What's In Your Electronic Medical Record?

In the age of the internet and rapid developmentsWhy are Electronic Medical Records
of information technology, the way we view, edit,advantageous?
and exchange documents is changing andAn electronic medical record may contain three or
becoming more and more advanced. The medicalfour essential sections. There may be a section
world is no exception to this as medical recordsthat allows for free writing about each patient
are now becoming known as electronic medicalthat the doctor can input whatever information he
records or EMR's. If you are one who isfeels will be necessary later. There may also be a
somewhat unfamiliar with electronic medicalsection where conclusions and any future plans
records, then this article is for you. Read on tocan be entered and stored. There may also be a
learn more about medical records, what isstructured section which can contain data that is
contained in them, and some advantages tomore template based (check boxes) or there can
having all medical records be stored electronically.be controlled vocabulary by selecting certain
What is a medical record?medical terms from a dropdown list, or medical
A medical record is very important in the medicalcodes can be inputted. Since all of this data is
field as it is a reference to each patient withstored electronically it will be clearly legible, neatly
valuable information about the patient. It includesorganized, and will allow for easy editing.
such basic things as the patients name, addressThere is also another section that can be
and date of birth. The medical record is essentiallyattached to the electronic medical record but it
a history of each patient and containsdoes not allow for free editing on it. I am referring
documentation regarding the patient's formerto picture-related information such as charts, and
symptoms, diagnosis and treatments. Medicalgraphs. Pictures can also come from other places
records were usually kept independently with eachin the form of letters and bio tests, etc. and can
healthcare provider that the patient wasbe attached to a patient's medical record.
associated with.Although picture related information cannot be
Paper-based medical records require a lot of time,edited directly there may be notes made
space and effort to maintain, store and organize.regarding the information found in the image in
Another disadvantage to the paper-based medicalanother section referring to the image.
records is that all notes taken on them are usuallyAnother huge advantage to keeping electronic
handwritten which allows for confusion on possiblymedical records is the ease of access and small
important issues due to a legibility problem. Whilestorage space required. All patients records can
medical records are very important, they do havebe stored digitally on a server and entered into a
a few problems that need to be worked out todatabase allowing for an incredibly fast way to
make them even more useful then they werefind a particular patients record. Some software
originally intended to be.companies that specialize in electronic medical
Why should we have Electronic Medical Records?records even allow all patients medical records to
Because medical records are so important to abe accessed securely from anywhere via the
healthcare provider when responding to a patientsinternet.
needs, more accurate and accessible informationAs you can see, medical records are very
is a must. Initially, the cost to go fromimportant and contain extremely pertinent
paper-based medical records to electronic medicalinformation regarding each patient. With such an
records can be time consuming and costly but theimportant record there needs to be an effective
benefits will greatly outweigh the costs in the longmethod to keeping these records organized,
run. Taking the medical record to the digital worldlegible and easy accessible. All of this can be
can have tremendous advantages over theaccomplished with electronic medical records.
traditional paper-based records of the past.