Ah, but its complicated…
Like it or not, electronic health records are the new standard. While not legally required, many factors push us in this direction. Acupuncture is slowly, but surely moving on a path towards Medicare and Medicaid.[ref]Duran, B. (2013, April). Acupuncture One Step Closer to Medicare Inclusion. Acupuncture Today. Retrieved from http://www.acupuncturetoday.com/mpacms/at/article.php?id=32722[/ref] How many of you plan on accepting Medicare/Medicaid patients?
The United States is behind the rest of the developed world when it comes to electronic health records. Some countries, including the United Kingdom and the Netherlands have 97% and above EHR compliance. The current Obama and past Bush administration both advocate full use of EHR by 100% of the medical profession by 2014.[ref]Health IT news staff writer. (2004, April 26). President Bush continues EHR push, sets national goals [Web log comment]. Retrieved from http://www.healthcareitnews.com/news/president-bush-continues-ehr-push-sets-national-goals[/ref][ref]United States Government, Office of Health and Human Services. (2011). We Can’t Wait: Obama Administration takes new steps to encourage doctors and hospitals to use health information technology to lower costs, improve quality, create jobs [Press release]. Retrieved from http://www.hhs.gov/news/press/2011pres/11/20111130a.html[/ref]
Over the past ten years medical professionals and organizations have steadily adapted to the new federal expectations. A recent article in the Annals of Family Medicine explores this increase since 2001[ref]Xierali, I, C Hsiao, et. al., (2013, Jan/Feb). The Rise of Electronic Health Record Adoption Among Family Physicians. Annals of Family Medicine, 14-19. Retrieved from http://annfammed.org/content/11/1/14.full[/ref]. In 2011 little under 70% of family physicians used EHR systems.
After some delay, private health insurance is endorsing electronic health records as well. The following is from a 2010 article on the blog HealthIT news[ref]Blumenthal, D. (2010, August 16). Private Sector Shows Support for Meaningful Use [Web log comment]. Retrieved from http://www.healthcareitnews.com/blog/private-sector-shows-support-meaningful-use[/ref]:
If you accept health insurance, you may soon see EHR requirements set by them that mirror the standards set by the HITECH act. It is also clear from this excerpt that medical licensing boards and major employers are also endorsing the use of EHR.
If it’s not required for me, why should I go paperless?
From the information above I hope you got the impression that the entire medical field is on a slippery slope towards full EHR implementation. Currently acupuncturists and many other holistic practitioners are not actively involved in this move because they don’t legally have to at the moment. I would argue that now is the time to consider using electronic health records in your practice. Currently you have the time to develop a well thought out EHR system that perfectly fits your unique practice. You can start this process on your own terms and not when forced by private insurance, governing bodies or even your own patients.
I am confident that we can create electronic systems that fit our style of care. While the majority of systems are allopathically oriented, there are many options for acupuncturists.
Too often holistic practitioners are the last stop of patients with complicated medical histories and a long list of pharmaceuticals. Sometimes it can take weeks to collect all the necessary medical records to safely and effectively treat these patients. The goal of EHR is to seamlessly connect all of a patient’s providers so they are on the same page. I believe this set will also increase dialogue between medical doctors and holistic practitioners. This will create a greater understanding between both parties and of course better care for our patients.
One prevailing argument for EHR has been safety. The ability for a program to point out drug interactions and herb-drug interactions is valuable. However I fear that practitioners may rely on such programs instead of their own knowledge and instincts. On the other hand it is better than the all too often circumstance of a dozen medications prescribed by half a dozen providers, none aware of each other. When looking at current research there is no straight forward answer to EHR programs increasing safety. I think more time needs to pass before we really see the true story on how EHR will effect patient safety.
Where will you go from here?
I think most practitioners have a feeling of what direction they want to go in when it comes to electronic records. Some are very adverse to the idea and feel no need to transition, especially those with cash based practices. For others, especially recent graduates, electronic records are appealing, but are struggling to find the right hardware and software for their practice.
As with any widespread change in an industry, this transition will be fraught with problems and unforeseen consequences. It will take time and our dedication to remaining flexible and always pursuing the best for our patients.
Please comment on this article with your opinion on electronic health records. My goal with these articles is to educate and spark conversation. I hope to hear from you soon.
In my next article I’ll be addressing how HIPPA plays into electronic records and other technologies like e-mail and using mobile devices.