Between 2005 and 2010, Kaiser Permanente, an integrated managed healthcare consortium based in Oakland, California, set up Kaiser Permanente HealthConnect, a system of Electronic Health Records (EHRs), in 17 of its hospitals and 45 medical office buildings. This first EHR experiment was carefully followed by a group of researchers, who focused on tracking patients suffering from diabetes. It was only this year that the results of the study were published in the American College of Physicians’ Annals of Internal Medicine and they appear to provide substantial proof that the use of EHRs leads to greater efficiency in the treatment of certain types of patients.
Up-to-date, centralised information
“Increases in information availability, decision support and order-entry functionality help clinicians to identify the most appropriate patients for drug-treatment intensification and retesting, which leads to better care of patients with diabetes,” argues Dr Marc Jaffe, clinical leader on the Kaiser Cardiovascular Risk Reduction programme. Results from previous researchs which focused on assessing improvements in the patient-physician relationship due to new technologies had already shown substantial progress in glycaemic, cholesterol and blood pressure screening and control. In this latest study, the use of EHRs were found to help clinicians to better target changes in treatment and carry out follow-up testing for patients with diabetes mellitus. Replacing bulky paper files, which easily get mislaid and often contain obsolete information, EHRs provide medical practitioners with all relevant data on a given patient – i.e. ensuring the physician obtains not only the most up-to-date but also exhaustive information on the patient. In cases of diabetes, where glycaemic levels have to be constantly checked, EHRs can help to make vital information available to the doctor almost immediately.
Some concerns still remain
There are certainly no theoretical objections to the use of EHRs. They provide up-to-date, centralised information and help ease the logjam in overloaded hospital filing systems. However, quite apart from occasional personal reluctance to switch from paper records to digital systems for reasons of habit, EHRs still cause some physicians a degree of concern. While few doubt that EHRs are the future for medical files, there are still a number of stumbling blocks to avoid when implementing the new approach. The greatest fear is over the security of such highly personal data when it moves online, even though it is only available on networks where use is restricted to healthcare professionals. Nevertheless, Kaiser Permanente seems to be showing the way forward in a highly efficient manner. No security problems have so far been raised and the standardisation of EHRs across the consortium’s hospitals has promoted valuable information sharing, an area where hospitals in Europe are still facing obstacles.