Walk into any big, busy physicians' practice and ask the receptionist if an EMR system is in use. Some will say yes, but if you peer behind the desk you'll see stacks of paper, folders and films still overflowing.
Many other providers – a far greater percentage than you might imagine – have yet to even attempt the adoption of electronic record-keeping.
Healthcare has been slower than many other industry sectors to adopt this type of IT. Myriad reasons – from costs to privacy constraints – are given for the logjam.
But consumers are loath to the old way of doing things. Today they're used to accessing information electronically. Thus, rapid advances in do-it-yourself EMRs – personal healthcare records (PHR) – are evident.
Just this week, diverse groups, ranging from Google (Mountain View, California) to AARP (Washington), have endorsed a Markle Foundation (New York)-sponsored collaboration to increase consumer access to personal health information with a set of best practices for all related Internet services.
"Most people generate a lot of information at the various places they receive healthcare services," Josh Lemieux, Markle Foundation director of the personal heath technology initiative told Medical Device Daily. "If you have a medication allergy, for example, it's important not only for you to know, but all those who treat you need to know. If people can compile that information from the various places they get services – such as communicating with doctors on a secure website or reordering drugs online – they can benefit from Internet technology.
"And, if there's going to be interconnected information on the web, there must be policies to make sure that information is well-cared-for."
Technology companies, healthcare delivery systems, insurers, large employers and others are proliferating options for consumers to keep their own copies of health information and connect to health-related services online. However, this emerging space is evolving without a common set of information practices and expectations, according to Markle.
The framework developed by the Markle-operated Connecting for Health public-private collaboration includes four overviews and 14 specific technology and policy approaches for consumers to access health services, to obtain and control copies of health information about them, to authorize the sharing of their information with others, and sound privacy and security practices.
"The most important aspect for these practices is that they are implemented comprehensibly," Lemieux said. "We don't want to elevate any one practice as being higher than others. They are meant to be taken together."
He added, "When taken together, they provide a good level of facilitation to the consumer in accessing information and connecting to services. Consumers can be assured the information will be handled according to their expectations. That's the whole idea of a framework, rather than just a great execution of, say, the consent practice."
Lemieux said this framework of best practices also should be embraced by med-tech companies.
"Many devices produce a great deal of data that can be useful not only to clinicians, but directly for consumers. For example, someone with diabetes could use a glucometer and have its readings graphed for them on some type of secure Internet service," he said. "To the extent that they're able to see the information and share it with their clinicians, it could have a large impact on patient-doctor communications, adherence to treatment and setting goals for managing their conditions."
So, Lemieux added, "if device manufacturers see an opportunity to provide a consumer view to its product, then this framework could be helpful in the effort to develop practices to guide that service innovation."
The actual polices adopted are extensive, including topics on consumer consent, chain-of-trust agreements, what to do in the event of a security breach, discrimination, consumer control of their information, audit trails, portability issues, security safeguards and enforcement of policies.
Twenty documents cover the gamut of policies in detail and can be accessed at www.markle.org.
Markle also released a survey indicating that four in five U.S. adults believe that PHRs would help people:
- Check for errors in their medical records (87%).
- Track health-related expenses (87%).
- Avoid duplicated tests and procedures (86%).
- Keep their doctors informed of their health status (86%).
- Move more easily from doctor to doctor (86%).
- Manage the health of loved ones (82%).
- Get treatments tailored to health needs (81%).
- Manage their own health and lifestyle (79%).
Organizations that have adopted the new PHR policy include AARP, Aetna (Hartford, Connecticut), American Academy of Family Physicians (Leawood, Kansas), Association of Online Cancer Resources (New York), America's Health Insurance Plans (Washington), BlueCross BlueShield Association (Chicago), CapMed (Newtown, Pennsylvania), Center for Democracy and Technology (Washington), Center on Medical Record Rights and Privacy (Washington), Cisco Systems (San Antonio), Consumers Union (Yonkers, New York), Dossia (Washington), FollowMe (Sonoma, California), Google, Geisinger Health System (Danville, Pennsylvania) and Health Care For All (Boston).
Also, InterComponentWare (Wayne, Pennsylvania), Intuit (Mountain View, California), MedicAlert (Turlock, California), Microsoft (Redmond, Washington), National Breast Cancer Coalition (Washington), National Partnership for Women and Families (Washington), NewYork-Presbyterian Hospital (New York), Pacific Business Group on Health (San Francisco), Palo Alto Medical Foundation (Palo Alto, California), Partners Healthcare System (Boston), RxHub (Alexandria, Virginia), SureScripts (Alexandria, Virginia), U.S. Department of Veterans Affairs (Washington), Vanderbilt Center for Better Health (Nashville) and WebMD (New York).