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Will Electronic Medical Records Improve Your Health or Make Medicine More Dangerous?

Posted on behalf of Goldberg Finnegan, LLC on Oct 22, 2014 in Medical Malpractice

a doctor reviewing charts with a patientTechnological advances have improved our health and our lives in many different ways. Though new technologies have created better and more effective treatments in many parts of the medical industry, medical record keeping is one area that is just beginning to utilize electronic medical records.

As more physicians and hospitals move away from traditional paper records and digitize their existing records into electronic medical records (EMRs), patients may begin to see changes which are both welcome and worrisome.

Electronic Medical Records Could Save Lives

Digitizing medical records allows physicians to see a complete, and legible, version of the patients entire medical history. Rather than searching through paper files, parts of which may be lost or in multiple locations, a doctor could have access to a patients entire history. This may allow physicians to make more complete diagnoses based on long-term symptoms and patterns, rather than relying on incomplete records and the patients memories. Also, having immediate access to full patient records and files may also prevent doctors from ordering duplicate tests and unnecessary treatments, saving the patient additional expenses and potential complications.

Patients with EMRs are now able to easily transfer their records between physicians. Bulky medical records no longer have to be copied or shipped to other locations, instead a file can be easily downloaded. Another benefit to web-based EMRs is that patients are able to update their symptoms or fill out medical forms from home before coming to a physicians office.

In all, EMRs can be a positive development for patients and their health. However, there are many possible legal issues and complications which could make the shift towards EMRs more of a Trojan horse than many patients and physicians realize.

Electronic Medical Records Could Cost Lives

In order for EMRs to benefit patients lives, health care providers need to utilize them properly.  For instance, in the recent case of Ebola in Texas, a nurse placed in one portion of the EMR that the patient was recently arrived from Africa, but the physician never saw that section of the EMR, did not ask the question himself to the patient, and discharged a man infected with Ebola.  That one additional piece of information potentially would have averted the current Ebola situation in the United States.  Whose fault is it: the nurse for not telling the doctor; the doctor for not reviewing the entire EMR; the physician for not taking a full examination of the patient; or a combination of the entire system?

[G]iven the time constraints of physicians seeing any one patient, it is unrealistic to believe that they will take the additional time to search for and read past EMRs on a patient.

That leads to another concern for medical records:  if there are multiple areas to enter information into the computer system, and the health care providers do not look into each area, then crucial information will be missed.  Also, given the time constraints of physicians seeing any one patient, it is unrealistic to believe that they will take the additional time to search for and read past EMRs on a patient.

Last, EMR systems are only as strong as the systems on which they are built.  For a physicians office, what happens if the power goes out you would have no access to your patients medical records, and an entire days patients would go without proper care? 

So, while EMRs can make patient care better, they are not the one and only solution for patient safety, which needs to be the number one goal when making changes to patient care.  Proper policies and procedures need to be implemented; care providers trained properly; care providers must act reasonably and not cut corners; and ease of access of the information.

Legal Complications with Electronic Medical Records

While doctors may have access to more information with EMRs which may allow them to make better treatment decisions, it is possible that physicians may likewise have more liability for the choices they make in treatment.  Physicians are held to a reasonable physician standard i.e. did they act reasonably given all of the information they had or should have had.  If a patients entire medical history is at a doctors fingertips (through a tablet device, for instance) then there will be little excuse for missing potential complications or drug interactions which are known to harm their patient.  It may be easier to prove a doctor liable for medical negligence if he or she did not consult the entire file prior to prescribing a course of treatment. 

Doctors and patients could also find themselves without access to records at all if there is a problem with their EMR storage provider.

Doctors and patients could also find themselves without access to records at all if there are problems with their EMR storage provider. One physicians office in Maine found themselves without access to any patient records after a billing dispute. The provider cut off all access to any records, and refused to allow the medical office into their files until their bill was paid. A similar issue occurred in Wisconsin, where Milwaukee Health Services sought a restraining order against their EMR vendor who was also refusing to provide access until its bill was paid. A judge ruled against Milwaukee Health Services, and required the company to pay its bill in order to gain access to the records. If a patient was injured because his or her doctor could not access the EMRs because they refused to pay a bill, there would almost certainly be legal liability on the part of the medical provider.

Finally, one of the main concerns for many people about EMRs is the potential for electronic records to be hacked or leaked to outside parties. Medical records are subject to strict privacy laws through HIPPA, and normally cannot be given to any outside parties without consent. However, as more hacking scandals hit the news and data from the Cloud or supposedly secure server networks is leaked, patients may not feel very confident in believing their medical records will be kept private in electronic form.

Regardless of the potential concerns with EMRs, it seems as if the technology is here to stay. The benefits of EMRs can be substantial, however, we must recognize that they come with downsides. Doctors, medical facilities, and patients will all need to work together to use EMRs to both improve doctor efficiency and treatment options while protecting patient safety and patient privacy.  Through improved communication and openness about the digitalization process, hopefully the popularity of electronic medical records will result in improved care for all patients.

 

Sources:

http://www.wsj.com/articles/ama-urges-overhaul-of-electronic-records-1410840063

http://www.bostonglobe.com/news/nation/2014/09/21/electronic-health-records-vendor-compugroup-blocks-maine-practice-from-accessing-patient-data/6ILpMv78NARDsrdU5O0T9N/story.html

http://blogs.wsj.com/experts/2014/09/18/the-promise-and-peril-of-electronic-medical-records/

http://www.scmagazine.com/more-than-10k-electronic-medical-records-compromised-at-houston-health-system/article/369842/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065078/

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