Web based EMR
Review of Benefits & Costs
Given the ubiquitous use of the Internet and the growing use of electronic patient data a natural home for the EMR (electronic medical record) may be the Internet. This would allow the EMR to be available to all providers, all patients at anytime from anywhere. In 2003, an estimated 93 million Americans used the Internet to search for health related issues, a 27% increase over 2002 . It’s likely the EMR will transition to the Internet in the near future. However, there are costs and benefits to consider.
Benefits of Internet based EMR
- Immediate access of the entire medical record by consulting or referred clinicians 
- Patient access to a portion of the clinical record, otherwise known as the PHR (personal health record)
- Patient self-reporting or monitoring of conditions
- Reduced costs of hardware and software as opposed to client-based software
- More informed patients can lead to better treatments and encourage preventative medicine. (3)
- Promotion of disease surveillance practices
Costs/Risks of Internet based EMR
- Internet based security concerns. (VPN technologies can help increase security) (2)
- Rely on the Internet infrastructure, which may be slow and uncontrollable
- Challenge of adopting uniform medical terminology or codes for all patient records
- Determining where patient data is stored and questions of data ownership
- Questions of patient privacy if security is breached
- Determining who would operate and house patient data in regional primary or secondary databases
If you’re undecided on this issue, the US Military and Microsoft may have answered our question for us. A 1.2 billion dollar EMR system called AHLTA, which is similar to an Internet based system has already been deployed to 60% of the military on a global scale with positive critiques. (5) Even though it’s not truly an open-access system given it’s only available on military networks, it is globally based with much of its data crossing the Internet.
Another example of the move to the Internet EMR is Microsoft’s product called Healthvault which can store PHR data, connect medical equipment to a PC for data uploads, store medical images and order prescriptions. Further evidence, health technologies are moving to the Internet.
- The online health care revolution: how the Web helps Americans take better care of themselves]. Fox S, Rainee L. . Washington (DC): Pew Internet & American Life Project; 2000. 
- Medical Records and the Internet. Jantos, Laura D., June 2001.
- Information on the Web: Results From the HealthStyles Survey. Bansil, Pooja MPH, April 2006,2002–2003.
- How to Use an Internet-Based Medical Records Repository and Retain Patient Confidentiality, Website: http://www.hipaadvisory.com/action/patientconf.htm, Schoenburg, Roy, March 2007.
- Medical Record System. Gilmore, Gerry, Nov. 2005.