Electronic Medical Records
(Part 1 of 2)

Dr. Nancy Graesser: We do not have electronic medical records at this time. Eventually, we’re just going to have to.  That’s what the trend is going to be in medicine.

Christina Morgan: Pickerington Dr. Nancy Graesser is among the estimated 90 percent of small, private practice physicians in the U.S. who have yet to implement electronic medical records. Electronic records are, as she says, the trend in medicine, driven by President Bush’s announcement more than a year ago that most Americans should have an electronic medical record within 10 years. The president says such records will save lives and improve the quality of care.

But the transition from paper to computer is slow, and there are many reasons. Among them, a federal panel to decide the standards for all aspects of electronic medical records was named just four months ago. Evaluating the various systems on the market is an added burden for doctors. Another burden for doctors is the cost of buying the system; one estimate puts that between $200,000 and $250,000 for one small private practice.

Dr. Andrew Thomas is associate medical director of The Ohio State University Hospital and one of those heading up the med center’s transition to electronic records. He says major medical institutions began at least five years ago to take computers to the next level and use them for more than just reporting test results.

Dr. Andrew Thomas: The same efficiencies you get at results reporting, you also get at test scheduling. Beyond ordering now, most places are moving to electronic documentation so there’s not just one chart where everyone has written their notes or their impression or their plan for the day for the patient.

Morgan: Picture lap tops on wheels, being rolled from patient room to patient room in the hospital; computer screens at the nurses’ station—all capable of accessing a single patient’s medical record at the same time. And for anyone who’s ever wondered if they’re the only ones unable to make out the handwriting on the prescription their doctor gives them—well, you’re not alone. Reducing errors in medication and prescriptions is one of the reasons given by President Bush behind the push for electronic medical records.

Thomas: From a patient safety perspective, having legible handwriting’s important. So, if it’s typed or electronic documentation, it’s legible.

Morgan: Austin, Texas, psychiatrist Dr. Deborah Peel agrees that being able to get information more quickly and easily will improve medical care, be more efficient, and help with safety. But Peel is concerned about privacy issues and wants to know who will have access to personal medical information.

Dr. Deborah Peel: The problem is, if the patients don’t control who gets to see it, the information’s going to be used to harm them.

Morgan: Peel is the founder and chair of the Patient Privacy Rights Foundation, based in Texas. She cites a couple of examples from recent security breaches where hackers got into bank and other company records and obtained personal information including names, addresses, social security numbers on thousands of consumers. Consider the possibilities if that happened to private medical records.

Peel: Once our records are out there, it’s not like a genie you can put back in a bottle.

Morgan: Dr. Thomas contends, no system of storing records is completely safe--including paper records, the ones stuff in the colorful folders that have filled file cabinet shelves in physician offices for generations.

Thomas: Someone can walk off with a chart. Someone can photocopy things. There’s actually no security beyond a lock on a door for your medical records room.

Peel: Actually, being able to lock a door and keep paper files from being moved around or copied is currently more secure than electronic record-keeping.

Morgan: The debate is likely to continue in coming months about security and many other aspects of electronic medical records. But there’s another issue of concern to doctors: that technology might literally come between them and their patients.

Dr. Jonathan Hollister: We have an electric medical record which means I type a lot on the keyboard. That drives me nuts, in the fact that I have to sit there and type while they’re talking.

Electronic Medical Records part 2