Electronic Medical Record Utilization in Personalized Healthcare Management

In last week’s post, we discussed about personalized medicine, the systematic changes it brings to disease diagnosis and management and technologies including genome sequencing and interpretation platform that enable customized medicine practice come true.  However, if observe closer, one would find that there’s one missing link here: how all the personalized information of patient is transferred from genomics sequencing and interpretation entities to doctors hands? Given the amount of data and information involved in DNA sequencing, it’s very unlikely to be transformed in physical paper form. Moreover, under comprehensive healthcare management approach mentioned in the last post, how do doctors manage patients’ personalized records, both in terms of disease history and relevant medical compliance information? All of those questions point to another hot topic in healthcare industry nowadays—Electronic Medical Record (EMR).

Opposed to paper-based healthcare record, EMR stands for a computer-based system that would contain every patient's clinical history, laboratory results, and treatments records. From the very natural points, we can easily list up several advantages of such digitalized process of patients’ record: Reducing redundancy in record-keeping efforts and improved operational efficiency; reducing cost of physical paper storage required by relevant laws; improving accuracy and reducing malpractice disputation and related lawsuits; and generally better facilitate preventive medical care and long-period therapy of the chronically diseases.

Little disagreement will arise to the statement that electronic information transformation is the least surprising technology we are using nowadays. Retail Chains scan the bar code of each of their merchandise and promptly get the price and product information; counter clerks at banks at every corner swipe our bank card on their scanning machines and all the transactions are conducted. Even in restaurant business, online ordering and customized orders are becoming more and more common. Actually, if you think about it, everything in our daily life is virtually informational transformed. But when the light cast on health care industry, despite all breakthroughs going on in this arena, its information transformation process is surprisingly old-fashioned,especially in U.S, a country where disruptive innovations come up into being nearly every second. Currently, less than 30% of US physicians use electronic medical records, compared with 89% or more in several countries including the Netherlands, New Zealand, and the UK. Less than 10% of US hospitals use a robust health information system that includes records and physician order-entry capabilities. In spite of the existing of relevant technologies for more than 30 years, physicians and doctors seems just boycotting with the EMR system. What’s wrong here?

Two main issues are lying here: EMR will change the usual patients’ practice and patient-physician relationship. Doctors are getting used to writing their prescriptions on paper while talking with patients. Such interactions between them are very important particular in medical treatment, since this is real people lives in sake, not simply data and objects like merchandise in supermarkets or your loan contracts with banks. The depersonalization as well as the not so user-friendly interface of current existing EMR system prohibits the adoptions of EMR by physicians and many patients who care about talks and personal involvements with their doctors.

Second, there’s a lack of standards and structured data definitions for EMR systems in the US, which slows down nationwide adoption of EMR. Without standardized data and structure, the data exchange between providers using different health IT sys­tems is severely limited. Some of them may transferable, yet much may incompatible, making physicians’ incentive of adoption such system even weaker.

There are also many other issues around EMR such as private information security and training and adoption cost. We could positively believe that government promotion and the passed law will pose great potentials in the development of the electronic medical record system; however, as long as those issues are still haunted, EMR is leaving question marked by public hesitation.