The Need for Electronic Medical Records (EMR) – A Patient’s Perspective

Posted by Ram Pant on February 07, 2010

This is the first part of tri-series article. The name of the individual has been changed to protect his identity. This is so that he would freely share his experiences with us.

Frank Johnson had a heart attack in December, 2007. Frank is a highly educated professional business person aged 68.

The other day Frank went to visit his Primary Care Physician (PCP). Upon registering at the counter he was asked for the co-payment. Frank paid $10 co-payment to his doctor’s administrative assistant. She gave him a receipt – a paper copy that was electronically generated. Frank commented “Oh you folks are now using electronic records?” She confirmed to him that the office was beginning to use some electronic medical records (EMR).”

A few minutes later Frank asked the administrative assistant, “What happens when I go to New Jersey, as I do most weekdays and I am admitted to a hospital due to an emergency?” She told him that the New Jersey hospital most likely will have an EMR system that is different from the one that his PCP uses and that the two systems would not be compatible. When Frank asked, “How will they get my records?” She told Frank that she will have to fax it to them. Since Frank has decided to build an EMR system, he is very familiar with EMR related programs and problems. Her response was merely a confirmation of what Frank already knew, however, Frank was not happy with the answer.

Frank is nearing the age of 70 with a chronic heart disease and hypertension. In 2007 when he had a heart attack he went through a procedure called, “angioplasty” and had two stents embedded within each of the two of his blocked arteries. Other than this part of his health history, Frank considers himself in excellent health. He walks regularly and works out at a local gym for about two hours a day and performs yoga (breathing) about 40 minutes each day, usually 6 days a week.

In 2008, the hospital where Frank received his angioplasty treatment did not have as much electronic records as it does today. Frank wanted to make sure he had all the records associated with his treatment. Frank went to the Records Room in the basement of the hospital to pick up the records. When Frank arrived at the Records Room, the first thing he noticed was the large number of tall shelves. These tall shelves had hundreds and possibly thousands of folders with patient records. The staff who worked in the Records Room were very friendly and cooperative. They pulled out folders with Frank Patient’s name and made copies of the records he asked for. However, Frank was alerted that not all the records may be in the folder, especially if the lab test or procedure was done very recently. The whole process took about 30 minutes.

If Frank had a medical emergency in New Jersey where he went to work from Boston most weeks of the month, the doctors in New Jersey would either treat him without adequate knowledge regarding his health or would have to wait for the records from his PCP and the hospital. They would have to be faxed to the New Jersey emergency room. If the emergency took place during the weekend, the transfer of records may not be efficient or even possible. Depending on the nature of the emergency, Frank may or may not be able to tell the New Jersey medical care providers whom they could contact to get information on his medical history.

Frank lives in Cambridge, Massachusetts part of the Boston Metropolitan area. Boston has some of the most advanced high tech companies and /or their divisions. But when it comes to EMR, there is a lot more work to be done. I believe the kinds of experience Frank is encountering will be true for most of the people living in the United States.

Part 2 and Part 3 will cover the following items:

  • The records must be in electronic form
  • Must somehow be interoperable with other similar function systems
  • Situations
    • When Frank visits his PCP
    • When Frank visits his specialist
    • When Frank has an emergency e.g. an accident
    • When Frank has a multitude of services from a multitude of providers
    • During Frank's out of town trips
    • During Frank's International trips
    • Medical evacuation
    • Vacations & Travel
    • Chronic diseases
  • Engaging patients and their families
  • Allergies and drug allergies
  • Reaction between drugs
  • Improve the ability of a physician to automatically retrieve Frank's medical history and provide appropriate medical care
  • Use of the web
  • Incentive for doctors
  • Incentive for nurses at hospitals
  • Incentive for hospitals

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