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Comparison of computerized patient record CPR, electronic medical record EMR, and electronic health record EHR software

29 April, 2013 (09:12) | Computers are Magic, Data management, Data quality, EPR, hand held records, Paper Records, Standardisation | By: rupertfawdry

Michael Kauka is the CEO of Avaz Group LLC, a leading provider of patient documentation services and technology, and a vocal proponent of electronic records — by any name — and of standards of data. Here are my responses to the seven advantages of electronic records listed in his Comparison of computerized patient record CPR, electronic medical record EMR, and electronic health record EHR software. (click title to read his full article).

1. It allows for simultaneous, remote access to patient data by all authorized providers.
It only allows access to those authorised providers with reliable, constant Internet access.

 2. It facilitates faster and better communication among providers.
It only allows faster and better communication among providers with reliable, constant Internet access.

 3. It reduces errors which results in better health care and lower cost.
Possibly less error, but not yet proven. Installing and frequently upgrading paperwork is vastly less expensive and can have just as great an impact on reducing errors. An excellent example is the pre-surgery paper checklist, which has had a far greater and cheaper impact on improving patient safety worldwide than any electronic system.

 4. Electronic systems facilitate safer data and improve patient data confidentiality.
Safer data only with reliable, constant Internet access.
I have far greater confidence in the paper record that I hold in my personal possession than any electronic record accessible a) to anyone worldwide who is “authorised” to access my record and b) to any really expert computer hacker.

5. It allows for flexible data layout and therefore integrates easier with other information resources.
The layout on paper is far more flexible and can cost effectively be far more frequently improved. The most successful examples of integrated and interoperabble records in use worldwide are paper-based:  the Japanese mother-child record and the British hand-held pregnancy notes.

In theory, there may be easier electronic integration with other information resources, but only with the kind of software that is not available in most hospitals. Going through a portal into an apartment block does not mean that those accessible through the front door are an integrated community.

6. It allows for incorporation of various related electronic data, and records are may be continuously processed and updated.
This may be true in theory in a single organisation using only one system, but in practice most patients have their health and social care provided by multiple separate organisations using disparate systems that do not link to each other.

7. It makes the searching and finding of data considerably easier.
This may sometimes be the case for some types of digital data. However, give me a paper record and a collection of electronic scans of past records and I can far more easily find things like

  • the handwriting I can recognise of the most recent occasion in the continuing medical casenotes when my patient was seen by a particular previous clinician
  • the red corners indicating those pages documenting previous surgery

 

In conclusion, given all the many other advantages of paper that I have enumerated in my article, Paper fights back, I would be a very foolish budget holder who rushed to digitalise all patient records.  Paper (like the radio compared with television or bicycles compared with cars)  still has many neglected advantages. Paperless records are not in the best interest of every patient.

 

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