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In the very near future, all of our medical records may exist only in electronic form. President Bush, in 2004, established a new office within the U.S. Department of Health and Human Services – the Office of the National Coordinator for Health Information Technology. He has also set a goal for electronic health records for most Americans by 2014.
Electronic records have many benefits. Physicians will be able to enter notes in text or standard formats, which will lead to more complete documentation; radiology images will be captured in digital form and can be easily transmitted; and computerized order-entry systems will allow physicians to order lab testing and drugs from the pharmacy more easily. Also, the electronic records provide a simple mechanism for giving patients electronic reminders for medication allergies and prescription refills.
Another benefit will be that the patient’s complete medical history will be available to the treating physician. Currently, physicians will only have partial access to the patient’s history because of the patient moving to new areas and difficulties in obtaining full records. With an electronic record, the physician will be able to review the patient’s entire medical history, hopefully cutting down on the rate of misdiagnosis.
The use of electronic health records will also open hospitals up to greater medical malpractice liability. The risk of data loss or destruction, inaccurate data entry, or unauthorized access to medical records all pose risk problems for medical service providers. A look at the early implementation of some of the programs shows that there are many kinks to be worked out of the system. For example, one pediatric health care facility reported a rise in the mortality rate of critically ill children after the installation of a computerized prescriber order-entry system. The time required to input data into the system required that nurses and physicians spend more time away from the patients’ bedsides.
Progress has been slow towards meeting the 2014 goal. This is especially true among solo practitioners and small practices, for whom the overhead costs of electronic upgrades may be too great. Because more than half of America’s physicians practice in one or two-person offices, this is problematic for the program.
The study Health Information Technology in the United States: The Information Base for Progress shows that only about 5% of hospitals are currently using electronic health records. Karen Bell, director of the Office of Health IT Adoption believes it is unlikely that America will achieve Bush’s 2014 goal.
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