From Paperwork To Patient Care

The State of Electronic Medical Record Systems

A decade ago, the Institute of Medicine (IOM) issued a report on computer-based patient records (CPR), which laid out what is considered today to be an enduring vision for electronic patient records systems. The report identified five objectives for future systems:

• Support patient care, and improve its quality; 
• Enhance the productivity of health care professionals, and reduce administrative cost associated with health care delivery and financing; 
• Support clinical and health services research; 
• Accommodate future developments in health care technology, policy, management, and finance; and 
• Ensure patient data confidentiality.

Systems should also support clinical knowledge and decision making by incorporating “practitioner reminders and alerts, clinical decision support systems, links to bodies of medical knowledge, and other aids,” IOM said. The patient record envisioned by IOM would be comprehensive and inclusive of care delivered across all settings. The report made seven recommendations; including the adoption of the CPR as the standard for medical and all related records and the creation of a joint private-public sector institute to promote CPR development and create uniform national standards for data and security. IOM also said private and public payers should factor the cost of CPR systems into reimbursement.

While much has changed in the delivery of health care and technology capabilities in the time since IOM issued its report, experts say that the kind of CPR system described by IOM is still far from the norm in today’s marketplace.

Providers’ interest in electronic medical records has risen with their need to achieve efficiencies and cost savings, share information with other providers, and capture data that help improve and demonstrate quality of care. Nevertheless, experts say adoption of EMR systems by health and long term care providers has been limited.