EHRs: The Starting Point of Healthcare's Future

There are several definitions of electronic health records, but no matter how EHRs are defined, they are only the beginning of a bigger plan of healthcare, said Adam Greene, JD, partner at Davis Wright Tremaine.

Mr. Greene spoke at AHIMA's 2011 Legal EHR Summit in Chicago on Aug. 15, emphasizing that there are a lot of federal agencies involved in health information technology with different goals, but all have the same overarching theme of improving patient care.

Many consider EHRs the goal of meaningful use and therefore the goal of health IT. However, Mr. Greene said EHRs are a starting block that is leading toward health information exchanges and eventually a fully integrated learning healthcare system. But before a hospital or health system can even think about a HIE or the ultimate goal of being a connected healthcare system, they must implement EHRs and understand the true intent of them.

There are several different governmental regulators and players within the EHR world, and it's important for healthcare providers to understand the roles of each one, Mr. Greene said. For example, the Office of the National Coordinator for Health Information Technology only regulates EHR software, supports EHR adoption and generally tries to sow the seeds of health IT, but CMS oversees the EHR incentive programs for meaningful use while the Office of Civil Rights enforces HIPAA privacy. Discerning the different roles and goals of different agencies will help in a provider's attempt to implement its EHR, he said.

Mr. Greene also noted HIPAA is one of the biggest issues with EHRs due to patient information sitting in an electronic realm. He said there are several things to understand, most notably that having an EHR system that qualifies for meaningful use does not equate to HIPAA compliance. Meaningful use centers on improving patient care and quality of care while HIPAA revolves around the security of the patient's protected health information.

EHRs, combined with HIPAA, are providing opportunities for healthcare organizations, most notably the improved patient privacy rights, Mr. Greene said. "One of the most exciting things is the faster, less expensive means of obtaining a copy of a medical record," he said. "And it better facilitates patient amendments and more easily accounts for disclosures."

But some of those opportunities are also causing challenges for healthcare providers and physicians. Greater patient access could lead to less provider control over patient records and perhaps less trust of what patients submit. "A lot of providers have distrust toward patient-provided information," Mr. Greene said. "Will greater transparency have a chilling effect? You have to wonder if providers are less likely to write certain notes." Other challenges include being responsible for so many patient disclosures, many of which a provider may be unaware of, as well as what would happen if there was disruption of service. Mr. Greene emphasized that providers must have good plans in place if there is suddenly no availability of their EHRs.

Ultimately, the functions of an EHR are more than just patient health and business uses. Mr. Greene said research, public health and cost reductions are major facets of EHRs, which are less about the provider and more about everyone else. "Implementing health IT just for the sake of implementing health IT is not the goal. It's for the sake of improved outcomes, and now it's going to be about, 'Let's go nationwide and pull 1,000 people with this condition about what's working," he said.

Related Articles on EHRs:

Physicians' EHR Perceptions Differ Depending on Usage, Survey Finds
5 Common Misconceptions With EHRs
5 Considerations on Health Information Exchanges: What Your Hospital or Health System Needs to Know

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