Health Care Systems/Delivery 22 Apr 2009 03:43 pm

I Know You Are Bored But I Have Something Else to Say About Electronic Health Records (EHRs)

This AM, I heard part of an NPR report on a survey conducted about patients’ attitudes about EHRs.  I didn’t catch all of the report but I gathered that people were more or less skeptical that EHRs would save much money.  Frankly, I was surprised that anyone asked the general public what it thought about EHRs since few people have had any real experience with EHRs.  I would consider the results of the study more or less useless.  EHRs are fabulous (as I have discussed earlier) but are not often used in the U.S.  Who cares of they save any money, if they markedly improve patient care?  No question- setting up and using EHRs cost more than the traditional approach to medical records- mostly illegible physician notes and reams of nicely typed hospital record sheets with illegible notes and nicely typed laboratory test results.

How to use EHRs effectively

It’s nearly driving me crazy that we (physicians and patients) have not figured out how to use EHRs effectively.  Let me suggest the following: assign every person to a “medical home” or MH .  The MH could be a large hospital/clinic system with outlying clinics or whatever.  Anyway, if every person in the U.S. had a primary care doctor or nurse or whatever, who was affiliated with the MH, the primary care provider and the patient could jointly take  responsibility to update the EHR which is maintained by the MH.  Thus. at least within the MH each patient’s EHR would be easily accessed by authorized providers or the patient.

How do I know we can do this?

Most of us already have electronic records maintained at our local banks, national investiment banks (e.g., Vangard), and utility providers.  These providers have a databases that we can access if we have user names and passwords.  We can do the same with EHRs.  Finding a way for all providers to have access to all EHRs is a bit trickier but that’s far less important than the first step- a medical home for every person.  I assure all of you that we can do it.  It will be a wondrous thing.

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