Today, it’s easy to think of electronic medical records (also known as electronic health records) as just a substitute for paper record-keeping and little else. That kind of limited view obscures the massive advances made in the nature of healthcare today, which has a rich history. A doctor in 1940, transported to today, would be shocked at the changes in healthcare due to electronic record keeping.
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Today, it’s easy to think of electronic medical records as just a substitute for paper recordkeeping and little else. That kind of limited view obscures the massive advances made in the nature of healthcare today, which has a rich history. A doctor in 1940 transported to today would be shocked at the changes in healthcare due to electronic recordkeeping, which has changed the course of medical science as we know it. The real history of electronic medical records dates back to the 1960s with problem-oriented medical records, that is medical records as we understand them today. In the 1960s, Dr. Larry Weed’s problem-oriented medical record was a breakthrough in medical recording. This innovation allowed third-party facilities to independently verify the diagnosis. But before Dr. Weed’s system, a doctor only had access to their diagnosis and the treatments they provided. Now, new doctors had access to a patient’s entire medical history. In 1972, the Regenstrief Institute develops the first EMR system, but the system fails to attract many physicians, but by the late 1980s, low-cost personal computers gave way to widespread adoption of EMRs.
Large hospitals can now provide the same level of servicing for each patient without worrying about specific doctor patient relationships. However, the technology didn’t really gain traction with smaller facilities or private practices. Regardless of their adoption rate, many practice management functions, such as billing and scheduling, were being moved to computers. And in the 1990s, the establishment of the internet made accessing health information online easier than ever, setting the stage for web-based EMRs.
In 1991, the Institute of Medicine recommended that by year 2000, every physician should be using computers to improve patient care. In 2009, President Barack Obama signs ARRA into law. The American Recovery and Reinvestment Act provided incentives for healthcare facilities who demonstrate meaningful use of electronic medical records. Today, electronic medical records are increasingly paperless. Patient medical records are more accessible than ever before, meaning that data technology is on the verge of becoming fully portable and comprehensive. Even with all the advancements in EMR technology, 70% of physicians are unhappy with their current system. Specialists especially have difficulties adapting to their EMR software due to their different needs and areas of focus. However, EMRs are becoming increasingly specialized for different areas of practice and environments, allowing you to easily streamline workflows, improve data entry and increase doctor patient interaction.
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The real history of electronic medical records begins in the 1960s with “problem-oriented” medical records – that is, medical records as we understand them today. The problem-oriented medical record was a breakthrough in medical recording. Up until this time, doctors usually recorded only their diagnosis and the treatment they provided. The ‘problem-oriented’ record was the first time that third-party facilities were able to independently verify the diagnosis. When properly implemented, this model provided a more effective means of communication among members of the healthcare team while facilitating the coordination of preventive care and maintenance.
How Portable Records Became Electronic Records
With portability, however, came the dawn of the computer era. Many of the earliest computer applications were in use at hospitals and government institutions, but very few other places. However, with the portable medical records model, large hospitals could now provide the same level of service for each patient without worries that only specific providers had knowledge of that patient. Computers, of course, really didn’t gain traction in smaller facilities and private practices until they did with the general public, so before the 1980s it was rare to see a computer being used at all in a private practice, let alone for storing medical information. Even though the portable record-keeping system had become far more commonplace, records were largely (as it is today for a declining number of practices) paper that had to be physically stored and moved.
However, business technology was advanced enough that even paper records could be sent electronically, via fax, in cases where an office needed to get in touch with a patient’s family doctor in case of urgent care. But time is often of the essence in most caregiving scenarios, and because of this, the electronic system became the standard. Medical providers realized that in every medical specialty, from urgent care to rehab, there were always unique cases that had to be resolved.
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The Internet and the Rise of the Electronic Medical Record
By the 1990s, technology had entered most medical offices and computers were being used to a limited degree for record-keeping purposes. But, it wasn’t until the age of the internet that large-scale change became far more visible. Even in its early stages, the internet became a vital tool for recording and transferring prescription histories and other medical records. Finally, within the last decade or so, most major medical systems in the developed world could easily communicate with each other when needed.
Electronic Medical Records Today and the Future
Today, medical records are increasingly paperless, although some private practices continue to use a combination of paper-based and computerized records. Patient records are more accessible than ever before with data technology becoming increasingly portable and comprehensive. Current refinements in the medical records industry are aimed at the continued specialization of systems to further streamline workflows, boost productivity and improve doctor-patient interactions.
Two major challenges, however, remain when it comes to electronic medical records. The first challenge is, of course, security. Due to the unique nature of doctor-patient privacy, questions around electronic data and privacy have been shaping both public policy and private software development. HIPAA guidelines, for example, were designed to deal with the security of patient medical records. Challenges in this area remain and both the public and private sectors are focused on strengthening the security of medical records at all access and transmission points.
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The second problem as we move from the present to the future is that many physicians are still not satisfied with their current EMR system. One of the biggest obstacles to improved EMR satisfaction lies within specialized outpatient care facilities (Occupational Medicine, Employee Health, Wound Care, and Rehab Therapy). Many of the EMRs on the market follow a simple, one-size-fits-all model. While on the surface, these generic EMRs appear to operate equally across all specialties, closer examination easily uncovers that these generic models simply fall short of expectations. One-size-fits-all EMR systems often create more problems than they solve for specialized care facilities. However, there is hope. Specialty-based EMRs bridge the gap between software and practitioner through effective design, optimized workflows, and practice-specific documentation.
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