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Is It Time For Nursing Homes To Embrace Electronic Medical Records?

In a January 2009 speech, President Obama supported creating electronic health records for all Americans within five years, lowering the cost of health care, making the system more efficient, preventing medical errors, and saving money and jobs.

The term “electronic health records” does not refer to any specific system and could refer to Picture-2811 sophisticated system that allows doctors to order tests, send prescriptions, and track medical history or a much less sophisticated system. Therefore, one of the first requirements would be establishing standards for what constitutes an electronic health records system.

Only 17% of the nation’s 800,000 doctors and 8% of the nation’s 5,000 hospitals currently use electronic medical records (“EMR”). This low percentage could be attributed to cost. Electronic systems could cost tens of thousands of dollars to implement and also require annual maintenance fees.

These electronic systems also require skilled personnel to build and implement the technology. Studies indicate that the plan could cost at least $75-100 billion over the ten years that hospitals would probably need to implement the program, with the biggest costs probably going towards paying and training the labor force needed to create the network.

Electronic health records also raises questions about information privacy and security. HIPPA (Health Insurance Portability and Accountability Act) does not currently include any regulations of Web data handling and patient privacy. Already, lawmakers are pushing for safeguards to protect consumers.

Despite concerns over cost and privacy, electronic health records could help improve the quality of health care. Supporters assert that it could help eliminate redundant tests, better prepare doctors for their patients, prevent medication errors, reduce malpractice lawsuits and help patients be better-informed.

Additionally, supporters claim that a fully computerized health record system could save the heath care industry $200-300 billion a year. This could eventually slow the rise of health care premiums, which would save Americans money. However, some people do not think that a national electronic health record system will save the nation as much as President Obama asserted ($80 billion a year).

Nursing home facilities and residents might also benefit from electronic records. This is because records can be shared among health care providers. Many times, nursing home residents require hospitalization for injuries, illness, and disease.

Electronic medical records could better allow doctors and nursing home staff to share information concerning changes in physical and mental health. This could help provide more updated and personalized care of residents through electronic records of any changes in condition.

However, nursing home facilities have different information needs than hospitals. Nursing home facilities need larger records with more extensive patient histories and descriptive information focused on the long-term treatment of residents instead of acute hospital-oriented systems.

A study by the American Association of Homes and Services for the Aging (AAHSA), suggests that 43% of U.S. nursing homes maintained electronic health records, with 48% using computerized physician orders, 51% using electronic medication orders, and 41% using electronic systems to manage laboratory information.

The study also revealed that larger facilities and those that were part of a chain were more likely to use electronic systems than smaller, stand-along facilities. The greater percentages of nursing homes using electronic records suggests that implementing electronic health records in nursing homes might be an easier transition than in other health care facilities. In addition, electronic systems that allow staff to document care at the point of service delivery could improve the quality and accuracy of medical-record documentation and improve quality of care.

Resources:

New York Times: Privacy Issue Complicates Push to Link Medical Data

B-net: Electronic records in long-term care

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