Everyone probably realizes by now that I love to read first hand experiences with EMR and EHR. I guess I’ve always loved stories and I’ve always loved to tell stories, so maybe that’s where that comes from. I guess this is why I loved Katherine Rourke’s post called “Would An EMR Have Improved My Son’s ED Care?” on the Hospital EMR and EHR website. It’s a great read if you love first hand experiences with EMR as I do.

Katherine does raise a challenging question, “Does an EMR improve patient care?”

In past presentations, I’ve always put the idea of an EMR improving patient care under the “possible EHR benefits.” (See a full list of EMR and EHR Benefits) As many things in life there’s a big “Depends!” that is the b est answer to that question. The answer to this question depends on what kind of care you were offering previously, the type of care you offer, the EMR you chose, the features you chose to employ in that EMR, the match between your workflow and the EMR workflow, and I’m sure another dozen other depends as well.

What’s more important to point out is that an EMR can improve patient care. I certainly can’t guarantee that an EMR will improve patient care in your clinic, but I’ve seen many cases where it has improved patient care and so I know it’s possible. The biggest determining factor in whether an EMR will improve patient care in your clinic is your desire to have it do so.

Many times in life, you get what you want. Do you want an EMR to improve your patient care? Or were you too focused on wanting to get the EHR Incentive money? Not that these and other benefits are mutually exclusive, but the focus of your EHR implementation matters a lot. Make sure you’re focused on the right things and your EMR selection and implementation will go 100 times better. In fact, it will even improve patient care if you want it to.

While HIT insiders and pundits take it as a given that installing an EMR benefits everyone, it’s not so obvious to some gun-shy practices.   Even researchers like myself switch gears every time I try to explain what EMR technology can do.

That’s why I was pleased to come across the following blog item. This piece offers a very solid list of twelve reasons why EMRs can improve patient care, including the following (in no particular order of importance):

*  EMRs are less subject to physical damage and data loss than paper records, as the data can be backed up and stored elsewhere.

* EMRs reduce wait times for patients, as there’s no need to wait for a receptionist to pull a chart and get it to the treating clinician.

* Data stored in an EMR can be sent more easily to other clinicians than when using a paper record. (This may not be true if the EMR is balky — in reality, only an HIE can really fulfill this promise — but it should be true.)

* EMRs that integrate e-prescribing reduce the risk that a  patient will get the wrong drug/dose, as poorly-written prescriptions stop being an issue.

The piece also notes that with an EMR in place, practices should have neater workspaces to use (no paper accumulation) and have better access to care documentation during emergencies.

Now, to inject a note of skepticism here, it’s unlikely that most practices will realize all of these benefits quickly.

In particular, I highly doubt that practices will be able to cut back on paper quickly, since if nothing else, they’ll have to do something with the reams of letters and faxes that other providers send to them, and possibly images as well. (It’s no coincidence that the author works for an HIT consulting firm.)

Still, it’s good to see a well-rounded wrap-up of how EMRs might support day-to-day patient care.  It’s easy to assume that everyone understands EMRs’ potential — but I’d argue that many clinicians are just beginning to draw these conclusions.

That being said, would you add any clinical care benefits to our blogger’s list? Would you disagree with any of his conclusions?

Healthcare InformationWeek has an article that discusses the challenges of EMR security and privacy. A lot of the stuff is nothing new to those of us in the healthcare space. Although, it’s interesting to see how they summarize things like the goal to be full EMR by 2014 and the EMR stimulus money.

However, the article did include these interesting stats on the number of breaches that happen in healthcare and the focus IT managers put on privacy and data security in healthcare.

Healthcare providers and other health businesses aren’t stepping up to protect privacy, according to a recent study. Some 80% of healthcare organizations have experienced at least one incident of lost or stolen health information in the past year, according to the study, released this month from security management company LogLogic and the Ponemon Institute, which conducts privacy and information management research.

Also, some 70% of IT managers surveyed said senior management doesn’t view privacy and data security as a priority, and 53% say their organizations don’t take appropriate steps to protect patient privacy. Less than half judge their existing security measures as “effective or very effective.”

I was surprised that 80% of organizations have had an incident of lost or stolen health information. However, I honestly don’t see this ever changing. Stuff happens even with the very best efforts.

I did also like this quote of John Halamka about the challenge of balancing privacy and security with sharing the patient information to provide better patient care.

“You want to protect the patient’s preferences for confidentiality,” Halamka said. But you also need to get information where it’s needed. “If you come to the emergency department in a coma, and you have a record that includes psychiatric treatment, HIV, drug abuse, and other information, would you share part of it or all of it? My preference would be all of it, with the hope that emergency workers would use it discreetly, to save my life.” But other people may feel differently, Halamka said, and healthcare policy needs to serve all those needs.

I’m a little surprised that Halamka has had psychiatric treatment, HIV and drug abuse. He’s doing quite well considering that history. (that’s sarcasm in case you didn’t note it) His history aside, I’m totally with him on wanting that information available as well. However, he’s totally correct that many people wouldn’t want that stuff shared. Enabling the consumer to make that decision though is a hard nut to crack.