from Medscape Family Medicine
Posted 02/19/2003

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.