FEED-BACK.COM E-ZINE

July / August 2008
Volume 11 Issue 4

Electronic Health Records

Improved technology solutions have supported strong growth in the electronic health records market.  Health information that is integrated into a networked system can be accessed by qualified providers across a wide spectrum of facilities (e.g., clinics, hospitals, labs, pharmacies, etc.). In theory, electronic health records offer continuity of care and cost savings for patients and providers.

Historical Perspectives

A medical record documents patient care and medical history in a systematic way. Information is typically gathered and stored by health care providers in file folder or digital formats. In general, the terms "electronic medical records" (EMR) and "electronic health records" (EHR) are used interchangeably, although EHR may be the broader classification within the health informatics field. Personal health records include material that is maintained by patients.[1] 

Benefits & Disadvantages

Ideally, electronic health records enable health care providers to coordinate a patient's care among different practitioners (primary care physician, specialists, etc.) in various locations (clinic, office, hospital, etc.). Benefits include:

Because EHRs are intensely personal documents, confidentiality is a critical issue. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) set extensive national standards for use, disclosure, and protection of an individual's health information. For example, paperwork that explains HIPAA requirements is routinely distributed to individuals who receive medical care in the United States.

Establishing an EHR system requires an enterprise-wide commitment by staff and large capital investments. The steps for transitioning to digital records (e.g., automated data insertion, copying and pasting, transcription, etc.) also demonstrate the ease with which information can be added to electronic health records. [2] 

A study conducted by researchers at the Veterans Affairs Puget Sound Health Care System examined a random sampling of 1,479 patients whose records were appended during a one-month period (167,076 progress notes).  Records were analyzed for copying using a stringent methodology.  In conclusion, the authors suggested that electronic medical record systems could be improved through re-engineering to avoid duplication and enhance monitoring of copied material. Policies and procedures can be implemented to emphasize accurate transferring of information over high productivity (e.g., ethical electronic documentation training, requiring attribution when copied text is re-used, etc.). [3]

The Market

ChannelWeb has published an extensive review of competitors that participate in the electronic medical records market, along with estimates of the U.S. installed base and revenue forecasts.  While computerized appointment and billing systems are well-established in physician practices, the number of offices with ten or fewer doctors that use EMRs is estimated to be between 20,000 and 40,000.  According to International Data Corporation, the "electronic health record information technology" market is growing 15% annually and may be worth close to $5.0 billion by 2015.[4] Extrapolation using these estimates suggests a market value of approximately $1.8 billion in 2008.

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[1]  US Department of Health & Human Services, OCR Privacy Brief (pdf).
[2]   Wikipedia.
[3]   "Are Electronic Medical Records Trustworthy", AMIA Ann. Symp. Proc., 2003; pp. 269 - 273. (Available online at: www.pubmedcentral.nih.gov).
[4]   "Health-Care VARs Win With Electronic Medical Records Solutions", ChannelWeb, July 3, 2008