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COPYRIGHT 2003 Thomson Financial Inc.
This is the second in an occasional Perspectives series on electronic health records. The first appeared in our Oct. 20 issue.
Electronic-health-record initiatives and products are emerging at health plans and hospitals around the country. And you would be hard pressed to find anyone who doesn't want medicine to take advantage of computers for accessing, storing, communicating, and analyzing clinical information, at least in theory. Money is the most frequently mentioned obstacle to implementing EHR at every site of health-care delivery. But those in the trenches point to more daunting hurdles.
* Two words: digital, interoperable. First off, it's important that people understand what a useful EHR is and is not, say many experts. To accomplish its goals, an EHR must be both digital and interoperable, most agree.
What does "digital" mean in this context? The short answer: no scans.
A system in which physicians share data via electronically transmitted scanned patient records, charts, or images may look like a working EHR. But it doesn't fit the bill because, among other things, its data points can't be disaggregated and manipulated to reveal trends, which are at the heart of diagnosis.
"There are a number of [EHRs] today that are not actionable," says Intermountain Healthcare Chief Information Officer Carvel Whiting, who superintends Intermountain's extensive computerization initiatives. "You need everything digital in separate fields. You can't just take a scan. People can see that, but it's not actionable."
Scanned records or images transmitted electronically don't allow a system to generate a graph or chart of a specific set of lab results that can show a patient's changing condition over time. Scanned records...
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