The Barriers to Electronic Medical Record Systems and How to Overcome Them
- Affiliation of the author: Regenstrief Institute for Health Care; Indiana University School of Medicine, Indianapolis, IN
- Correspondence and reprints: Clement J. McDonald, MD, Regenstrief Institute for Health Care, 1001 West Tenth Street, RHC-5th floor, Indianapolis, Indiana 46202-2859. E-mail: Clem{at}regen.rg.iupui.edu
- Received 30 December 1996
- Accepted 21 January 1997
Abstract
Institutions all want electronic medical record (EMR) systems. They want them to solve their record movement problems, to improve the quality and coherence of the care process, to automate guidelines and care pathways to assist clinical research, outcomes management, and process improvement. EMRs are very difficult to construct because the existing electronic data sources, e.g., laboratory systems, pharmacy systems, and physician dictation systems, reside on many isolated islands with differing structures, differing levels of granularity, and different code systems. To accelerate EMR deployment we need to focus on the interfaces instead of the EMR system. We have the interface solutions in the form of standards: IP, HL7 / ASTM, DICOM, LOINC, SNOMED, and others developed by the medical informatics community. We just have to embrace them. One remaining problem is the efficient capture of physician information in a coded form. Research is still needed to solve this last problem.
Footnotes
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Supported by grants N01-LM-4-3510 and N01-6-3546 from the National Library of Medicine, HS 07719 and HS 08750 from the Agency for Health Care Policy and Research, and 92196-H from The John A. Hartford Foundation, Inc.
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Presented in part as the 5th ACMI Distinguished Lecture at the AMIA Fall Symposium, Washington, DC, 1996.
