- © 2008 Canadian Medical Association or its licensors
We wish to comment on the editorial about electronic medical records.1 Adoption of electronic health records has been slow in Canada. In some provinces fewer than 30% of medical practices use an electronic health record as their primary record-keeping tool and many of these practices do not use essential features of the system. Perhaps the design and deployment of these systems could account for this disturbing statistic.
Vendors of electronic record-keeping systems tend to focus on the expedient addition of clinical data. However, the increasing quantity of longitudinal information that includes personal and family histories, detailed notes on clinical encounters, laboratory results and referral material can result in data overload. Thus, the electronic medical record can become a hindrance rather than a support.
The needs of all stakeholders must be carefully considered in the design of electronic medical record-keeping systems. To be relevant and useful to clinicians and their patients (the primary stakeholders), electronic health records need to be used at the point of care. Policy-makers in the health care system are important secondary stakeholders because data from electronic records can be collated for use in managing the health care system.
Software vendors and the provincial bodies responsible for electronic health record certification must understand the impact of the way in which information is presented on the usefulness and usability of electronic records. Rather than being a passive repository of information, the electronic record should be capable of revealing complex trends and patterns. As well, training methods must be adjusted so that health care providers are taught to understand that facts must be added to the health record in the context of continuing care and not only to provide a medicolegal historical record.
Footnotes
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Competing interests: None declared.
REFERENCE
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