EHR technology must be standardized
November 17, 2011
Throughout all of the debates and disagreements associated with healthcare reform, one idea is universal throughout the political field – each side wants to improve the quality of medicine and decrease the associated costs. Missouri is no different. One way to improve the quality of medicine is through new technology, such as electronic health records (EHR). Already in Missouri, the use of EHR is becoming more widespread through the Missouri Office of Health Information Technology (MO-HITECH) initiative. In the state, 83 percent of hospitals have some degree of EHR technology in place. No new technology though is perfect, and EHR is no exception. To make EHR a sustainable tool in Missouri’s healthcare field, it is important that the records and data are secure, but still transferable. The portability of data that EHR provides is one of the system’s highest benefits. Despite the associated implementation costs and technical hurdles, healthcare providers in the state are seeing the benefits EHR bring, such as increased efficiency and quality of care.

When discussing EHR, the terms “availability” and “transferability” are nearly synonymous. Availability refers to how easily and quickly a patient’s healthcare provider can access that patient’s records. In May 2011, when a tornado struck St. John’s Mercy Medical Center in Joplin, MO, the patients’ records there were available almost immediately following the tragedy. The hospital there had already implemented an EHR system and was not reliant on paper records. Because of the non-physical nature of the medical records, they are less susceptible to loss in similar situations and can be made available even when ordinary records would be lost, damaged, or destroyed. Transferability refers to the ease in which healthcare providers can share patient data between each other to improve care. The geographic location of a patient will no longer be an obstacle for providers since through the transferability of records, availability will be nearly instantaneous.

With transferability though, there are still concerns that can be seen as hurdles to implementation. First, transfers of patient information must be secure and confidential. Inappropriate third-party access to data could result in embarrassment, discrimination, and even risks of insurance coverage limitations. MO-HITECH encourages security systems such as authentication, authorization and auditing to keep patient records secure. Next, in order for patient records to be transferable, computer systems operating EHR software in Missouri must be interoperable. Semantic interoperability allows computer systems to interpret data fields and produce “intelligent” data usage. In order to reach this point, Missouri needs to overcome technical hurdles such as inconsistent terminology standards and take advantage of a universal interpretation of patient data. Such hurdles can be diminished by clear public policy that establishes a common vocabulary for all Missouri EHR users.

Though initial costs can be high and implementation will bring a set of standardization challenges, the benefits received from having an EHR system in Missouri will be evident quickly and felt throughout the long run making up for any early encumbrances. Transferability of EHR in Missouri will mean quicker access for healthcare providers to patient information. Quicker access leads to more efficient medicine. Quality of care will increase, and in the long run, costs will fall making the initial investment in EHR worthwhile. Already, many healthcare providers in Missouri are beginning to use EHR. It is the duty of Missouri policy makers to make the transition easy and to standardize the way EHR is used in order to promote smooth transferability.

Commentary by Maria Chappelle-Nadal, Missouri State Senator (D-14), University City, MO

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