The development of electronic medical records began in the facilities of providers – that’s where the medical information was housed. Much of the discussion of EMRs continues to focus on the needs of providers; that’s appropriate given the state of the technology. At the same time, the scope of use for EMRs is expanding as illustrated in the figure below.
Early implementations were largely restricted to prearranged exchanges among a limited number of members of a local medical community. EMRs and the Internet are both evolving rapidly and the Internet now provides the technology to move information in any form to anywhere at any time. HIPAA standardized the coding and transmission of medical billing information. Various agencies and bodies have evolved or are evolving standards for coding and transmitting the contents of electronic medical records. The technical problems associated with the creation and movement of EMR information are significant, but solvable.
Now there are additional sources of complexity as the needs of users change, “ownership” of data becomes less clear, the number of potential security leaks increases, etc. Those will be addressed in future posts. The important point here is that the conversations about EMR scope and issues needs to expand to reflect the growing number of stakeholders, and the ways the records and their data will be used.