As the nation progresses toward the creation of a national health information network for health information exchange, it is worthwhile to discuss a little about the impact PHRs have on physicians and their patients at ambulatory clinics, otherwise referred to as Outpatient Clinics in the rest of the world apart from the generally common large in-house inpatient EHR implementations at hospitals large and small.
There has been an upsurge of interest and enthusiasm among the cared for community for the need of a commonly accessible set of health records through common, interoperable electronic protocols. Since the coming of the PHR the traditional concept of the physician storing the patients' records is changing. As the nationwide Health Information Network NHIN takes shape, the government is gearing itself up to streamline the health information exchange theme with the stakeholders in healthcare but now with central focus on the patient. The emergence of the PHR as the link between the care giving institution and a virtual medium for the longitudinal storage and archival of medical data is gaining momentum as both the physicians' communities and the patients embrace the model, though not at a fast pace.
Probably a significant offshoot of adoption of electronic health records by ambulatory or OP practices is the benefits gained by networking although with privacy and confidentiality issues protected. The creation of a Master Patient Index MPI, a database that holds patient medical record entries populated from all care giving facilities network wide. This index is the entry point linking patient information for an enterprise-wide view of individual and aggregate patient information. Patients are matched within the MPI database through their unique identifier called an Integration Control Number (ICN). The Master Patient Index (MPI) along with the patient's Personal Health Record offers the provider a complete view of a patient's medical and treatment history. It has the ability to uniquely identify patients across the entire enterprise and provide a list of all treating facilities at which a patient has received care. The MPI becomes a convenience in promoting and managing groups of patients such as retirees, veterans and corporate pensioners. With appropriate additions of financial modules the index becomes a conjunct in designing benefit plans.
Preventing erroneous recording and documentation of identities is another advantage of adding indices in the system. Data quality of patient demographic information and the identity management process is built in the system. Avoiding the use of "unknown," "deceased," and other inaccurate responses for demographic data fields adds to data quality. If the information is not known, the field is best left blank until it is obtained.
The figure that represents usage of electronic means of communication, smart-phones as tools in managing healthcare IT shows encouraging progress over time.
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