Rumble over records
Patient access and the development and use of EMR
THE ISSUE of medical records was once again thrust into the spotlight with a recent Supreme Court decision which ordered that parents be given access to their baby’s health records within 24 hours.
The hospital had refused to hand them over. Since then, the question is still up in the air as to who owns medical records, prompting Minister of Health Dr Christopher Tufton to seek an opinion from the attorney general.
In several countries, while the medical practitioner is the custodian of health records, patients ultimately have the right of access. In the United States, the original medical records is the property of the physician’s office that created it; however, patients are given access and can even get copies of their records held by providers covered under the Health Insurance Portability and Accountability Act Privacy Rule.
In the United Kingdom, the Data Protection Act provides that patients have the right to view their records. Australian Privacy Principles, 12, states that “... where an individual requests access to their records, the organisation must give access to personal information in the manner requested by the individual if it is reasonable and practicable to do so.”
Under South Africa’s Promotion of Access to Information Act, 2000, patients have rights to the information as contained in their medical records; however, they do not own their medical records as they belong to the establishment that created them. The exception, however, is where a patient pays for a copy of his/her medical records. – Malcolm Lyons and Brivik Inc Attorneys South Africa.
ELECTRONIC MEDICAL RECORDS
All of these countries either already have in some way or are exploring the implementation of electronic medical records (EMR). It is important to establish this kind of ownership and/or access because healthcare is currently going through digital transformation and technology is being seen as the solution to many of the ills that have plagued the medical industry and health sector globally.
Access to medical records is one of them. A transformation of healthcare requires several technological inputs. However, a healthcare transformation process cannot be complete without the introduction of EMR.
Electronic medical records will solve the issue of continuity of care and would also make it easier for patients and their physicians to share, view and access records. The current system of paper records makes it difficult for persons to access data from disparate sources, which can significantly affect continuity of care.
This can also be time-consuming, people may not even know about some pieces of data, for example, those that may exist from childhood, and as we have seen many times, records get lost or ‘misplaced’.
EMR is a digital representation of a patient’s medical history, including doctor’s notes, diagnoses, diagnostic and test results such as MRI and X-ray and any other relevant health information that can be shared across a platform for access by all caregivers, and in some cases the patient.
Currently, the University Hospital of the West Indies’ Health Information Management System can accommodate this as all the inputs are there. Once this type of system is also used by other public and private sector health facilities, the necessary linkages can easily be made.
A nationally embraced EMR will provide several benefits and will result in overall improvement in patient care across the public and private sectors.
It could also eliminate many of the risks associated with lost or inaccessible health records and provide for:
Better communication between medical providers, leading to more timely, safer, efficient and accurate diagnosis.
Creation of individualised health profiles to carve out specific healthcare pathways for patients.
Lower costs associated with the ability to truly take advantage of preventive medicine and healthcare.
Reduction of waste and the need for multiple testing to assist diagnosis.
Coordination of healthcare services and providers.
Better clinical decisionmaking.
Health forecasting and analysis through the use of the available data.
Overall improvement in health outcomes generally.
Healthcare needs to be completely patient-focused for us to achieve the short- and long-term rewards that are possible through digitisation.
This means that it is important that patients have access to their information to be able to fully participate in decisions to improve their health and well-being.