Physicians should adopt electronic health records.(GUEST EDITORIAL)

Information technology can make a difference in the quality of health care. It's not the whole story; it's not a panacea, but it can help us deliver better care. The evidence that electronic health records offer benefits falls in several domains:

* Availability. Electronic health records are available 24/7. They are legible. More than one user can view them at a time, which turns out to be quite an advantage.

Data are available from remote locations to be viewed by covering physicians. I feel like I can take much better care in my own practice when I'm covering for another physician because I can look up the patient's data in less than a minute and get a pretty good sense of what's going on.

Electronic health records can be made available to others. That brings up security issues that we probably haven't worked out as well as we need to if we're going to get society to agree to make medical information available electronically on a much more wide-spread basis.

Electronic records can nearly always be found. In most health care settings that use paper records, when patients show up, the records are not there about 20% of the time.

* Enhanced communication. Medicine can be a very communication-intensive activity. That's especially true for things like delivering excellent chronic disease care. In our Partners HealthCare network, when primary care providers refer patients to see a specialist, half of the specialists do not know what the primary care provider's main question was. A third of the time, no information comes back to the primary care provider from the referral visit. Electronic records can improve that. And electronic technologies may help improve communications between providers and patients.

* Decision support. There are remarkably few published data looking at the cumulative impact of electronic decision support on costs, but some unpublished data identified an 18% reduction when decision support (such as listing the cost and appropriateness of various drugs) is delivered to providers electronically as they are prescribing.