Electronic health record
[4] Combining multiple types of clinical data from the system's health records has helped clinicians identify and stratify chronically ill patients.
It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date,[5] accurate and legible.
The EMR, in contrast, is the patient record created by providers for specific encounters in hospitals and ambulatory environments and can serve as a data source for an EHR.
In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.
[23][24][25] Challenges with sharing the electronic health record with patients includes a risk of increased confusion or anxiety if a person does not understand or cannot contextualize the testing results.
via securely sharing anonymized patient treatments, medical history and individual outcomes (including by common primary care physicians).
"[85][86] The U.S. National Institute of Standards and Technology of the Department of Commerce studied usability in 2011 and lists a number of specific issues that have been reported by health care workers.
As mobile systems become more prevalent, practices will need comprehensive policies that govern security measures and patient privacy regulations.
[93] When a health facility has documented their workflow and chosen their software solution they must then consider the hardware and supporting device infrastructure for the end users.
The success of eHealth interventions is largely dependent on the ability of the adopter to fully understand workflow and anticipate potential clinical processes prior to implementations.
[95][96][97] A 2008 Sentinel Event Alert from the U.S. Joint Commission, the organization that accredits American hospitals to provide healthcare services, states, 'As health information technology (HIT) and 'converging technologies'—the interrelationship between medical devices and HIT—are increasingly adopted by health care organizations, users must be mindful of the safety risks and preventable adverse events that these implementations can create or perpetuate.
"[101][102] A 2010 Board Position Paper by the American Medical Informatics Association (AMIA) contains recommendations on EHR-related patient safety, transparency, ethics education for purchasers and users, adoption of best practices, and re-examination of regulation of electronic health applications.
[103] Beyond concrete issues such as conflicts of interest and privacy concerns, questions have been raised about the ways in which the physician-patient relationship would be affected by an electronic intermediary.
[citation needed] The other way to mitigate the detriment to physician productivity is to hire scribes to work alongside medical practitioners, which is almost never financially viable.
[109] In the United States, Great Britain, and Germany, the concept of a national centralized server model of healthcare data has been poorly received.
[113] The Health Insurance Portability and Accountability Act (HIPAA) has developed a framework to mitigate the harm of these threats that is comprehensive but not so specific as to limit the options of healthcare professionals who may have access to different technology.
A challenge to this practice has been raised as being a violation of Stark rules that prohibit hospitals from preferentially assisting community healthcare providers.
[124] In 2006, however, exceptions to the Stark rule were enacted to allow hospitals to furnish software and training to community providers, mostly removing this legal obstacle.
[134] At the same time they reported negative effects in communication, increased overtime, and missing records when a non-customized EMR system was utilized.
Mandl et al. have noted that "choices about the structure and ownership of these records will have profound impact on the accessibility and privacy of patient information.
"[139] The required length of storage of an individual electronic health record will depend on national and state regulations, which are subject to change over time.
Again, overall requirements for the design and security of the system and its archive will vary and must function under ethical and legal principles specific to the time and place.
[citation needed] While it is currently unknown precisely how long EHRs will be preserved, it is certain that length of time will exceed the average shelf-life of paper records.
One proposed solution to the challenge of long-term accessibility and usability of data by future systems is to standardize information fields in a time-invariant way, such as with XML language.
Olhede and Peterson report that "the basic XML-format has undergone preliminary testing in Europe by a Spri project and been found suitable for EU purposes.
The European Commission is supporting moves to facilitate cross-border interoperability of e-health systems and to remove potential legal hurdles, as in the project www.epsos.eu/.
Radiologists will be able to serve multiple health care facilities and read and report across large geographical areas, thus balancing workloads.
With the newly enacted Directive 2011/24/EU on patients' rights in cross-border healthcare due for implementation by 2013, it is inevitable that a centralised European health record system will become a reality even before 2020.
[149] The Lloyd George envelope digitisation project is the aim to have all paper copies of all historic patient data transferred onto computer systems.
and further the letter states: "Before synthetic patient identities become a public health problem, the legitimate EHR market might benefit from applying Turing Test-like techniques to ensure greater data reliability and diagnostic value.
