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Patient advocates harness the potential of EMRs

March 24th, 2011

by Jacqueline O'Doherty

With the advent of EMRs and the government's stimulus benefits, doctors are slowly but surely incorporating them into their practices. The government has increased the benefit this year to encourage more physicians to jump on the bandwagon. Currently only 30 percent of primary-care physicians and 20 percent of hospitals have installed some form of electronic medical records.

The benefits to the physician are many. When a doctor uses an EMR, he immediately has access to the most recent, relevant patient history. This can help the doctor make informed decisions when treating, such as what tests need to be ordered, as well as medication management. The system can also give the doctor reminders and alerts, i.e., if a prescription drug is contraindicated. This is a huge cost saver both in time and money.

As a patient advocate, the most obvious benefit of the EMR is increased patient safety.

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Recently I escorted a senior client who lives in an assisted living facility to his PCP, one he had been seeing for many years. We left with a script for an MRI. As I'm leaving the office, script in hand, I'm thinking something is wrong here. Something was wrong, the patient has a pacemaker. There is no way he could undergo an MRI. Perhaps had that office had an EMR, the physician would have been alerted. (Though really, he should have known this.) But because the patient had a patient advocate and the error was caught, he was not inconvenienced. However, for a patient who doesn't have an advocate, this could have been a major aggravation, especially considering the arrangements that need to be made just to transport some seniors to medical appointments.

Another patient benefit of the EMR is the advantage of easier access. The EMR system allows for more rapid communication with the physician and office. If the patient has a quick question for the doctor, it can be asked and answered through email. Appointments can be made and reminders sent, prescriptions ordered and refilled using the system. Also, with access to an EMR the patient can check his own lab results, which results in better monitoring of his health, especially if the patient has a chronic condition such as diabetes. This contributes toward more patient empowerment. In fact, studies have shown the more involved patients are with their own healthcare, the better their recovery and overall health will be.

However, I would like EMR systems to allow even more access to patients. Currently, the patient still has to ask for a copy of his medical records. The patient cannot see his own history on EMRs, doctors' notes or specialists' reports. After the patient requests his own records, the office will then print them out and the patient usually has to pay for them. The medical records should be able to be accessed electronically by the patient. After all, it is the patient who is being treated, it is his health, his body, and therefore, by rights, it is his record.

While EMRs provide many benefits, there are some drawbacks. To start, there is the concern of medical identity theft and HIPAA compliance. No governing body ensures the patient information is encrypted. It is a requirement, but there is no enforcement. However, there are very hefty government fines for HIPAA violations, which in turn strongly inspire compliance with encryption. Additionally, there are some patients who are discouraged by the physician sitting behind a laptop tapping away instead of looking at them as they talk. They feel the computer screen is a barrier to the doctor/patient relationship. And lastly, there is a fear that private information, especially bad health habits, will be documented and seen by insurance companies, which will result in either higher premiums or cancellation of coverage.

Still, the trend toward EMRs should promote patient-centered care and advance collaboration between the physician and the patient. This will contribute to a less fragmented and much improved healthcare system.

Jacqueline O'Doherty is a certified patient advocate based in Peapack, N.J., with Health Care Connect, LLC.

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