- © 2008 Canadian Medical Association or its licensors
I appreciated the timely and informative editorial on electronic medical records.1 I am a family physician, and I have recently finished the transition to electronic medical record-keeping and have kept an online diary at http://drgreiver.blogspot.com/. One of the many reasons I chose to convert was patient access; both Romanow and Kirby advocated for this.2,3 It would be hard for me to manage my household budget if I could only access my banking data once every 3 months and then only if I remembered to ask.
As mentioned in an earlier CMAJ editorial,4 the burden of making the transition from paper to electronic record-keeping continues to fall mainly on the shoulders of physicians, whereas the benefits accrue largely to patients and the health care system. Those of us who have transferred our records continue to deal with incoming paper-based data that must be scanned in as well as many outgoing paper-based referral forms in proprietary formats that are not compatible with our systems. A RAND report found that reducing these “network externalities” is a crucial factor in accelerating the transition to electronic record-keeping.5 However, the electronic island phenomenon (in which an office is an electronic island in a sea of paper) is alive and well, illustrating regulatory inertia and the continuing existence of silos in our health care system.
According to the theory of diffusion of innovations, innovations that offer a larger relative advantage will diffuse faster than those that offer a smaller relative advantage.6 Consistent and ongoing funding and increased assistance with the transition to electronic record-keeping would help; our regulatory colleges must ensure that they do not unnecessarily impede the movement to electronic medical records. The e-will and e-work have to be shared across the entire health care system, and we should involve our patients. We will all be users of the system at some point in our lives; would anyone reading this not wish they could access their own chart, should the need arise?
Competing interests: None declared.