Political and health policy leaders have expressed great hopes for the potential of electronic health records and health information technology. What needs are met by converting records at doctors’ offices, clinics and hospitals to an electronic format?

Probably the greatest gap we see right now, if we look at our health care system (and you’ve probably heard this many times) is that we don’t actually have a system. It was Mike Leavitt, the former Secretary of Health and Human Services, who first made that statement. A big part of why we don’t have a system is that medical records locked in file cabinets can’t be shared. In fact, even within a practice they can’t be quickly addressed to meet the needs of a patient.

Let me take you down a bit of a path, if we could. If a patient has come to my office for five or ten years, I have many, many paper records in a chart. So how do I quickly assess what is the critical information that I need to get to the top of that record? Very important things can be buried in that history. As we move to electronic records, one great immediate benefit is that I can now organize my view of how I see that patient’s history. If the patient has allergies, those can be drawn right to the top. If I’m looking for medications the patient may be on, that information can be drawn right to the top, and it can be updated much more readily. I can be prompted to update that conversation with the patient. Also, if the patient happens to have a chronic condition, such as diabetes or chronic lower back pain, I can see what’s been done previously.

So this allows a significant increase in speed.

It enables me to see those things quickly so that I can address that patient’s needs faster. We all know that we’re being forced to see more and more patients in order to increase the revenue stream. When I have to quickly see patients, while dealing with three-inch thick paper charts, how do I get this done and be sure that I didn’t miss things? Even new information that may have been gathered by the receptionist when the patient came in today, is now available. It can be folded in and viewed with the rest of the historical data.

This certainly represents a significant change in work flow, but it can help me to achieve a better outcome for this patient because I have access to all of that information.

We can only have a paper chart in one location. I’ve watched many practices that have three or four locations, where the support staff has to spend a good deal of time gathering up charts to be brought over to the next location, and then having to refile the charts that were just brought in from the last location.

So in a practice that has electronic health records, you’ve got immediate access to the information, wherever it’s housed.

Yes. I can even access it from my home, if I set it up appropriately. Not that I want to extend everyone’s hours, but if I’m called in an emergency circumstance after hours, where’s the chart? It’s at the clinic. I can’t look at it, I can’t eyeball it unless it’s in electronic form. I’m remembering that they were in today. But what medication were they on, or at what level of the spine did they have a problem?

So far you’ve been addressing the value of EHR within a practice. What is envisioned in terms of communication from one practice to another and the development of a single comprehensive electronic health record for an individual?