On the Record
With all the prep for next week's American Health Information Management Association Convention and Exhibit and our HIM Team of the Year coverage (Yes, we have a winner!), I've been neglecting my Google Alerts. Well, I found some time this morning to browse the news on electronic health records (EHRs), and there's a whole lot of good, bad and ugly.
Boston researchers have identified yet another benefit of EHRs: flagging domestic abuse. According to the Boston Globe, the researchers examined 6 years of hospital admissions and emergency room visits, looking for cases that involved risk factors like injuries, poisoning and alcoholism for women and depression and psychosis for men. Using that data, researchers identified domestic abuse victims an average 2 years before the diagnosis was listed in a patient's chart, the report said.
The researchers developed an EHR-friendly module that could alert physicians when signs point to abuse. The screening tool could also be adapted to assess risk for other conditions, like diabetes and depression, all in the effort to provide what researchers called "predictive medicine." It doesn't guarantee a problem exists, but puts providers on alert in case one develops.
While the Boston study is all about keeping tabs on records, some patients may be looking to wipe theirs clean. The American Recovery and Reinvestment Act requires providers to participate in a national HIT network, but patients will determine which information doctors can access. Abortions and sexually transmitted diseases (STD), for example, could be withheld, according to Rep. Patrick Kennedy. "This is totally going to be up to the individual," he told CNS News.
Given the social stigmas, it's understandable patients could want to keep such conditions under wraps, but all politics aside, is that best for delivery of care? Coordination of care depends on having complete information-just ask a cardiologist waiting for hospital discharge notes-so if something as critical as an STD is left off the record, doctors might not deliver the most effective care.
And speaking of coordination, take a look at this communication debacle. The Tennessee Department of Human Services (DHS) is attempting to save face after a caseworker sent the wrong fax number to 100 providers who submit information for disability determination. So where did all of those social security numbers and private health details go? To a solar-powered fan manufacturer in Indiana, where the owner told reporters he's been receiving medical records for years.
Tennessee DHS owned up to the recent mix-ups, but said past problems are due to the department and manufacturer having similar fax numbers. The department's fax number is owned by the Social Security Administration, so Tennessee DHS can't change it, the report said.
One IT buff said it's a case for EHRs. Sure, digital systems would eliminate fax flubs, but it's probably just as easy to misdirect information with the click of a mouse. (C'mon, like you haven't sent an e-mail to the wrong person?) And let's face it, making all those operations paperless would be pretty darn expensive.
How expensive? Well, North Shore-Long Island Jewish (LIJ) Health System is spending a whopping $400 million to install inpatient EHRs at its 13 hospitals and partially subsidize costs for community and hospital-based physicians who go electronic. I frequented a North Shore-LIJ hospital as a kid (OK, not so much frequented as was born there and got stitches in the emergency room), so it's nice to know family members will be getting high quality care--or at least that's the hope. And with that multi-million dollar price tag, I'm sure executives are looking for a big payoff.