Although electronic medical records (EMR) are considered a key component to improving health care quality and, potentially, efficiency, only 1.5% of US hospitals surveyed in 2008 had a comprehensive EMR1. In contrast, the Veterans Health Administration (VHA) has had a comprehensive EMR since the 1990s. In this issue of the Journal of General Internal Medicine the article by Humphrey et al.2 provides an interesting example of the promise and the unexpected lessons encountered while attempting to harness the power of the VHA EMR to improve the process of screening for colorectal cancer.
Primary care physicians are held responsible for a variety of screening tests in addition to providing chronic care and addressing acute complaints. Within the VHA, there are recommendations to screen for cancer (cervical, breast, colorectal), obesity, cardiovascular disease (abdominal aortic aneurysms, dyslipidemia) and sexually transmitted infections (chlamydia and gonorrheal infection)3,4. In the context of other duties competing for physician attention and human limitation in general, an EMR is broadly thought to assist in the implementation and quality assessment of such screening initiatives. For example, an EMR can facilitate identification of the target population for a particular test and can issue reminders that a screening test is due. The EMR will provide widely accessible documentation of the test and its results once completed. Finally, the EMR can improve the efficiency of auditing test performance for feedback to the stakeholders.
Full article
Fisher, Deborah A., Journal of General Internal Medicine, 26(7), 683-684, DOI: 10.1007/s11606-011-1722-9
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