Viktor Poluektovas
“We should connect every hospital to the Internet, so doctors can instantly share data about their patients with best specialists in the field”.
President B. Clinton in his State of Union address on Feb. 4, 1997 1
Introduction
It seems normal nowadays that progress in hardware development, mix in software applications and interfaces has brought multimedia patient record systems into hospitals’ routine life 2 . Computerized Patient Administration System is not a Sci-Fi story any more, but an every day necessity brought to life by the commonly accepted belief that the paper record cannot meet the demands of modern health care 1 . “The efficient transfer, storage, dissemination and security of data and information are the essential components of an effective health service 3 ”.
The interest in computerized patient records (CPR) initially began in medical records and information management departments in hospitals focused on the need to replace the paper-based system and lower the costs of maintaining medical records. Since then hospitals have started migrating their paper-based records to the CPR, which has the potential to transform the work routines of the care unit drastically 2 . Reestablishing the workplace through Information Technology is an important strategic issue for today’s hospitals.
It is essential to describe the concept of the electronic health record (EHR) as a lifelong record of the patient’s entire medical history, which is a combination of electronic patient records (EPR-records of the health care provided by a single institution) from hospital, community, mental health and social service records 3,4 . Thus, whenever the patient applies for the health service, the institution will keep an EPR and share it with EHR, “providing dates and details of patient care, which will be made accessible instantly to those carers who need that information 3,4 .”
When patients are registered on their first admission to hospital the Patient Administration System (PAS) will maintain their medical history, so that during the later visits, the patients can be found in the system just using surname and date of birth 6,3 . The key is “the hospital number, which is a unique code given to each patient and retained throughout their hospital episodes 3 .”
Presently, medical practitioners are becoming more and more motivated to adopt IT systems because of government requirements for data gathering, societal expectations and personal practitioners’ desire to “extend their business to its full potential 5 ”. While there is still some opposition from both health professionals and patients towards “paperless” practice and acceptance of the new technology due to high cost, elusiveness regarding time, hesitation of technical failure and security concerns about the ability to keep patient records confidential on the “net”. In addition to this problems, there are doubts among medics about future remuneration methods as, for example, it is difficult to charge for services like e-mail communication with patients and some doctors are worried that computer-based medicine may undermine the traditional face-to-face patient-doctor relationships 5 .
Despite this fact, some countries like the UK are well advanced in the use of IT in general practice 5 .