Electronic Medical Record: A Balancing Act of Patient Safety, Privacy and Health Care Delivery

Abstract:With almost $35 billion appropriated in government incentives and additional funds spent in development by institutions, the concept of an electronic patient record (EPR) within integrated health information technology (HIT) systems has taken the United States by storm. However, the United Kingdom's expensive struggle to implement a seamless EPR highlights the variety of pitfalls and unforeseen complications ranging from recognizing the importance of accurately assessing EPR-related patient risks to understanding the difficulties in the exchange of information across a gradient of distinct interfaces. Furthermore, the tenuous relationship between HIT implementation and patient outcomes in the short-term draws into question the value of EPR construction costs along with the ethical and privacy issues they create. Nonetheless, experts agree that with future software advances and physician familiarization, a robust HIT will be an important asset to patient autonomy, epidemiologic and clinical research, evidence-based error reduction and the potential for cost reduction. This article seeks to review the current status of this initiative and potential pitfalls that remain.

[1]  Safely implementing health information and converging technologies. , 2008, Sentinel event alert.

[2]  Janet M. Corrigan,et al.  Key Capabilities of an Electronic Health Record System: Letter Report , 2004 .

[3]  D. Chou Health IT and Patient Safety: Building Safer Systems for Better Care , 2012 .

[4]  A. Wu,et al.  Disclosure of "nonharmful" medical errors and other events: duty to disclose. , 2012, Archives of surgery.

[5]  Robin C. Meili,et al.  Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. , 2005, Health affairs.

[6]  Calvin Franz,et al.  Cost-benefit analysis of a hospital pharmacy bar code solution. , 2007, Archives of internal medicine.

[7]  Joseph Erdos,et al.  The Veterans Affairs Healthcare System: A unique laboratory for observational and interventional research. , 2006, Medical care.

[8]  J van de Geijn,et al.  The imaging revolution and radiation oncology: use of CT, ultrasound, and NMR for localization, treatment planning and treatment delivery. , 1985, International journal of radiation oncology, biology, physics.

[9]  L. Koniaris,et al.  Should Informed Consent for Cancer Treatment Include a Discussion about Hospital Outcome Disparities? , 2008, PLoS medicine.

[10]  D. Swinglehurst,et al.  Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method. , 2009, The Milbank quarterly.

[11]  M. Kulldorff,et al.  Syndromic surveillance in public health practice, New York City. , 2004, Emerging infectious diseases.

[12]  R. Cebul,et al.  Electronic health records and quality of diabetes care. , 2011, The New England journal of medicine.

[13]  Erin R. Holmes,et al.  Factors that physicians find encouraging and discouraging about electronic prescribing: a quantitative study. , 2013, Journal of the American Medical Informatics Association : JAMIA.

[14]  C. Marano,et al.  To err is human. Building a safer health system , 2005 .

[15]  T. Pawlik,et al.  Ethics and the Law: Is There Common Ground on Informed Consent for Disparities in Hospital Outcomes? , 2011, Annals of Internal Medicine.

[16]  J. Hippisley-Cox,et al.  The electronic patient record in primary care—regression or progression? A cross sectional study , 2003, BMJ : British Medical Journal.

[17]  Sowmya R. Rao,et al.  Electronic health records in ambulatory care--a national survey of physicians. , 2008, The New England journal of medicine.

[18]  W Katherine Yih,et al.  Integrating clinical practice and public health surveillance using electronic medical record systems. , 2012, American journal of public health.

[19]  Joann G Elmore,et al.  Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead , 2011, Annals of Internal Medicine.

[20]  Liron Pantanowitz,et al.  Contemporary issues in transfusion medicine informatics , 2011, Journal of pathology informatics.

[21]  M. Uguccioni,et al.  [AHCPR/AHRQ guidelines. Agency for Health Care Policy and Research and Agency for Health Care Research and Quality]. , 2001, Italian heart journal : official journal of the Italian Federation of Cardiology.

[22]  Stephen E Lapinsky,et al.  Mobile computing in critical care. , 2007, Journal of critical care.

[23]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .