Recently, Dr. Donald Lindberg, director of the National Library of Medicine, appeared on C-SPAN's Washington Journal to discuss electronic health records, their benefits, and some of the issues regarding their adoption.
What Is the Difference Between a PHR and an EHR?
- Information in an electronic health record, or EHR, is typically entered and accessed by healthcare providers. It may only have information from one healthcare provider or a group practice.
- A PHR is a record controlled by the individual and may include health information from a variety of sources, including multiple healthcare providers and the patients themselves. The PHR is separate from, and does not replace the legal record of any healthcare provider.
What is an electronic health record?
An electronic health record is a systematic collection of information about a patient's health. It contains such things as a medical history, personal statistics like age, height and weight, allergies, if any, medications taken, and more.
Most people think it would be like the chart my doctor has. But that falls very short.
What you really want is a thumb drive or a little memory stick that has your lifetime health record, so that if you need to go to the doctor or hospital, you have your blood pressure readings from five years ago.
What are the advantages of electronic health records?
Most importantly, they provide immediate access to a patient's clinical record. This helps healthcare providers make more-informed decisions about how to treat or care for someone. And they provide anonymous, secure data for important medical research.
Since health records are being compiled today by individuals, their insurance companies, medical providers, etc., would there be a main repository for them?
There really is no main repository. Obviously, the people who pay the bills have some record on billing. But that doesn't usually give enough insight into the kind of care used to help manage cases.
So, if there were a thumb drive, every time I went to a different doctor, he would plug it into a computer and my record would pop out?
That's what I recommend. Are we close to that? No. But not so far off, either. For instance, the Veterans Administration has a good electronic health records system called My HealtheVet. They don't give you a thumb drive—but they do let you call up your information and send it to your new doctor, if you wish. This makes great sense for the 35 or 40 percent of the VA's patients who get their care outside the system. Rather than drive six or seven hours to a VA hospital, they go to their own local doctor across the street and tap into My HealtheVet.
So, bring us up to speed on what kind of progress is being made with electronic health records.
We are making good progress. About 35 percent of doctors are now using some kind of computer-based patient records in their offices. They're not all interchangeable but are getting there. Thirty-five percent of the nation's hospitals have adopted electronic health records. And the federal Department of Health and Human Services (HHS) estimates 90 percent of community pharmacies were filling prescriptions electronically in 2011. That's a big deal and getting bigger.
How many Americans already have electronic health records?
As many as half of all Americans have at least a partial electronic medical record at some health institution. According to a national survey done last year, some 56 million U.S. consumers had accessed their medical information on electronic health record systems maintained by their physicians.
How is the National Library of Medicine helping with electronic health records?
The Library has been an early and enthusiastic supporter of research to advance electronic records. A special focus of ours is on the standards necessary to combine health data seamlessly from many different organizations, including funding the scientists who are advancing the field.