Information Technology Reference
In-Depth Information
Chapter 4
Clinical Practice
In this chapter we'll see how the technical concepts discussed in
Chapter 3
can be
combined into a workable electronic health record system in the typical provider
practice. I'll use as examples some systems I consider to have state-of-the-art
approaches to electronic records. As we discussed in
Chapter 2
, there are around
1,000 commercial electronic health record systems and I'm certainly not familiar
with the substantial majority of them. I have selected carefully but that doesn't mean
that the systems I profi le are the only - or even the best - products available, nor can
I promise that they will be the best choice for any particular provider office.
Why Electronic Records?
Care Coordination:
This is so obvious that it's often overlooked. Paper records are
physical objects that can be in only one place at a time. They can be copied, mailed
and faxed but these are not efficient processes and the records are often not avail-
able when needed at a remote location. Electronic records, when connected to a
health information exchange, can be immediately available when and where needed,
assuming proper procedures are in place to protect their confidentiality and to assure
they are only being accessed by authorized personnel.
Safety:
Paper records can also be hard to read. In its 1999 report
To Err is Human:
Building a Safer Health System
the IOM estimated that avoidable medical errors
contributed annually to 44,000—98,000 deaths in US hospitals. [
1
] Hospital-based
errors were reported as the eighth leading cause of death nationwide, ahead of breast
cancer, AIDS, and motor-vehicle accidents. These findings have received wide
attention in the mass media as well as in medical publications. In the April 2011
issue of
Health Affairs
David Classen
et al
report that as many as one in three
patients in the US encounters a medical error during a hospital stay. [
2
] The Agency
for Health Quality and Research (AHRQ) even posts a tip sheet to help patients
avoid medical errors when in the hospital. [
3
]
