Ask the pediatrician: e-health records

Q: About 4 years ago you spoke about the new electronic medical record system in your office. Remind me what it’s about and why you thought it was an important step.

A: The electronic health record is a system of computers, computer programs, and storage hardware that is gradually replacing the paper charts that have been used for the last 50 years. Four years ago I thought paper records would be gone in two or three years, today close to 70 % of primary care group practices are using one of these systems. After four years, my own practice group is just starting to tap the potential utility of the system.

Q: How has its introduction affected what you do?

A: In my practice, all of us – the doctors and nurse practitioners, the nursing assistants and the support staff – all use computers to record all that we do. When a practitioner comes into an examining room, he or she is carrying a large laptop computer instead of a paper chart. While taking the information about our patients, we are typing that information into the computer, will record our examination, write prescriptions if necessary, order laboratory tests or immunizations, and our plan for follow-up. The old paper records are available, but rarely used even for reference. The most important task for us now is to make the record more accessible for our patients.

Q: How will that be done?

A: Right from the beginning we have been able to have computer access to all our records from home over a secure connection. The next step will be to allow each of our families to have similar access to their own records. A mom could download her child’s last physical examination for school, or forward it directly. Secure email will allow us to send home laboratory results as soon as we receive them from the lab. A new patient could complete a family history form for their family on line before the first visit, saving time for a longer visit, or add onto the family history that a relative developed diabetes, for example. With a webcam we may be able to evaluate a minor injury without a visit, saving every one time and money. Community surveys or rapid notification of the presence of a particular illness in our community could be easily accomplished. I admit to being pretty excited, and look forward to new and better ways to do my job.