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Press Start: Lead an Empowered Life as a Clinical Laboratorian

National Health Record

Published June 10, 2008 11:38 AM by Glen McDaniel

The Bush administration has said the U.S. should have a national electronic health record system (EHR) by the year 2014.

This discussion regarding the need for electronic medical records goes back several years, but was really focused in this administration when the Department of Health and Human Services (HHS) created a federal advisory board called the American Health Information Committee (AHIC) to look specifically at recommendations for establishing a national health record system.

There are many advantages, of course, such as easy access and portability of information from rural to urban sites, from small to large providers, from coast to coast. There are also challenges, such as maintaining privacy and confidentiality, interoperability (various systems talking to each other) and the individual cost especially to smaller healthcare providers. Ideally, there would also be one large platform on which the entire system is built. This is not an easy task. The UK went through this headache a few years ago.

What is truly baffling is that neither AHIC, nor the "AHIC successor organization" (abbreviated ASO) have clinical laboratory representation on their boards. Despite the fact that a large part of the medical record consists of laboratory data and there are regulatory requirements for the storage of lab data (by the Joint Commission, state, CMS, CLIA, etc.) the lab has been lumped in as "ancillary services" with pharmacy and other groups.

There is a great potential to serve patients who might, for example, be able to access their lab results through the Internet within hours, and for providers to have access to a patient's entire medical history wherever the patient presents, but the system will be lacking unless the laboratory community has input early on.

posted by Glen McDaniel
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2 comments
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Thanks for the information, Stephanie. A great benefit of electronic health records (EHRs) is that of the possibility of direct access by patients. Traditionally the medical record has been held sacrosanct and stored in huge paper volumes or computers, neither of which  is easily accessed by a typical patient; nor are patients encouraged to read theor records.

The electronic health record formats and portals will make it easier for patients to have real time access to their personal health information as well.

Many physicians are still reluctant to use electronic records for their own  order entry or documentation. They are much more comfortable retrieving information that others have placed in the record.

Medicare has launched a project to encourage physicians to utilize  electronic health records. http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52675

CMS will provide  financial incentives to physicians in 12 regions to encourage them to use EHR in their practice.  The program will be phased, with possible increased Medicare reimbursement for physicians who successfuly adopt each phase.
Glen McDaniel June 12, 2008 1:32 AM
Atlanta GA

The allergy/immunology/reference laboratory in Winston Salem where I worked in late 2006/early 2007 used the Orchard/Harvest laboratory information system, which does allow physicians to view patient test results online.  See www.orchardharvest.com.  Unfortunately, this system does not have a Blood Bank component.   Their web site claims, however, that they have "worked with a variety of blood bank and billing system vendors to develop and install fully-integrated packages to fulfill the requirements of hospitals and reference laboratories."

This company happens to be "looking for a few good MTs" who may be tired of their evening/night jobs if they're "day people,"  the "boredom" of the lab, etc.  See

http://www.orchardharvest.com/about_us/careerops/careerops.html
Stephanie Mathis, MT(ASCP), Generalist - Clinical Laboratory Scientist, Medical Staffing Network June 11, 2008 5:52 AM
Danville VA

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