How often do patients or their legal representatives want access to their old chart data, how can it be provided and is the information of value to them? In 2006 my son-in-law requested a copy of his medical records.
He is an RN with fifteen years of nursing experience.
This was his comment.
"In 2006 we got my medical records and it was obvious that personnel with no medical background had done the copying.
The information was out of order and largely irrelevant.
" Until the advent of electronic medical records the answer was simple: copy the applicable portions of the patient's paper chart and deliver them to the authorized requestor.
As my example demonstrates though this was not always a satisfactory solution for the patient.
Undoubtedly, it was not all that great for the clinic either.
As the sheer volume of paper increased this became more time consuming and more costly and probably less useful.
With the increase in volume, clinics began using offsite storage for their paper charts and/or reducing them microfilm.
When microfilm was created, often the paper charts were still kept as the ultimate backup, usually in offsite storage.
Practitioners were uncomfortable letting go of records which have served them well.
The Need: The era of electronic record keeping made significant improvements in access to those records.
The storage of electronic records is easier, record retrieval takes less time and costs less.
However in the practical application of these options it did not take long to discover there were many unforeseen challenges.
The Internal Archive Utility provided by some EMR systems allows old chart data to be stored and retrieved in a format currently known to the clinic.
This is often accomplished by moving the records out of the production or live database.
This presents several problems:
Whether it is converted or not, the legacy EMR can be kept onsite to use for the access and retrieval of old chart data.
This presents several concerns/problems:
Summary A standalone archive system for patient chart data offers the medical practice an effective alternative.
It is common knowledge that dealing with complex EMR functionality is a challenge and requires significant investment beyond the purchase and installation of an EMR, whether as a new system or as a replacement.
A reliable standalone archive removes significant causes for concern, i.
e.
the storage, safety and retrieval of patient chart data and allows the practice to focus on using their EMR system to help provide patients with better health care.
Next: "The Benefits and Value of a Standalone Clinical Data Archive"
He is an RN with fifteen years of nursing experience.
This was his comment.
"In 2006 we got my medical records and it was obvious that personnel with no medical background had done the copying.
The information was out of order and largely irrelevant.
" Until the advent of electronic medical records the answer was simple: copy the applicable portions of the patient's paper chart and deliver them to the authorized requestor.
As my example demonstrates though this was not always a satisfactory solution for the patient.
Undoubtedly, it was not all that great for the clinic either.
As the sheer volume of paper increased this became more time consuming and more costly and probably less useful.
With the increase in volume, clinics began using offsite storage for their paper charts and/or reducing them microfilm.
When microfilm was created, often the paper charts were still kept as the ultimate backup, usually in offsite storage.
Practitioners were uncomfortable letting go of records which have served them well.
The Need: The era of electronic record keeping made significant improvements in access to those records.
The storage of electronic records is easier, record retrieval takes less time and costs less.
However in the practical application of these options it did not take long to discover there were many unforeseen challenges.
- There is a significant cost associated with getting charts into an electronic format or converting from one electronic record to another.
- Verification of the accuracy and completeness of electronic records is a major concern especially when they are stored in more than one format or data repository.
- It is either difficult or impractical to add new chart information to a retained (backup) copy of an electronic record.
- Multiple copies must either be synchronized or used together when presently a complete patient chart.
- The provision for data security through offsite backup and other means must be re-evaluated.
- Adequate protection of PHI is more difficult when the number of organizations and people who have access to it increases.
What was done under the previous scenario my now be inadequate. - There are huge amount of data stored for each patient, a dramatic increase in a short period of time.
This has created response time delays for system users.
Database storage, backup and management have become more costly and difficult.
The Internal Archive Utility provided by some EMR systems allows old chart data to be stored and retrieved in a format currently known to the clinic.
This is often accomplished by moving the records out of the production or live database.
This presents several problems:
- Retrieval of patient records is uncertain or inadequate.
- In some cases the archived records cannot be found.
- These utilities may not offer an export function.
- For those that do, rarely is there an option to export the data in bulk, i.
e.
for all or a selection of patients.
Whether it is converted or not, the legacy EMR can be kept onsite to use for the access and retrieval of old chart data.
This presents several concerns/problems:
- The cost of maintaining the old system
- The risk of the server crashing or not working
- Ongoing staff training due to infrequent use of the system.
Summary A standalone archive system for patient chart data offers the medical practice an effective alternative.
It is common knowledge that dealing with complex EMR functionality is a challenge and requires significant investment beyond the purchase and installation of an EMR, whether as a new system or as a replacement.
A reliable standalone archive removes significant causes for concern, i.
e.
the storage, safety and retrieval of patient chart data and allows the practice to focus on using their EMR system to help provide patients with better health care.
Next: "The Benefits and Value of a Standalone Clinical Data Archive"
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