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Electronic Health Records

"The question consumers are asking is, ?We use technology to pay bills and to stay in touch with family and friends, so why shouldn't providers use technology to improve the care they deliver?'" said Parmeeth Atwal of the Office of the National Coordinator for Health Information Technology, which oversees EHR implementation. "Increasingly, I think it's an expectation."

In fact, it's becoming a reality in Minnesota, North Dakota and Wisconsin, which are ahead of most states in EHR implementation. Research suggests that, when done properly, EHRs can deliver benefits to patient outcomes and an organization's bottom line. EHR implementation, however, is rife with technical complications and high startup costs.

In the future, advocates hope to make health care a keystroke away for all patients. But for some, it's already a reality, even if their doctor is eating lunch - in Estonia. Christopher Tashjian, a doctor with the Ellsworth Medical Clinic, was one of the first physicians in the country to have his practice recognized by the federal government for using electronic health records (EHRs). While checking his email in a McDonald's during a vacation in Estonia, Tashjian read an urgent message from a patient whose blood pressure medication had run out. After accessing the patient's medical record from his mobile phone, he sent off an electronic refill notice to a nearby pharmacy.

"I didn't want her to go without medication or have to come into the clinic to get one," said Tashjian. "The whole thing took about a minute to get done."

That's precisely the promise of EHRs, which digitize health records, allowing health care organizations to more easily share information among many necessary users, including patients and various health care providers, with the expectation that doing so will improve health care outcomes.

Enter the federal government, which has made heaps of money available to encourage EHR installation and help train medical staff in its use, especially those in rural or disadvantaged communities without the financial assets to purchase digital records. While this assistance appears to help medical organizations make the EHR leap, money alone cannot untangle the many transitional challenges that come with electronic health records.

Medical records and health information technicians organize and manage health information data by ensuring its quality, accuracy, accessibility, and security in both paper and electronic systems. According to the BLS, "Employment of medical records and health information technicians is expected to increase by 21 percent from 2010 to 2020, faster than the average for all occupations. The demand for health services is expected to increase as the population ages. Additional records, coupled with widespread use of electronic health records by all types of healthcare providers, should lead to an increased need for technicians to organize and manage the associated information in all areas of the healthcare industry." In May 2010, there were 179,500 Medical Records and Health Information Technicians employed in the United States.

The National Center for Health Statistics report showed that 34 percent of the nation's office-based physicians used basic but fully functional EHR systems. This includes things like patient history and demographics, clinical notes, medication and allergy lists, and computerized prescriptions. The NCHS report also noted that an additional 23 percent of physicians were using at least some EHR functions, meaning that most physicians are ankle-to-hip deep in digital records.

"That's huge. ... All points say yes to electronic health care records," said Atwal. And that's important because digital records, say advocates, will improve care by giving doctors access to a patient's history, helping them to determine necessary care and testing through best practices and ensuring that checkups are not missed. E-prescribing eliminates bad handwriting and pharmacy phone calls to double-check the scrawl.

Tashjian, one of the first doctors to meet federal guidelines for meaningful EHR use, is convinced that electronic records provide better care for patients. "You can get a longitudinal view of a patient's health history as opposed to a snapshot you often get using paper records."

Existing research on EHRs supports that view. Of the 154 peer-reviewed studies on EHRs from 2007 to 2010, 92 percent found better patient outcomes and other positive results from EHRs, according to a study done by the Office of the National Coordinator for Health Information Technology. In a New England Journal of Medicine 2008 study, physicians reported that EHRs improved patient communication, enhanced decision support with alerts and reminders, improved billing accuracy and prescribing, reduced paperwork and made referrals simpler.

"Just think of diabetics losing their limbs because of the disease and how improved care could allow them to avoid that fate," said Tashjian. In fact, a study of 27,000 diabetics in the September 2011 New England Journal of Medicine found that "EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care." And saving patients from surgery and a challenging recovery should translate into savings for patients and insurance plan sponsors, whether private employers or government.

(MFW Note: Students interested in obtaining a Post-Baccalaureate Certificate, Certificate of Completion or Transfer of Credits information, must contact the CAHIIM Accredited program they wish to enroll in regarding their institutional policies.)

For more information about medical records and health information technicians, including details about certification, visit

Source: Fedgazette, Frank Jossi, 4/18/12