Rights and responsibilities of users of electronic health records

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Introduction

Electronic Health records are routinely used in many countries costing them billions of dollars for the investments in electronic technology which replaces paper charts. The authors indicate primary reasons driving the initiatives are the desire to improve health and the system of health care delivery.[1]

Background

The rationale stems from many years of concern for patient safety and quality care related to the inefficiencies of a paper based system. Unexpected consequences have surfaced in the day to day operations of using EHRs. It was noted that processing information electronically can reduce clinician productivity, increase work load, disruptive workflow and lead to the perception of the cost of EHRs outweigh the direct benefit of the system. Clinicians have sometimes see the use of the EHR as a loss of autonomy secondary to increased external oversight and loss of control over data management.

Analysis

The article offers a list of rights and responsibilities that can be used as a foundation on which designers, developers and policy makers can rely when implementing and using EHRs.[2]

Though these rights are not part of the Hippocratic Oath, they suggest professional privileges that front-line physicians should possess related to EHR features and functions, user privileges, and organizational processes.

The 10 Rights are:

  • Uninterrupted access to records by providing fail-safes and downtime processes which ensure patient care continues in the event of an outage
  • No missing data from the patient’s profile
  • Succinct patient summaries of patients, medical problems, medications, lab results
  • Ability to override computer generated alerts
  • Safe electronic health records by ensuring errors related to EHRs will be reported, investigates and resolved in a timely manner
  • Training and assistance
  • Reliable performance and measurement
  • Compatibility with real world clinical workflows
  • Facilitation of communication, coordination and teamwork
  • Rationale for clinical decision support CDS should be evidence based

Conclusion

The article stated addressing these concerns will be challenging but can make the care delivered through EHR based systems safer and efficient.

Comments

References

  1. Sittig, D. F., & Singh, H. (2012). Rights and responsibilities of users of electronic health records. CMAJ : Canadian Medical Association Journal, 184(13), 1479-1483. http://doi.org/10.1503/cmaj.111599
  2. Sittig, D. F., & Singh, H. (2012). Rights and responsibilities of users of electronic health records. CMAJ : Canadian Medical Association Journal, 184(13), 1479-1483. http://doi.org/10.1503/cmaj.111599