For more than a decade, healthcare operations have been urged by oversight bodies and related industries to migrate from traditional paper-based methods of record keeping to paperless or electronic documentation.
As with any change in how business is conducted and services are rendered, this has presented numerous challenges to the healthcare industry. Electronic medical records, called EMRs and often interchangeably referred to as electronic health records or EHRs, have taken hold in practices and hospitals across the country. However, implementation to date has been slow and somewhat haphazard.
While healthcare operations have automated information like patient care notes, billing and scheduling, information generated from phone-based communications has remained largely relegated to the notepad method used since telecommunications became widespread more than a century ago.
An overview of electronic medical records in healthcare
Simply stated, an electronic medical record is a medical record in digital format. These can include documents like patient care notes, treatment records, billing statements, images like x-rays and MRI outputs, or any other type of patient information that is electronically created or transmitted from one authorized party to another.
Advantages of electronic records over traditional media include ease of collaboration among medical professionals, rapid transmission of patient data, ease of storage and retrieval, and centralization of patient-relevant information.
A key advantage of electronic media over other record formats is accuracy. Illegibility of notes and other information in the medical industry has long been a prevalent and troublesome issue. Standardized electronic forms and input methods reduce illegibility and the risk of medical error, contributing to more successful patient treatment outcomes.
Why adoption of electronic medical records has been slow
Unlike other industries that create extensive volumes of data, like insurance and finance, the medical profession has been slow to adopt electronic records management systems.
As of 2005, only one-quarter of primary physician offices had implemented a complete EMR solution.
There are many reasons for healthcare’s hesitancy, including:
- Interoperability challenges between systems
- Lack of standardization
- High software costs
- System complexity and installation difficulty
The US Veterans Administration’s VistA EMR system is currently the largest in the nation. Using something called Bidirectional Health Information Exchange (BHIE) protocol, the system is in use in all VA hospitals and has been targeted for integration in all Department of Defense healthcare facilities.
The protocol has been made available for download and use by non-VA-affiliated practices as well. For operations not using BHIE, there are currently more than 25 vendors of EMR systems in the US, with varying degrees of interoperability between systems.
Medical operations using the same or compatible systems experience significant benefits in billing accuracy and reduced service duplication. However, few of these systems can actually communicate with each other directly. A lack of established standards contributes to low interoperability.
At present, there are at least nine standardization bodies and eight proposed set of standards covering various aspects of healthcare operations.
Practical and operational concerns delaying EMR adoption
In addition to the high-level difficulties delaying widespread adoption of EMR systems, there also exist a host of practical, operations-level concerns that have not been adequately addressed across the board.
These concerns include, but are not limited to:
- Sharing records between offices or facilities
- Information access authorization
- Adequate hardware resources
- Set-up and maintenance costs
- Resistance to change
- Concerns of liability and information ownership
- Ensuring information is unaltered
While there appear to be many challenges to EMR adoption, healthcare organizations can use call recording to provide many of the benefits of EMRs while overcoming many of the common challenges.