Digital technology has brought radical transformation into the present world with smart phones, tablets and web-enabled devices becoming the veritable mode of communication in day-today life. Similarly, digital technology has also invaded the health sector to make health care delivery system quick, easy and patient-friendly.
An electronic health record (EHR) is a digital version of a patient's paper chart - real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider's office and can be inclusive of a broader view of a patient's care.
EHRs are a vital part of health IT and can: 1) contain a patient's medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images and laboratory and test results; 2) allow access to evidence based tools that providers can use to make decisions about a patient's care and 3) automate and streamline provider workflow.
All health data converted into EHRs help greater and more seamless flow of information through the digital health care infrastructure (leveraging digital progress) and can also transform the way care is delivered and compensated. Health information can be created and managed by authorized providers in a digital format, which is capable of being shared with other providers across more than one health care organisation.
EHRs are built to share information with other health care providers and organisations such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics so they contain information from all clinicians involved in a patient's care.
The EHR benefits are improved patient care, increase patient participation, improved care coordination, improved diagnostics and patient outcomes, practice efficiencies and cost savings.
All health data converted into EHRs help greater and more seamless flow of information through the digital health care infrastructure and this can also transform the way care is deliveredThe best example is of a senior journalist, who hit by a hoodlum went into coma at Itanagar in 2017 and his EHRs created at Ramakrishan Mission Hospital were sent to Arya Hospital, Guwahati, whose specialist had advised to airlift the patient to that hospital. The patient regained conciseness and his EHRs were sent to a famous hospital at Chennai, whose neurologist after checking the EHRs certified the patient as OK.
In fact, Union Ministry of Health & Family Welfare in September 2013 had notified the EHR Standards for India, which became more necessary as understanding of those standards, their implementation and the expectations from the healthcare systems continued to improve.
Healthcare Information and Management Systems Society (HIMSS) defines Electronic Health Record (EHR) as a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. This includes patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.
While state governments continue to give hope, Kerala is the only state in India which has successfully collected and stored electronic health records of 2.58 crore people through its 'eHealth project'. The state government initiative allows patients to walk into any government hospital without carrying any papers.
Sharing insights about Kerala's eHealth project, Dr Shabeer Ali, MD of Trivandrum-based software company HODO, that develops EHRs, said, "Specifically 86 government hospitals in the state have implemented the eHealth project, and 2.58 crore people have been empanelled in this system. In Kerala, while the public sector has taken this initiative to collate health information, the private sector is new at adopting such technology."
The National Digital Health Blueprint (NDHB) which was proposed in 2019 plans to establish and manage the health data and infrastructure required for its seamless exchange, promoting adoption of open standards and developing several digital health systems that span from wellness to disease management. Interestingly, the NDHB also aims at 'leveraging information systems already existing in the health sector.'
Fortunately the present Indian healthcare experts and clinicians do understand the potential of artificial intelligence (AI) and big data, however, implementation of standardised EHRs can only be seen in radiology, billing and registration systems.
Most of the IT systems in leading hospitals are primarily for billing and their records and not EHRs in the true sense. It is time for hospital administrations to plan and make EHRs a reality, without which there would be no clinical data for implementing AI or Big Data, as there will be no data," says Professor Rajendra Pratap Gupta, a public policy expert who serves with Digital Health Guidelines group at WHO.
With more than 75% of outpatients and more than 60% of inpatients in India being treated in private healthcare facilities, the government urgently needs to bring these establishments on-board for using HER, Rashmi Mabiyan wrote in Healthworld on 06.01.20.