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E-health records are quite the hot topic these days, what with Google and Microsoft actually teaming up to create privacy standards for health information online, and the push toward e-health records from the government.

But for Ephraim McDowell Regional Medical Center (EMRMC), in Danville, Ky., electronic health records, or electronic medical records, are almost old hat. The hospital, which is part of the larger Ephraim McDowell Health organization, began the move to electronic records as early as 2001.

The hospital has been working to implement a single electronic records system in each of its departments. Currently, nursing documentation and parts of the emergency department have gone live on that system, as has diagnostic imaging. On deck next are the computerized physician order entry system, slated for next year, and bedside medication verification soon thereafter.

EMRMC spokesperson Shawna Sharpe told IT Business Edge in a recent interview that hospital decision makers knew it was time to make the switch to electronic records because “EMR was the ‘missing link’ that [would connect] all the providers in our community.” It would coordinate and integrate the information in all Ephraim McDowell Health facilities and, as such, allow improved patient care.

Though the hospital doesn’t participate in Google Health or Microsoft’s Health Vault yet, Sharpe said it is researching the initiatives. “This is the way of the future,” she said.

Before such initiatives as Google Health or Microsoft HealthVault will be of much use to patients, health care providers like EMRMC will have to be on board, and their technology will need to support the same formats.

Think about it: How are the hospitals and doctors’ offices and insurance companies and pharmacies and other entities to which patients authorize the release of their information going to share it if they are using different technology based on different standards? And what if the personal health information platform a patient chooses — be it from Microsoft, Google or some as-yet-unknown vendor — is not compatible with the e-records systems the patient’s providers use? Worse yet, if the patient’s health care providers do not use e-health records yet, is that patient out of luck?

The Healthcare Information Technology Standards Panel (HITSP) is focused on precisely those issues. HITSP has recently released interoperability specifications addressing such things as reporting lab results, managing medication, and patient access to their own records (aka consumer empowerment).

The adjudicated national standard for personal health records such as those that Google Health and Microsoft HealthVault will compile is the Continuity of Care Document, or the CCD. Dr. John Halamka, the chairman of HITSP, who also serves as the CIO and Dean for Technology at Harvard Medical School, says CCD will allow such things as physician notes, radiology reports, pathology reports and chart summaries to be included in a user’s personal health report, along with the medical problems, allergies and medication lists that could be included in its predecessor, the Continuity of Care Record.

According to a Microsoft spokesperson, HealthVault currently supports the CCD standard. Google does not yet support CCD, but it does support the CCR. A Google spokesperson told IT Business Edge the company is “working toward supporting other interoperability standards such as CCD… Google Health is an open platform and will support several interoperability standards in the near future.”

Of course, not every health care provider or pharmacy is “digitized” quite yet. The Medicare Modernization Act mandates certain formats for e-prescribing and medication history, Halamka says, and as of January 23, 2008, the HITSP standards are required for any health care IT system acquired by the federal government, but it will take another two to three years before the private hospital community and the private doctor’s office community are on board.

For the private sector, the Certification Commission for Healthcare Information Technology (CCHIT), is working on personal health records standardization, and is expected to certify personal health record functionality in 2009. Until then, compliance with the HITSP standards is voluntary.

That’s not to say, however, that there aren’t incentives for compliance in the private sector. Halamka notes:

There is a safe harbor that allows hospitals to buy electronic health records systems for doctors in the community. But the proviso is they must be interoperable systems that are CCHIT certified. That means, “Gee, Doctor… You can get a free one, if you pick the right one.”

Until everyone is on board, both Google and Microsoft have workarounds for providers who still work from paper records. Google has integrated with online health services that will scan users’ paper records so that they can be uploaded to Google Health accounts. Similarly, a Microsoft spokesperson says that, for a small fee, users can obtain fax numbers that will connect directly to their HealthVault accounts, so that their paper records can be faxed in.

And perhaps the most important detail: Nothing will be viewed, taken from or added to a user’s personal health record without the user’s permission. “You can, at any time, delete that information, disconnect those links, or “dis-enroll” …. You are in total control of your information,” Halamka says.

About the Author:

Lora is an attorney and journalist who covers regulatory and legislative issues for IT Business Edge’s Managing Compliance Standards weekly report.

Article Source: ArticlesBase.com – Making the Move to Electronic Medical Records