How would you like to be able to get a list of all of your diabetic patients,
sorted by age group, sex, need for insulin, and more? What about notifying
patients who have passed a certain age whereby it's in their best interest to
receive a pneumococcal vaccine? If efforts among some of the medical
associations lead to a flexible electronic medical record, then these and
other actions may become a real possibility in the foreseeable future.
The
American Academy of Family Physicians (AAFP) announced late in January that it
had "a business plan to create a not-for-profit foundation to develop and
distribute an open-source electronic health record (EHR)." The Academy also
stated that "the plan includes partnering with other medical associations who
have expressed strong interest in helping establish and fund this foundation."
What, exactly, would this mean? Would you be able to notify appropriate
patients about the recall of certain drugs or the need for vaccines? Or be
able to come up with a list of patients who might be eligible for clinical
trials?
And how widely used would this electronic record be? Would the
participation of "other medical associations" enable its broad adoption, or
will it be limited by differences between current record systems and the new
digital record? What about privacy requirements and the need for training of
physicians and other healthcare providers in using the EHR?
In a January 22, 2003 news release, the AAFP described the qualities and
capabilities of the electronic medical record that it envisions:
"An electronic health record system is essential in increasing the quality
of health care and improving patient safety. An EHR should contain detailed
clinical notes; prescription ordering and management capability; a secure
messaging system; lab and test results reporting; evidence-based health
guidelines; secure and confidential patient access to health records; public
health reporting and tracking system; mapping to clinical and administrative
standard code sets; and the ability to interface with leading practice
management software. The open-source EHR will be designed to run on PCs,
Macintosh, Linux, UNIX, Palm and PocketPC hand-held devices."
It certainly looks like the organization has anticipated a lot of the
issues and potential problems facing an electronic record and has come out
strongly in favor of it: "Our ultimate goal is to provide an EHR that is
low-cost; has a set of simple, uniform end-user interfaces; and will support a
seamless, secure exchange of clinical data between health care providers,
organizations, institutions and patients," David C. Kibbe, MD, the AAFP's
Director of Health Information Technology, said in the news release. "The time
has come to move from theory to action on this."
Well, we agree that the time has come. But why should the historically
hampered efforts to create an electronic medical record succeed now? Perhaps
the degree of cooperation among medical associations will tell us. The sharp
focus on the ability to gather and use public-health information in the face
of possible bioterrorism should help martial resources.
The AAFP is attempting to recruit the financial participation of the
American Medical Association, the American College of Physicians-American
Society of Internal Medicine, the American Academy of Pediatrics, and the
American College of Obstetricians and Gynecologists, according to a report
published in the February 17 issue of American Medical News.
We are very interested in the progress of this effort and look forward to
keeping you abreast of the latest developments.
Let's hear from you, too. Email me your thoughts about the development of
an electronic medical record. You can reach me at
FamilyEditor@webmd.net.