When compared to third-world healthcare, EHRs prove to be infinitely more valuable. But that doesn’t mean EHRs can’t be improved. By Linda M. Girgis, MD, FAAFP
When compared to third-world healthcare, EHRs prove to be infinitely more valuable. But that doesn’t mean EHRs can’t be improved.
By Linda M. Girgis, MD, FAAFP
As we wait to see how Meaningful Use Stage 2 will roll out, many people are striving to make EHR systems that are truly meaningful. The government is issuing mandates to try to improve clinical outcomes and thus reduce healthcare spending. EHR vendors are trying to make systems that are more user friendly, and of course make a profit in the process. And providers are in the midst of all these changes, trying to implement them to stay up-to-date and compliant. Yet, many of us feel the technology is just not where we need it to be yet.
I recently had the opportunity to see what health IT (HIT) is like in Egypt, a third world country. It left me wondering what truly makes an EHR, or even a medical record, meaningful.
In Egypt, there simply is no HIT. In fact, for the most part, there is no such thing as a medical record a physician keeps in their possession and the patient is responsible for maintaining their records.
For example, if a patient has blood work or other test, they are given the original reports which they are to keep and no additional copies are made. When the patient needs to see a doctor, the patient brings the records to the appointment. If they are lost, they are simply lost.
Anyone can see how this system could harmful to a patient and make medical care more redundant. That being said, however, many people in Egypt do not receive medical care.
I think the answer to a meaning record lies somewhere between these Egyptian and American systems. In the U.S., there is too much push for data and I prefer to keep my focus on my patient.
I may have a patient who I know doesn’t smoke and never will because they watched their favorite uncle die from lung cancer, and I may have discussed this with the patient on many occasions. Yet, unless I check the smoking status box in the metric section of their EHR, it’s not considered meaningful. Surely the interaction is much more important than a simple check mark.
How can we make records that are meaningful and have a system for tracking meaningful use?
- Let doctors define what is meaningful.
- Relax requirements on metric reporting. For many doctors, our face-to-face treatment of the patient is much more valuable than spending time checking boxes in a medical record.
- Let the medical record go back to being a record of what is needed to provide the best care for any given patient. It has become too much of a tracking system for billing and other non-clinical uses. Too much minutia gets incorporated into the chart that needs to be filtered to get to relevant details.
- Let doctors decide what systems works best for them. We all have our own work flows and when we need refer to records later, it makes us less effective and we end up seeing fewer patients.
- We need to achieve interoperability. We are still so far away from that goal.
While having all these mandates and updates is challenging and often costly, it is still better than having no records at all.
About The Author
Linda Girgis, MD, FAAFP, is a board certified family doctor with Girgis Family Practice. Dr. Girgis studied medicine at St. George's University School of Medicine and served her residency at Sacred Heart Hospital in Allentown, PA.